Sitting here, cup of tea in hand, I realised that I’ve not posted for some time. I’ve now been qualified a year and I suppose since my last rotation have had little time to reflect on the things that I’ve been learning and the challenges I’ve faced.
Anyway I thought I was high time to post something. Today I thought that I would talk about working with unpaid carers of our patients after an experience that I had last week. It’s a particular interest of mine and I delivered an in-service training on the subject. I’ve been interested in it since second year at university when I was involved in a project in a mental health inpatient unit, working with patients unpaid carers on their wellbeing . From my own experience I watched close family members deal with the physical and psychological strain of caring for a family member and how it took over their life.
Who are unpaid carers?
Just to clarify, A carer is someone of any age who spends a large amount of their time giving unpaid support to a friend, relative or neighbour who just couldn’t manage without their help. This could be due to age, physical or mental illness, disability or addiction. (Carers Trust, n.d.; Department of Health [DH], 2008). So I’m not talking about professional, paid carers who we may put in to assist patients when we recommend packages of care.
Why they are important?
Not only do carers help us discharge a patient quicker as we know that their domestic or personal activities of daily living will be looked after. They also play an important role in UK society. People are living longer as a result of advances in medicine (DH, 2008). So, the numbers of people with long term illness and disability are increasing. This unpaid care saves the government an estimated £119 billion per year (Buckner & Yeandle, 2011). Think about it, we may not need to put in packages of care for our patient or they can be reduced thanks to their carers support.
Even though this may be helpful to us and the patient, this can be at the expense of the carer’s wellbeing. Although caring can be a rewarding occupation, which I have seen first hand in my practice, the role of caring can have a negative impact on health and wellbeing. The research shows that caregivers can experience stress as well as decreased life satisfaction (Moghimi, 2007). Supporting carers is important not only to the wellbeing of the caregiver but also to the care recipient; many people with disabilities enter nursing homes as a result of carer burnout (Moghimi, 2007). So we need to look after our unpaid carers as happier carers mean happier service users.
Carers often neglect their occupational needs (Chaffey & Fossey, 2004; Coring, 2002; Jones, 1996). Kniepmann (2012) found that female carers of stroke survivors reported a decrease in doing their valued activities. If they weren’t able to do their valued activities they reported more stress, higher feelings of burden, less energy and lower mental health. Similarly, in Chaffey & Fossey’s (2004) study they found that their participants reported that caring had a substantial effect on their occupations, with a loss of valued activities, insufficient time for themselves and other relationships. Although it must be noted that these studies had their own limitations.
People who have meaningful occupations away from caring have better coping strategies and increased satisfaction with being a carer (Ablenda & Helfrich, 2003; Lopez, Lopez-Arrieta & Crespo, 2005; Rose 1996). As occupation is the ‘natural biological mechanism for health’ (Wilcock, 1999, p.2), We should be encouraging carers to put time aside for thier valued occupations and take a break (Chaffey & Fossey, 2004; Kniepmann, 2012). Carers who are not able to undertake these occupations may experience occupational disruption (Whiteford, 2004) or occupational deprivation (Wilcock et al, 1998) which can affect their wellbeing. This is where carers centres have a valuable part to play in supporting carers.
Local carers centres
Local carers centres offer a wealth of practical and psychological support. They differ locally with what they offer but common themes are:
- Sitting in vouchers. This is where carers get a limited amount of vouchers per year to use with a locally contracted care provider where a professional carer can sit in with the care recipient while the carer can go out or take a break.
- support groups and fun activities
- holistic therapies
- carers assessments. This is where social services assess what support carers need to perform their caregiving duties. This can be in the form of packages of care or support services for the carer.
- finiancal and benefit support and advice
- free use of the internet or photocopier
- respite breaks
Nationally there is also the carers direct helpline
So what can we do to help?
Good question, glad you asked.
- We should be encouraging carers to make time for themselves and return to valued activities to reduce their stress levels.
- recognising when carers are getting burned out and see what we can do to help
- encouraging them to apply for carers assessments if needed
- discuss packages of care, day centres or sitting in vouchers to enable them to have a break
- recognise the valuable role that they play
- signpost them to local carers centres and groups for support