Assessing and helping carers of older people

Cameron, Ian D.; Aggar, Christina; Robinson, Louise; Kurrle, Sue

doi:10.1136/bmj.d5202

Cited by 22 publications

(18 citation statements)

References 26 publications

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“…Research also shows that informal carers often have limited information regarding the available support services and rely on relatives to choose [21,47]. General practitioners, being the first point of contact for patients in many countries, may be best placed to identify informal carers, assess their needs and provide them with the relevant information on the support available [44,48]. National governments are aware of the challenges of identifying informal carers in the care system.…”

Section: Discussionmentioning

confidence: 99%

“…Promoting awareness of the role of carers is key. Many carers do not formally consider themselves as caregivers [44].…”

Section: Discussionmentioning

confidence: 99%

“…For example, it may be difficult for informal carers to access respite care because the cared-for person may consider it to be a first step towards institutional care [45]. Informal carers may also be reluctant to access support services due to feelings of obligation: this is especially true of spouse carers [21,[44][45][46]. Research also shows that informal carers often have limited information regarding the available support services and rely on relatives to choose [21,47].…”

Section: Discussionmentioning

confidence: 99%

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Mapping support policies for informal carers across the European Union

2014

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Abstract:Background: At a time when health and social care services in European countries are under pressure to contain or cut costs, informal carers are relied upon as the main providers of long-term care. However, still little is known about the availability of direct and indirect support for informal carers across the European Union. Methods: Primary data collection in all EU member states was supplemented with an extensive review of the available literature. Results: Various forms and levels of support have been implemented across Europe to facilitate the role of informal caregivers. Financial support is the most common type of support provided, followed by respite care and training. Most countries do not have a process in place to systematically identify informal carers and to assess their needs. Policies are often at an early stage of development and the breadth and depth of support varies significantly across the EU. Conclusions: Policy developments are uneven across the member states, with some countries having mechanisms in place to assess the needs and support informal carers while others are only starting to take an interest in developing support services. Given the unprecedented challenges posed by population ageing, further research and better data are needed to capture and monitor information on informal carers, to help design adequate support policies and eventually to evaluate their impact across the EU.

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Section: Discussionmentioning

confidence: 99%

“…Promoting awareness of the role of carers is key. Many carers do not formally consider themselves as caregivers [44].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mapping support policies for informal carers across the European Union

2014

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“…Prior studies have identified that some family members of critically ill patients can have high rates of depressive symptoms (5–9). Ascertaining the mental health of loved ones of critically ill patients is of particular importance since depression in family members could affect end-of-life care decisions in the ICU (5), and depression could impact a loved one’s ability to care for a critical illness survivor following their hospitalization (10). The latter point is particularly salient among survivors of severe sepsis, many of whom face levels of cognitive impairment and functional limitations that greatly increase the amount of caregiving they require (3, 11).…”

Section: Introductionmentioning

confidence: 99%

Depressive symptoms in spouses of older patients with severe sepsis*

Davydow¹,

Hough²,

Langa³

et al. 2012

Critical Care Medicine

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Objective To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse’s pre-sepsis history, whether this risk differs by sex, and is associated with a sepsis patient’s disability after hospitalization. Design Prospective longitudinal cohort study. Setting Population-based cohort of U.S. adults over 50 years old interviewed as part of the Health and Retirement Study (1993–2008). Patients 929 patient-spouse dyads comprising 1,212 hospitalizations for severe sepsis. Measurements and Main Results Severe sepsis was identified using a validated algorithm in Medicare claims. Depression was assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. All analyses were stratified by gender. The prevalence of substantial depressive symptoms in wives of patients with severe sepsis increased by 14 percentage points at the time of severe sepsis (from 20% at a median of 1.1 years pre-sepsis to 34% at a median of 1 year post-sepsis), an odds ratio (OR) of 3.74 (95% Confidence Interval [CI]: 2.20, 6.37), in multivariable regression. Husbands had an 8 percentage point increase in the prevalence of substantial depressive symptoms, which was not significant in multivariable regression (OR 1.90, 95%CI: 0.75, 4.71). The increase in depression was not explained by bereavement; women had greater odds of substantial depressive symptoms even when their spouse survived a severe sepsis hospitalization (OR 2.86, 95%CI 1.06, 7.73). Wives of sepsis survivors who were disabled were more likely to be depressed (OR 1.35 per ADL limitation of sepsis survivor, 95%CI: 1.12, 1.64); however, controlling for patient disability only slightly attenuated the association between sepsis and wives’ depression (OR 2.61, 95%CI: 0.93, 7.38). Conclusions Older women may be at greater risk for depression if their spouse is hospitalized for severe sepsis. Spouses of patients with severe sepsis may benefit from greater supports and depression screening, both when their loved one dies, but also when their loved one survives.

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“…Dementia is a major health problem worldwide impacting on the quality of life and physical, mental, emotional and social health of people living with dementia and their wider family and caring unit. Living with a diagnosis of dementia as well as caring for a person with dementia can lead to a decline in physical and mental health and also impact on employment and education prospects, finances and participation in social and community life [2]. …”

Section: Introductionmentioning

confidence: 99%

Development of an optimised key worker framework for people with dementia, their family and caring unit living in the community

Renehan¹,

Goeman

Koch

2017

BMC Health Serv Res

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BackgroundIn Australia, dementia is a national health priority. With the rising number of people living with dementia and shortage of formal and informal carers predicted in the near future, developing approaches to coordinating services in quality-focused ways is considered an urgent priority. Key worker support models are one approach that have been used to assist people living with dementia and their caring unit coordinate services and navigate service systems; however, there is limited literature outlining comprehensive frameworks for the implementation of community dementia key worker roles in practice. In this paper an optimised key worker framework for people with dementia, their family and caring unit living in the community is developed and presented.MethodsA number of processes were undertaken to inform the development of a co-designed optimised key worker framework: an expert working and reference group; a systematic review of the literature; and a qualitative evaluation of 14 dementia key worker models operating in Australia involving 14 interviews with organisation managers, 19 with key workers and 15 with people living with dementia and/or their caring unit. Data from the systematic review and evaluation of dementia key worker models were analysed by the researchers and the expert working and reference group using a constant comparative approach to define the essential components of the optimised framework.ResultsThe developed framework consisted of four main components: overarching philosophies; organisational context; role definition; and key worker competencies. A number of more clearly defined sub-themes sat under each component. Reflected in the framework is the complexity of the dementia journey and the difficulty in trying to develop a ‘one size fits all’ approach.ConclusionsThis co-designed study led to the development of an evidence based framework which outlines a comprehensive synthesis of components viewed as being essential to the implementation of a dementia key worker model of care in the community. The framework was informed and endorsed by people living with dementia and their caring unit, key workers, managers, Australian industry experts, policy makers and researchers. An evaluation of its effectiveness and relevance for practice within the dementia care space is required.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2448-0) contains supplementary material, which is available to authorized users.

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Assessing and helping carers of older people

Cited by 22 publications

References 26 publications

Mapping support policies for informal carers across the European Union

Mapping support policies for informal carers across the European Union

Depressive symptoms in spouses of older patients with severe sepsis*

Development of an optimised key worker framework for people with dementia, their family and caring unit living in the community

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