Support for family caregivers: A scoping review of family physician’s perspectives on their role in supporting family caregivers

Parmar, Jasneet; Anderson, Sharon; Abbasi, Marjan; Ahmadinejad, Saeed; Brémault‐Phillips, Suzette; Chan, Karenn; Charles, Lesley; Dobbs, Bonnie; Khera, Amandeep Sheny; Stickney-Lee, Jennifer; Tian, Peter George Jaminal

doi:10.1111/hsc.12928

Cited by 34 publications

(40 citation statements)

References 50 publications

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“…Being registered with the same GP as the person with dementia made support for carers easier to provide. This was consistent with a previous study that found that having both carer and patient registered in the same practice would facilitate looking after carers (Parmar et al, 2020). In Portugal, GPs are accountable for the whole family, which facilitate a comprehensive approach to patients and their carers, and brief and simple family interventions (Gonçalves-Pereira, 2017).…”

Section: Discussionsupporting

confidence: 90%

What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

et al. 2020

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Background Governments are being challenged to integrate at least part of dementia care into primary care. However, little is known about the current role of general practitioners (GPs) regarding dementia care, especially in countries that do not have dementia strategies in place. The aim of this study was to explore the experiences of GPs, persons with dementia and their family carers in Portuguese primary care settings, to better understand GPs’ contribution to dementia care. Methods A qualitative interview study of participants recruited from six practices in different social contexts within the Lisbon metropolitan area was carried out. Purposive sampling was used to recruit GPs, persons with dementia and carers. Interviews with GPs explored dementia care comprehensiveness, including satisfactory and challenging aspects. Interviews with patients and carers explored the experience of talking to GPs about cognitive impairments and related difficulties and the type of help received. Thematic analysis of interview transcripts was carried out using the framework approach. Results Five major themes were identified: GPs have a limited contribution to dementia care, the case of advanced dementia, doctor–patient relationships, doctor–carer relationships and management of chronic conditions other than dementia. Conclusion General practitioners seemed to contribute little to dementia care overall, particularly regarding symptom management. The exception was patients with advanced stages of dementia, given that specialists no longer followed them up. Remarkably, GPs seemed to be alone within primary care teams in providing dementia care. These findings strongly suggest that Portuguese primary care is not yet prepared to comply with policy expectations regarding the management of dementia.

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Section: Discussionsupporting

confidence: 90%

What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

et al. 2020

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“…The provision of person-centered care to those with dementia becomes complicated, however, as the person's dependence on family and friends increases to the point at which the needs and preferences of the person(s) providing care must also be considered in care planning. In an effort to call attention to the needs of family caregivers, Parmar et al from Alberta, Canada (15)(16)(17), developed a comprehensive set of caregiver-centered competencies aimed at training healthcare professionals to better recognize and address the needs of caregivers. They coined the term "care giver-centered" to specifically focus on a person-and family-centered approach to supporting caregivers as well as the people they care for.…”

Section: Introductionmentioning

confidence: 99%

A Biopsychosocial-Ecological Framework for Family-Framed Dementia Care

2021

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The biopsychosocial model has been applied through collaborative care dementia models to the diagnosis, symptom management, and treatment of dementia with a focus specifically on the person with dementia. Because individuals with dementia are increasingly dependent upon others particularly as the illness advances, dementia care requires the involvement and commitment of others, usually family, along with support from community-based resources. Hence, the quality and effectiveness of a person's dementia care are shaped in large part by the foundation of family relationships and the social and community networks in which they are embedded. While most current dementia care models incorporate biopsychosocial principles and recognize the essential role that family members play as caregivers, they fail to consider a patient's family system and relationships as potential risk factors or social determinants for care outcomes. This paper introduces a biopsychosocial-ecological framework to dementia care that is person-centered and “family-framed” in that it targets factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy. We use this model to illustrate how current dementia care practices tend to focus exclusively on the individual patient and caregiver levels but fail to identify and address important relational considerations that cut across levels. We call for the need to add assessment of family relational histories of persons with dementia and family members who care for them in order to better meet the needs of the patient and the caregiver and to prevent harm. This model accentuates the need for interprofessional education on family assessments and caregiver-centered care, as well as interdisciplinary, collaborative models of dementia care that assume more accountability for meeting the needs of family caregivers in addition to those of persons with dementia.

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“…33 Parmar et al found that, despite system reforms, the health and continuing care systems continue to operate in silos and focus narrowly on patient care with little attention paid to supporting caregivers. 34 The co-design approach we used to develop and execute our study may serve as a model for a way forward for health and continuing care system reform. By involving caregivers from the outset, our attention shifted from caregiver needs to caregiver goals and we were able to engage the caregiver community throughout the research process.…”

Section: Discussionmentioning

confidence: 99%

Caregivers’ failure to thrive: A case for health and continuing care systems transformation

Magnaye

Fast

Eales

et al. 2020

Healthc Manage Forum

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Excluding family caregivers and their goals from healthcare thinking and system design has contributed to their “failure to thrive.” Family caregivers are diverse, with dynamic, enduring, and variable life course care trajectories that are largely ignored. Using a co-design approach, caregivers prioritized their goals across seven life domains in an on-line survey. Physical, mental, and emotional health goals were top priorities across all ages. However, care-related goals were not caregivers’ highest priority. Goals related to financial well-being, social connections, employment, education, and care were variable across ages. Our findings suggest that transforming health and continuing care systems begins with recognizing variability of caregivers’ goals across their life courses. Adopting a co-design approach with family caregivers may serve as a model to develop a collaborative health and continuing care system. One that recognizes and supports family caregivers to achieve their goals, so that they not only survive but thrive.

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Support for family caregivers: A scoping review of family physician’s perspectives on their role in supporting family caregivers

Cited by 34 publications

References 50 publications

What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

A Biopsychosocial-Ecological Framework for Family-Framed Dementia Care

Caregivers’ failure to thrive: A case for health and continuing care systems transformation

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