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Ensuring carers receive care too

To mark Carers' Week, Dr David Newman discusses how GPs can help to ease the burden.

In the past decade, there has been an increasing awareness of the vital importance of carers in society and there is now an extensive network of carer-support organisations.

The burden on carers can be immense and can have a serious impact on their own health. Carers often do not recognise their role as carer, seeing it as a natural progression of their relationship with a loved one.

They often ignore their own needs and do not notice the increased stresses until a crisis occurs.

Respite care has been available for many years and can be invaluable for carers who are physically or mentally exhausted. However, the word can suggest escape from something disagreeable.

Those concerned with community care prefer to call it a 'short-term break', which implies a benefit for both the carer and the cared-for.

Legislation such as the Carers Recognition and Services Act 1995, the Carers and Disabled Children Act 2000 and the Carers (Equal Opportunities) Act 2004 gives carers the right to an assessment of their ability to care.

This will facilitate a complete appraisal of the care situation and will then enable greater support to be given where necessary.

Local authorities are required to take this into account when deciding which services to provide. It also enables these authorities to provide services to carers in their own right.

The carer assessment can be link to planned breaks for carers, support groups, general information and advice, benefits advice, services and equipment. It can help with fitting a carer's role within their own lifestyle and health needs.

Protocol

In the management section of the GMS quality framework, three points can be earned by having a protocol for the identification of carers and a mechanism for the referral of carers for social services assessment.

There are likely to be a number of hidden carers on any practice list and finding them might require some work.

This could involve pooling knowledge within the practice, as well as opportunistic identification of carers when they, or the person they care for, come into contact with the primary care team or are hospitalised.

An information leaflet or questionnaire could be placed in the waiting room, which can help carers to realise that caring is what they are doing and then identify themselves to the practice.

Another option is to use promotional materials, either gathered from carer organisations or designed in-practice.

GPs should also be aware of the effects of being a long-term carer, such as grief and loss. Feelings of guilt, frustration and anger are also common.

Carers can also feel isolated and think that the role is often imposed on them, or they might be concerned about the financial implications.

GPs have an important role in the identification of carers, the assessment of the carer's state of health, and signposting them to support services locally.

With support, carers' lives can be not only more bearable, but also more enjoyable.

- Dr Newman is a GP in Corby, Northamptonshire

CARERS - THE FACTS

- In the UK, one in eight adults is a carer (about six million people).

- Carers save the economy £57 billion per year, about £10,000 per carer.

- The main carer's benefit is £46.95 for a minimum of 35 hours, equivalent to £1.34 an hour.

- 79 per cent of carers say caring has affected their health; nine out of 10 believe that all carers should be offered a health check.

Help for carers

Carers UK: 020 7490 8818, www.carersuk.org

The Princess Royal Trust for Carers: 020 7480 7788, www.carers.org

A RECOMMENDED BOOK

The Selfish Pig's Guide to Caring When Hugh Marriott's wife developed Huntingdon's Disease, he decided to write a book. In The Selfish Pig's Guide to Caring, he offers the advice that he would have liked to have received when he was struggling in an unfamiliar role.

The book is easy to read, with many amusing illustrations. It is well researched, and looks at the problems faced by all carers rather than those who care for someone with a specific disease.

The main message is that carers will be more effective in their role if they concentrate on being 'shameless, determined, and utterly selfish pigs'.

Carers often fail to take care of themselves. They can feel lonely and invisible and the book offers ways to combat these feelings and suggests ways of communicating with other like-minded people. Carers also often suffer from fatigue, depression or burn-out, and the author emphasises that regular carer breaks are an absolute necessity here.

Topics such as sex, thoughts of murder, incontinence, benefits and officialdom are covered.

The Selfish Pig's Guide to Caring by Hugh Marriott is published by Time Warner Books and costs £7.99.

- Reviewed by Dr Newman.

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