Comment

Leading care for older carers

Recognising the challengers carers face.
Carer at work

Three in five of us will be carers at some point. For many these responsibilities will occur in older age. I regularly care for patients being cared for by older people. They can have a range of caring duties that are sometimes complex and arduous.

While the carers I meet often find their role rewarding, they face challenges.

The Healthy Caring Guide estimates 1.2 million UK carers many caring full time are over 65.

The Carers UK Valuing Carers 2015 report said an estimated 5.7 million carers were providing unpaid care. These figures have been recognised in recent legislation.

Several policies have ensured new statutory duties to support carers: The Care Act (2014), Commitment to Carers (2014), Five Year Forward View (2014) and Commissioning for Carers (2016).

These drivers are encouraging

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Three in five of us will be carers at some point. For many these responsibilities will occur in older age. I regularly care for patients being cared for by older people. They can have a range of caring duties that are sometimes complex and arduous.

carer at work
Carers regularly face challenges in their career. Picture: iStock

While the carers I meet often find their role rewarding, they face challenges.

The ‘Healthy Caring Guide’ estimates 1.2 million UK carers – many caring full time – are over 65.

The Carers UK ‘Valuing Carers 2015’ report said an estimated 5.7 million carers were providing unpaid care. These figures have been recognised in recent legislation.

Several policies have ensured new statutory duties to support carers: The Care Act (2014), Commitment to Carers (2014), Five Year Forward View (2014) and Commissioning for Carers (2016).

These drivers are encouraging health care leaders to provide practical advice and support mechanisms for carers.

Developing guide

NHS England has developed The Practical Guide to Healthy Caring. This guide provides information, advice and support available to carers about staying healthy while caring.

It is particularly relevant for carers over 65 years plus and those new to caring.

As part of a holistic nursing assessment community nurses will often encourage carers to look after their own health and well-being. As nurses, we try to advocate the importance of respite and time out with any carer, but especially those who are older.

The guide encourages carers to stay active and adopt healthy behaviours and lifestyle choices. The advice also touches on mindfulness, helping carers to recognise the ‘here and now’ and opportunities for making time for themselves.

Providing holistic care for the patient’s carer may significantly enhance the overall physical and emotional well-being of both of them. Community nurses have a role to play in identifying burnout or hidden older carers. We also have a duty to signpost them to further support.

Nurses need to be able to identify carers, recognise the challenges they face, and have the training and communication skills to approach and speak to them.

Equality for carers

Equality for older carers in the community will require strong nursing leadership. Some community practitioners may have lost confidence in their leadership abilities. This may be related to increasingly task-orientated caseloads, where patient demand exceeds holistic approaches. Community nurses are often overworked, so ensuring high quality of care for an older carer becomes an additional consideration.

Despite the challenges, community nurses are in a good position to lead creatively for the inclusion of the older carer’s needs. The nurse can have an influential role in ensuring all those involved in the patient’s care understand the value of the older carer. The lead nurse can provide evidence and clinical reasoning.

This enables a care package to be shaped and resourced in a manner that aids patient and carer. For example, if an older care is preventing a nursing home placement, additional resources to support the carer may prevent unnecessary financial expenditure and protect the caring unit (patient and carer).

Sometimes shared awareness of a carer can positively affect resources, for example, in avoiding duplicate care pathways. Good communication and collaborative thinking can save valuable health care resources.

Embracing complex cases and working across health care and social boundaries is an essential leadership ability for community nurses reaching out to older carers. Building new relationships to negotiate effectively for additional resources is an important part of facilitating care for older carers.

Ensuring junior nurses have the correct training, professional support and reflective abilities will also ensure long term sustainability of new resource implementation and innovative care pathways.

Successful and meaningful care for older carers requires innovative thinking from community nurse leaders. Many will embrace the leadership opportunity enthusiastically, particularly if there is local collaborative working and collective empathy.

Alongside political drivers relating to health equalities, nurses need to support each other to recognise and implement care provided beyond the remit of their professional boundary. Without carers providing the care that they do, our professional roles would be almost impossible.

Older carers deserve this extraordinary recognition.


Further information


About the author

Emma Vincent is an Interstitial Lung Disease Nurse at Glenfield Hospital, Leicester and member of the Primary Health Care Editorial Board

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