How GPs can better identify and support carers
One in 10 patients visiting their GP will be a carer but most will not walk into consultation and say, “hello, I’ve come to see you as I’m a carer”, as someone with diabetes might do.
As it is Carers Week, I wanted to talk about how GPs can better identify when someone who comes to see them is a carer. This is especially important, as early identification of carers and providing appropriate support can significantly improve their health and wellbeing, as well as having positive benefits for the person being cared for.
Becoming a carer of someone living with a terminal illness is often a gradual process. Like the illness affecting the person being cared for, the work of caring gradually impacts more and more on the carer’s life. Hence, most people will identify themselves as ‘just a wife/husband/daughter/son/friend’, rather than as ‘a carer’. But whether or not they recognise themselves as such, unpaid carers are estimated to save the UK economy about £119 billion per annum and represent a workforce larger than the NHS (Carers UK, 2011).
Carers of those approaching end of life face unique and significant challenges, which include (NCPC, 2012):
- difficulties coping as the person’s needs become more complex and demanding – carers are more at risk of mental health issues and are more likely to present late with physical health issues
- the demands of coordinating care and professionals on a 24/7 basis
- having difficult conversations about death and dying
- dealing with feelings of loss and grief
So how can GPs identify more people providing unpaid care to a family member or friend?
Four common presentations for carers
- The patient doesn’t present at all, or delayed presentation as the carer gradually recognises their role as a carer
- Opportunistically – attending a consultation together with their loved one; picking up prescriptions, a vaccination schedule; or perhaps the carer is mentioned in a discharge or clinic letter
- During a crisis with their loved one – at which point, their personal wellbeing is usually the last thing on their mind
- At some point after their loved one dies
Other opportunities to identify carers
- At new patient checks, ask: “do you care for somebody who could not manage without your help?”
- Adding carer questions to chronic disease templates
- When forms are received by the practice regarding applications for Disability Living Allowance or Attendance Allowance
Developing a strategy for your practice Some questions that can be helpful to ask when developing your carer’s strategy for your practice.
- In your next practice/multidisciplinary team (MDT) meeting, ask all the members of the practice/MDT to attend to agree the process for handling carers
- How friendly do you feel your practice is to carers?
- How do you work with local external organisations in your community to help identify carers?