Promoting a ‘Think Carer’ approach in health and social care services
Neurology The health and well-being needs of carers continue to go unrecognised: it is predicted that by 2030, one in five people in Ireland will be providing care to a loved one.
Ireland’s population is aging, which means that a growing number of people are living with dementia and other chronic conditions, whilst people with disabilities are also living longer.
Thus, many of our most vulnerable citizens depend heavily on the unpaid work of family carers who, through their selfless and often unrecognised work, save the state billions of euro annually. According to the CSO Irish Health Survey, 10% of the population over 16 are carers, a number that is set to increase into the future.
The caring experience
Providing care to a loved one can be rewarding for family members, but it is not without its challenges. However, carers are often not equipped to meet all of the needs of their family members(see Figure 1) Furthermore, the demands of the caring role mean that carers often have little time to look after their own health and wellbeing.
It is well documented that carers experience poorer physical and mental health than the general population; the demands of the caring role can leave them physically exhausted and emotionally isolated.
Carers’ own wellbeing is misunderstood
While carers are generally very highly regarded publicly (as exemplified by the recent ‘Carer of the Year’ awards), many report that their communities do not typically understand, or are reluctant to discuss, the challenges of caring and its impact on the carer. Carers are asked frequently about their loved one, but are rarely asked about their own health and wellbeing.
Feeling invisible as a carer
On a related point, despite the carer advocacy work of organisations such as Family Carers Ireland and Care Alliance Ireland, many carers report feeling undervalued, overworked and under-supported. Indeed ‘invisible’ is often a word they use to describe themselves and the challenging work they do. This invisibility of carers is likely to continue if we do not initiate a conversation about caring with all relevant stakeholders, including health and social care professionals.
Changing our policy on carers
Recent years have seen an increasing focus on community healthcare through the development of primary care centres in many areas around the country. Thus, health services may now be better placed to support vulnerable groups in the community such as carers. However, health care professionals need to be consulted, supported and made aware of the needs of carers before real change in this respect can happen.
Thinking of the patient and the carer
One possible solution to this challenge would be to provide awareness-raising events and training for health care professionals regarding the needs of carers. For example, in Australia, a programme called ‘Think Patient, Think Carer’ encourages primary care services to consider the needs of carers who may be supporting a person with a chronic condition.
Likewise, in England, the Royal College of General Practitioners has developed a toolkit and 'Action Guide' to help GPs better support carers. To date, no such community health initiatives exist in Ireland to support the health and wellbeing of carers at a national level, thereby indicating a yawning gap in current provision.
A new research project, being undertaken by a team at the Centre for Mental Health and Community Research, Maynooth University Department of Psychology, aims to address this gap in an Irish context by identifying the facilitators and barriers to the implementation of a community healthcare approach, whilst also investigating perceived carer stigma and training of health care professionals. It is hoped that the findings will inform the development of, for example, practice guidelines and training which could be implemented at a national level so that carers can be supported in appropriate, timely and effective ways. The early findings of this research will be available in late 2019.