Tackling unpaid carers ill health

The health of the UK’s six million carers suffers as a direct result of unpaid caring work. Indeed, according to In Poor Health, a survey of the impact of caring by Carers UK in 2004, the more hours a carer provides, the more likely it is that they will be in poor health. This is particularly so for those providing more than 50 hours a week, which is the case for nearly 21% of carers.

Using statistics from the 2001 Census, the survey revealed that by far the worst reporting of ill-health by carers was in Wales, where nearly one in four carers (24%) providing substantial care also suffered from ill-health.

Part of the problem is that some people don’t see themselves as carers, don’t want help, or rarely ask for it. “People don’t realise they are getting stressed – mentally and physically,” says Wendy James, a GP partner at the Ashleigh surgery, Cardigan, in Wales. “They feel they haven’t got time to go to a doctor until they reach a crisis, and as result they end up in hospital.”

But a new project, Ceredigion Investors in Carers, of which James’s practice is a participant, has won a Welsh social care accolade for raising awareness of carers and their needs among GPs, and providing them with help and support.

The project follows a succession of similar initiatives in the area. Its three partners are the Cardigan Health Board (Wales’ primary care trust equivalent), the county’s social services department, and the Red Cross Carers Fieldwork Project, which delivers some services for the council.

Awards

Particularly impressive has been the framework of good practice – with its bronze, silver and gold awards – that the project is establishing among GPs. Within 12 months of the project’s launch, 14 out of the county’s 16 practices have signed up to the scheme and secured bronze.

To get their rating, practices have to show they are actively encouraging patients who are carers to identify themselves, for example through a dedicated notice board, information on their website, or when registering new patients. That way doctors should be more alert to carers’ possible health needs, and carers should be closer to help when they need it.

Practices must also have someone leading on carers’ issues, and have their policies for carers summarised in a protocol. They also have to demonstrate carer awareness. For example, a carer must be given some flexibility in their appointment time, and, if they are looking after someone with severe needs, they may need to wait somewhere more suitable than a waiting room.

“We’ve never had anything like this for carers, and it’s not something we would have thought of doing,” says James. She believes it has been useful for her practice to pull together all its information on carers into one file. That way it reminds staff where they can refer patients, and what support is available.

As well as setting standards among GPs, the project organises a monthly support group for carers, which may include a speaker on a health or financial issue, a book-swap, or just tea and a chat.

Pauline Palmer and Jean Whitmore are both registered at the same practice, and have been looking after their mothers (aged 101 and 93 respectively) for more than 20 years. The women met through the project, as did their mothers.

Meeting others in similar situations has been one benefit of the project, says Whitmore. Her mother needed respite care when she had to go into hospital, but she wouldn’t have wanted to go if she hadn’t known she could meet Pauline’s mother there through the care home’s day centre.

“People don’t think of you as carers – they just think it is your duty,” says Whitmore, who sighs at having had to spend her retirement as a carer. “You cannot go anywhere, especially at short notice there is a long waiting list to get help from anyone and if you are ill you are stuck.”

It will take more than the project’s resources to tackle the multitude of issues facing carers – the physical demands and financial strains, the stresses and isolation – but their feedback on the Ceredigion project is positive. “They call it their little oasis,” says James. “It gives them a place where they can meet other carers and get support.”

➔ For more information on the project, e-mail carers’ opportunities co-ordinator Pennie Muir