‘Not another form!’: lessons for implementing carer assessment in health and social service agencies

Abstract

This article addresses some of the issues that need to be considered in implementing carer assessment in health and social service agencies. It is based on findings from three studies involving the use of the CARE (Caregivers' Aspirations Realities and Expectations) Assessment Tool in Canada, a comprehensive psychosocial instrument. The first study, carried out between 1999 and 2001, was aimed at developing the CARE Tool, and had as one of its objectives to evaluate the feasibility of its implementation into ongoing practice. The second study, conducted between 2000 and 2003, was designed to evaluate the impact of using the CARE Tool, and also had an objective concerning implementation. A third study was undertaken in 2005-2006, in part, to gain more understanding of the barriers and outcomes of implementing carer assessment. All three studies used focus groups and individual interviews as the main data collection method. In all, this article is based on 13 focus groups and five individual interviews with home care professionals and 19 individual interviews with home care managers or supervisory staff, all having experience with carer assessment. Similar themes emerged from the thematic analyses of the data from all three projects. All studies point to the following as preconditions to successful implementation: clarification of carer status within policy and practice; making explicit agency philosophy with regard to the role and responsibilities of families in care and conceptions of carer assessment; and agency buy-in at all levels. Four themes emerged as issues for implementation: integration of the carer assessment tool with existing tools; ensuring training and ongoing supervision; work organisation and resources required for carer assessment; and logistical questions. It would appear essential that a clear rationale for moving towards carer assessment and its place in a global approach to long-term care and carers are essential to its implementation.

Care Transition Experiences of Spousal Caregivers

“…Our findings contribute to the growing body of literature aimed at demonstrating the importance of needs assessments for family caregivers (Guberman, Keefe, Fancey, & Barylak, 2007;Nolan, Lundh, Grant, &Keady, 2003) by illustrating the fluctuating medical, physical, emotional, and social needs of spousal caregivers during the transition of their relative from the GRU to home. However, in addition to assessing caregiver needs, the strategies engaged in during hospital-to-home transitions might be an important part of a comprehensive caregiver assessment, and could be amenable to intervention (e.g., when caregivers were informed, they were able to enable physical health).…”

Partners in care?: views and experiences of carers from a cohort study of the early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003

“…For others, such an assessment was judged to be ‘not worth the paper it’s written on’. Other researchers have observed this lack of knowledge of entitlement and ambiguity about the outcomes of assessment to be common among carers generally (Guberman et al. 2007).…”

Reactions to caregiving of frail, older persons predict depression

“…Rather, their well‐being is usually taken into consideration when their care recipient is assessed by the aged‐care assessment team for eligibility for aged‐care services. However, even where legislation provides carers with rights to an individual assessment, existing assessment practice and the expertise of implementing carer assessments remain inadequate (Guberman et al . 2007).…”