Prerequisites for providing effective support to family caregivers within the primary care setting – results of a study series in Germany

Abstract

Background General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs. The results are used to derive starting points as to which measures would be sensible and useful to strengthen support offered to family caregivers in the primary care setting. Methods Between 2020 and 2021, three sub-studies were conducted: a) an online survey of 612 family caregivers; b) qualitative interviews with 37 family caregivers; c) an online survey of 3556 GPs. Results Family caregivers see GPs as a highly skilled and trustworthy central point of contact; there are many different reasons for consulting them on the subject of care. In the perception of caregivers, particular weaknesses in GP support are the absence of signposting to advisory and assistance services and, in many cases, the failure to involve family caregivers in good time. At the same time, GPs do not always have sufficient attention to the physical and psychological needs of family caregivers. The doctors interviewed consider the GP practice to be well suited to being a primary point of contact for caregivers, but recognise that various challenges exist. These relate, among other things, to the timely organisation of appropriate respite services, targeted referral to support services or the early identification of informal caregivers. Conclusions GP practices can play a central role in supporting family caregivers. Caregivers should be approached by the practice team at an early stage and consistently signposted to help and support services. In order to support care settings successfully, it is important to consider the triadic constellation of needs, wishes and stresses of both the caregiver and the care recipient. More training and greater involvement of practice staff in the support and identification of caregivers seems advisable.

Instruments in general practice to identify and to measure (over)burden due to informal care for caring relatives: a scoping review protocol

“…This hesitance sometimes leads to problematical situations. The results from these interviews match those of other studies, which showed that early and systematic identification of family carers remains challenging in the daily general practice setting 8 14…”

“…Less than 50% of caregivers (42%) report having been promptly identified by their GP. In only 18% of cases, the responsible GP approached the caregiver proactively 14. Qualitative interviews Wangler and Jansky conducted with 37 caregivers also stated that they initially feel an uncertainty about whether their needs and problems should be a matter for GP support.…”

Association between family caregivers' primary care experience when they report as patients and their stress related to caregiving: A pilot cross‐sectional study

“…Despite these limitations, to the best of our knowledge, this pilot study is the first to reveal an association between family caregivers' primary care experience and their stress, using the internationally established measure as a tool for assessing the quality of primary care. Expectations are pinned on primary care providers as agents who care about the needs, wishes, and stresses of family caregivers 4 . Findings from this study, showing that focusing attention on the individual as a whole person and building provider‐patient relationships that make it easier to seek consultations when needed were associated with lower stress related to caregiving, may encourage primary care providers and stakeholders.…”

“…3 Thus, it is ideal for health care providers to consider the needs, wishes, and stress levels of family caregivers as well as the care recipients; this is especially expected in primary care. 4 Previous research has examined whether the support provided by care recipients' primary care providers can affect caregiving-specific well-being, such as caregiver stress, [5][6][7] but few have investigated the impact of caregivers' own primary care providers on their stress. Care recipients and caregivers are not always registered in the same general practice, even in countries with established gatekeeping systems, such as the United Kingdom.…”

“…In a cohort study, family caregivers who cared for a disabled spouse and reported mental or emotional stress had a higher mortality rate than non‐caregivers or caregivers who did not report the stress of caregiving 3 . Thus, it is ideal for health care providers to consider the needs, wishes, and stress levels of family caregivers as well as the care recipients; this is especially expected in primary care 4 …”