- Caring for someone is a major determinant of poor health
- What helps carers?
- Supporting carers starts with recognition
- Further guidance
- Measuring impact
Approximately one in ten patients registered with a GP practice is likely to be a carer. Of these about a third will be caring for more than 20 hours per week, and a fifth caring for more than 50 hours per week.
Evidence shows that there’s a strong link between caring for someone and ill health. As well as being at increased risk of exhaustion, depression, anxiety and stress, carers are more susceptible to physical injuries caused by incorrect or lone moving and handling. At the same time, many carers are older people and therefore more likely to have health conditions of their own or lack the stamina to cope with the demands of caring.
Despite the strong like between unpaid caring and ill health, carers are often short of time and their attention may be focused almost exclusively on the needs of the person they care for. As a result, carers are less likely to find time to visit their GP practice when they are unwell or engage with services that can prevent ill health occurring.
Some carers turn down the chance to have diagnostic tests or hospital treatment, particularly when they fear leaving the person they look after alone or without good quality support. And very few carers identify themselves as such to health and social care services with a view to accessing support.
Supporting Carers in General Practice: A quick-start toolkit for GP practice teams
If you work in General Practice, one in ten of your patients is likely to be a carer. Our quick-start toolkit offers you easy ways to indentify who your carers are and how to make sure they receive the support they need to prevent them reaching crisis point.
While every carer and caring situation is unique, when carers are asked what would make life easier for them, or what has been helpful to them in the past, certain themes emerge time and time again. For example, when NHS England consulted with carers as part of their Commitment to Carers in 2013, carers said:
- Recognise me as a carer but also as a parent, partner, child, relative, friend and member of my local community.
- Share information with me and with other health professionals.
- Signpost me to information and help link professionals together.
- Make sure care is flexible and available when it suits me and the person I care for.
- Recognise that I may need help, not just as a carer but in looking after my own health and wellbeing.
- Respect me and involve me as an expert partner in care.
- Treat me with dignity and compassion.
Based on carers’ own words in NHS England’s & NHS Improving Quality’s Commitment to Carers 2014.
Before carers can be offered support, they must first be identified. Because carers often accompany the person they care for to medical appointments or are present when community nurses make home visits to housebound patients, staff working in the NHS are ideally placed to identify them.
In fact, many healthcare staff, including non-clinical staff working as receptionists in GP surgeries, already know which of their patients are carers. What’s more, carers often hold NHS staff in high regard, so a recommendation from a health professional is likely to be taken seriously and acted upon.
Research suggests, however, that some people are deterred from engaging with carers because:
- They are unclear about what kind of services are available to carers
Staff wouldn’t be expected to have detailed information on carers services, but simply an overview of what’s typically available, such as the ones set out on this simple carers services flyer.
- They feel uncomfortable approaching carers in case they ‘say the wrong thing’
Avoiding using the word ‘carer’ is advisable and asking a few exploratory questions instead is unlikely to cause offence.
- They fear it might lead to a much bigger conversation discussing topics on which they lack expertise
No-one would expect healthcare staff to have an in-depth knowledge of carers’ benefits and services. All they need to know is how a carer can get in touch with someone who does – usually via their local carers centre or scheme. Carers services will have leaflets you can hand out inviting carers to get in touch.
- They don’t have enough time to talk to the carer
It’s best to be honest and explain to the carer that you don’t have much time to spare but that you know that there are people who not only have the time but also the expertise and hand them a leaflet from your local carers centre or scheme.
- Health professionals are respected by carers and ideally placed to help them
A significant number of carers say that it was only when a trusted healthcare professional suggested to them that they were a carer that they finally acknowledged the impact caring was having on their life.
Some carers talk of a ‘light bulb moment’ when a nurse turned to them and said. “And how are you feeling? How is everything affecting you?” Similarly, people are often surprised to learn that there are services available to them, as carers, when so much of their time is spent arranging and co-ordinating services for the person they look after.
So the overriding message to healthcare professionals is that while displaying posters and leaflets inviting carers to self-identify can be helpful, the most effective way of identifying carers is through proactive engagement.
Carers Trust worked with the Royal College of GPs to develop a best practice guide - Supporting carers - an action guide for general practitioners and their teams.
For further guidance on how to support carers in general practice – read the carers support page on the Royal College of General Practitioners website.
For online resources on how nursing teams can support unpaid carers, visit The Queen's Nursing Institute Carers Project Resources section and the Royal College of Nursing's carers and families page.
Carers Trust has worked with the Department of Health and other partners to develop a new professional pathway which provides a framework for district and general practices nurses on which to develop new ways of working, strengthening partnership approaches and providing personalised health care for carers.
The Adult Carer Quality of Life Questionnaire, published by Carers Trust in association with the University of Nottingham, is a simple 40-item instrument which measures a carer’s quality of life in eight areas:
- support for caring
- caring choice
- caring stress
- money matters
- personal growth
- sense of value
- ability to care
- carer satisfaction.
It can be used on a one-off basis for the purpose of an assessment, or as a pre or post intervention tool to measure change and the impact of support.
The Carers Outcomes Star measures and supports progress for carers towards self-reliance or other goals. The Stars are designed to be completed collaboratively as an integral part of key work. It consists of a number of scales based on an explicit model of change which creates coherence across the whole tool and a star chart onto which the carer and support worker plot where the carer is on their journey.
How to support carers is a self assessment tool developed by the Improvement and Development Agency. It measures how your local authority is doing in relation to developing an effective multi-agency approach to supporting carers.