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Carers

Carers. Why Care About Carers?. Carers health suffers as a result. 52% report stress related illness. 51% report physical injury from caring. 70% of carers think GPs are unaware of their needs. Some Examples. 55 year old woman whose mother is in NH with advanced Alzheimer's.

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Carers

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  1. Carers

  2. Why Care About Carers? • Carers health suffers as a result. • 52% report stress related illness. • 51% report physical injury from caring. • 70% of carers think GPs are unaware of their needs.

  3. Some Examples • 55 year old woman whose mother is in NH with advanced Alzheimer's. • As a result her mother isn’t eating much. • Daughter spends hours trying to feed her. • Off work with stress and depression. • How could we help?

  4. Case 2 • 60 year old woman whose husband is dying at home. • District nurses go in to change syringe driver. • At 10am she smells strongly of alcohol. • DN has a quiet word with you. • What should you do?

  5. Case 3 • 75 yr old woman with IHD. • Husband with metastatic bowel ca is sent home from hospital on Friday pm. • 1 call per day from Social Services. • No equipment at home. • Deteriorates quickly and wife can’t cope. • Admitted to NH for respite on Sunday by OOH. • Dies in NH, when he really wanted to die at home. • How could this be prevented?

  6. Helping Carers • Record in their notes that they are a carer. • Always ask how they are coping. • Keep them informed. • Ensure they know how to contact you. • Provide written instructions and a clear plan for what to do in an emergency.

  7. Physically • Ask DNs to give practical advice on nursing skills. • Check they have equipment. • Ensure they have been offered SS input. • Every carer has right to ask for a full assessment of their needs by SS. • Consider respite options.

  8. Financially • Attendance allowance = tax free benefit for those > 65 who need looking after. • Disability Living Allowance = if <65. • Carer’s allowance = if caring for >35 hrs/wk. • Can be speeded up if ‘terminally ill.’ • This means progressive illness with death expected within 6 months. • GP needs to fill in DS 1500 report.

  9. Bereavement • Traditional model 1) Shock – detachment, disbelief, numbness. 2) Yearning – Pining, anxiety, grief. 3) Despair – Apathy, withdrawal, pessimism. 4) Recovery – Rebuilding identity and purpose.

  10. How Can We Help? • Flag notes to show recent bereavement. • Actively follow up bereaved patients. • Ensure all referrals and appointments are cancelled for the deceased. • Watch for depression, anxiety, substance misuse, self neglect.

  11. Abnormal Grief Reactions • Types • Inhibited grief – absent/ minimal. • Delayed grief – Late onset. • Prolonged/chronic grief – inability to rebuild life. • If abnormal grief suspected:- • Monitor carefully. • Consider bereavement counselling. • Refer to psych if persistent/ suicidal.

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