Caring for dementia carers: the role of general practitioners in Ireland

Abstract

Dementia carers form an important yet understated patient group who present unique challenges for general practitioners in Ireland.

Support for family caregivers: A scoping review of family physician’s perspectives on their role in supporting family caregivers

“…In total, 23 papers were from the peer‐reviewed literature and four published by associations in the grey literature. Peer‐reviewed literature included the following: three papers reviewing the ethics of physicians engagement with caregivers (Barnard & Yaffe, ; Gitlin & Hodgson, ; Mitnick, Leffler, & Hood, ); three literature reviews on the role of physicians in care of the dementia caregivers (O'Connor, ; Robinson et al, ; Sunne & Huntington, ); a report on the development of a survey on physician's perceptions of care for caregivers (Bedard, Gibbons, Lambert‐Belanger, & Riendeau, ), a policy paper (Moore, Frank, & Chambers, ), 12 qualitative investigations (Burridge, Mitchell, Jiwa, & Girgis, ; Burridge, Mitchell, Jiwa, & Girgis, ; Carduff et al, ; Doekhie, Strating, Buljac‐Samardzic, Bovenkamp, & Paauwe, ; Foley, Boyle, Jennings, & Smithson, ; Gill et al, ; Greenwood, Mackenzie, Harris, Fenton, & Cloud, ; Hum et al, ; Kiceniuk et al, ND; Krug et al, ; Leu, Frech, & Jung, ; Wang et al, ); and three reports on two surveys (Greenwood, MacKenzie, Habibi, Atkins, & Jones, ; Jones, Mackenzie, Greenwood, Atkins, & Habibi, ; Thyrian & Hoffmann, ). A policy paper Doctors of BC ,), two guides to developing caregiver‐centred care practice (Doctors of BC ,; Princess Royal Trust, ), and a survey (Skufca, ) were published by organisations.…”

“…The reimbursement for the time spent with caregivers may be inadequate, particularly if the caregiver is not the doctor's patient (Bedard et al, ; Burridge et al, , ; Carduff et al, ; Doctors of BC ,; Doekhie et al, ; Foley et al, ; Gill et al, ; Greenwood & Mackenzie, ; Greenwood et al, ; Hum et al, ; Jones et al, ; Kiceniuk et al, ND; Krug et al, ; Leu et al, ; O'Connor, ; Skufca, ; Sunne & Huntington, ; Thyrian & Hoffmann, ; Wang et al, ). To illustrate, in preliminary results from an ongoing Primary Care for Caregivers Study Kiceniuk et al (ND) reported that in Nova Scotia physicians cannot bill for time spent talking to caregiver unless the caregiver is a patient and had booked an appointment separately from the patient.…”

“…In total, 23 papers were from the peer-reviewed literature and four published by associations in the grey literature. Peer-reviewed literature included the following: three papers reviewing the ethics of physicians engagement with caregivers (Barnard & Yaffe, 2014;Gitlin & Hodgson, 2016;Mitnick, Leffler, & Hood, 2010); three literature reviews on the role of physicians in care of the dementia caregivers (O'Connor, 2011;Robinson et al, 2011;Sunne & Huntington, 2017); a report on the development of a survey on physician's perceptions of care for caregivers (Bedard, Gibbons, Lambert-Belanger, & Riendeau, 2014), a policy paper (Moore, Frank, & Chambers, 2018), 12 qualitative investigations (Burridge, Mitchell, Jiwa, & Girgis, 2017;Burridge, Mitchell, Jiwa, & Girgis, 2011;Carduff et al, 2014;Doekhie, Strating, Buljac-Samardzic, Bovenkamp, & Paauwe, 2018;Foley, Boyle, Jennings, & Smithson, 2017;Gill et al, 2014 Australia; N = 13; GP n = 6; Cancer consultants n = 7 Investigate the norms, assumptions and subtleties which govern caregiver-general practitioner [GP] consultations and explores factors affecting their interactions regarding caregivers' own health concerns GPs rely on patients to raise concerns but caregivers as patients may be disinclined to cue their GP Caregivers may not raise their health concerns with GPs, so it is up to GPs to prompt them to do so. GPs may not have the desire or capacity to engage with caregivers, but the potential difference GPs can make to caregiver's health is substantial.…”

“…The ways and means to actualising consistent support for caregivers within primary care practices remains elusive (Bedard et al, 2014;Burridge et al, 2011Burridge et al, , 2017Carduff et al, 2014;Doctors of BC 2016a,2016bDoekhie et al, 2018;Foley et al, 2017;Gill et al, 2014;Greenwood et al, 2011;Hum et al, 2014;Jones et al, 2012;Kiceniuk et al, ND;Krug et al, 2018;Leu et al, 2018;O'Connor, 2011;Skufca, 2019;Sunne & Huntington, 2017;Thyrian & Hoffmann, 2012;Wang et al, 2018). As Krug et al (2018) observed that expecting primary care physicians to reorganise busy practices to support caregivers is insufficient and that existing structures need to be recognised and reorganised.…”

Overlooking Informal Dementia Caregivers' Burden

“…At the same time, however, as a consequence of the care situation, CGs frequently do not have time to seek medical advice for their own conditions. Here, the demented patients' physicians have, in addition to the actual patient's treatment, an important function in recognizing the negative impacts of caregiving on those providing the care (Adelman et al 2014;Cohen 2000;O'Connor 2011). While the physician's responsibility is naturally limited to health issues of the patient, he or she might still have a goodand in some cases perhaps the onlyopportunity to recognize and address mental health issues in the CGs arising from the care situation.…”