Supporting family carers in Ireland: the role of the general practitioner

Abstract

Background Ireland has over half a million family carers who provide care to a family member or loved one. Internationally, it is recognised that general practitioners (GPs) have a critical role to play in the identification and support of family carers, but, to date, no guidelines exist in Ireland to support GPs in this role. Aims The aim of this study was to examine how carers are currently supported (or not) by healthcare professionals in Ireland, with a particular focus on the role of the GP. Methods A mixed method design was used, involving a national online survey (N = 132) of family carers in Ireland and one-to-one interviews with 10 stakeholders (4 GPs; 6 carers). The quantitative data were analysed using a series of descriptive and inferential statistics; the interview data were analysed using framework analysis. Results Sixty-one per cent of the carer sample reported experiencing psychological distress, more than two-thirds of whom (69%) reported ‘rarely’ or ‘never’ being asked about their own health and wellbeing. Sixty-one per cent also felt misunderstood in terms of the challenges they face in their caring role. Three key themes were identified from the interview data including (1) GP role ambiguity; (2) navigating informal processes and (3) changing needs along the care trajectory. Conclusions The findings suggest important gaps in terms of the role of GPs vis-à-vis their support of family carers. GPs themselves indicated that they need both greater clarity regarding their role with family carers and more training and resources in this regard. A requirement for more streamlined communication and information provision was also highlighted by both GPs and carers. Carers reported a need for more information on the role of GPs in supporting carers as well as more support in addressing, in particular, the psychological complexities of carer identity and help seeking.

Informal caregivers – A missing voice in clinical ethics

“…Many studies point to the crucial role of general practitioners (as well as public health nurses, health visitors, other primary care professionals, and pharmacists) in identifying informal caregivers and offering them primary support. 41 They also play the crucial role of checking and monitoring informal caregivers’ health. As ‘hidden patients,’ they may not develop any health problems in the early stages of caregiving, as the negative impact of caregiver's burden tends to accumulate over time.…”

Supporting family carers in general practice: a scoping review of clinical guidelines and recommendations

“…A number of guidelines suggest that the point of diagnosis or first appointment can be an opportunity to ascertain who will be providing most of the care or support for patients who have longer term illness/disability [1,2]. Additionally, transitions such as the care recipient moving to adult services, or relocating to a nursing home or other form of residential care, were also highlighted as particularly stressful times when carers may need additional support [21].…”

“…Crucially, this impact on carer health appeared to be present even beyond the end of the caring role. Furthermore, carers typically report higher levels of psychological distress [21] than non-carers [22]. Despite these psychological and physical impacts, robust systems to support those who provide care continue to be ad hoc, inconsistent, or absent [23].…”

“…The identification of carers, in the first instance, can be challenging, as many carers do not identify with the term 'carer' but, instead, identify with the relationship to the person for whom they are providing care [6]. Furthermore, health care professionals (HCPs) are not always aware of who is providing the care and, even when they are, evidence suggests they are reluctant to raise the question, as they are unsure of their role in this regard [21,24]. Thus, even when carers are identified, there is a lack of clear direction regarding how their needs can be best assessed and to where they can be referred or signposted for support [21].…”

“…Furthermore, health care professionals (HCPs) are not always aware of who is providing the care and, even when they are, evidence suggests they are reluctant to raise the question, as they are unsure of their role in this regard [21,24]. Thus, even when carers are identified, there is a lack of clear direction regarding how their needs can be best assessed and to where they can be referred or signposted for support [21].…”