Last week we launched a new pathway which focusses on the health and well-being of adult carers.. Based on feedback and insight from carers themselves, plus district nurses and general practice nurses, we have worked with the Queen's Nursing Institute (QNI) and Carers Trust to develop a new professional pathway to support local delivery. The new pathway provides a framework for district and general practices nurses on which to develop new ways of working, strengthening partnership approaches and providing personalised health care for carers – which will mean addressing service challenges and identifying solution focussed approaches locally.
This pathway shows how nurses can contribute to overcoming these challenges and contribute to individual and population improvement. District nurses and general practice nurses have the skills, knowledge and leadership to really make a difference for carers. Both professional groups are skilled in working effectively with partner organisations and stakeholders to ensure seamless support. We hope this pathway will support local delivery and raise awareness of carers health and well-being needs.
Looking after family members can be tough: emotionally, physically, socially and financially. Many who find themselves in ‘caring’ roles don’t even consider themselves as carers – so why is it important that we acknowledge the role and identify those with caring responsibilities?
The 2011 Census showed that there are now 5.8 million carers in England and Wales. Over a third of carers were providing 20 hours or more of care a week in 2011. Since 2001, the number of people caring for 50 hours or more a week has increased by 270,000, which represents a 25% increase. The results of the census demonstrated that the general health of carers deteriorates incrementally with increasing hours of care provided. People caring for 50 hours or more a week were more than twice as likely as those not providing care to report their general health as “not good”.
We know that carers can experience diminished quality of life and poorer health outcomes, often neglecting their own health and well-being and not readily seeking help for fear of being perceived as not coping or not being a dutiful wife, mother, daughter, husband, father, son or sibling. Dame Phillippa Russell’s recent blog clearly highlighted the multiple demands and impact on health and well-being. Carers are crucial to supporting care closer to home, avoiding unnecessary hospital admissions, and provisioning holistic person-centred care. Without a doubt carers are the experts in care and we need to ensure the best possible support is available to carers to maximise their own health and well-being. District nurses and general practice nurses are well placed to identify carers and work with them to support their health needs.
Over the last year we have worked with carers and practitioners to develop a deeper understanding of the challenges and how we can raise more awareness of the supports carers may need. Practitioners told us they needed more awareness in terms of identifying carers and they were often uncertain about services to support carers locally, the recently published QNI e-learning is already proving to be a huge asset for community nurses – try it and share with colleagues!
We were indeed privileged to meet so many carers, who shared their experiences, offered ideas of what ‘good’ would look like for carers – many of the ideas were simplistic, low cost but would make an incredible difference for carers. Listening to and engaging carers provided us with some very clear messages for district nurses and general practice nurses including;
We want to keep a normal home routine
- Take time to speak to carers and our families to find out our needs
- Help us with our ‘well-being’ and mental health
- Help us to stay in our home with as much support as is necessary
- Tell us what carer breaks and respite are available to us
- Help us to identify triggers to anticipate and prevent crises
- Help us to get support to manage care alongside paid employment/childcare responsibilities
- Recognise increasing frailty of older carers/likelihood of spouses undertaking mutual caring roles
A huge thank you to all those - particularly carers - who supported the development of the pathway – further work is ongoing with the QNI, RCN and carers organisations to support nurses to be more carer aware and to provide the much needed support for health and well-being.
Wendy Nicholson is the Professional Officer for School and Community Nursing at the Department of Health