Demographics, and the current public sector financial crisis, means the increased demand for family carers themselves to look after aging and frail people with dementia, is inevitable.
Whenever I talk about introducing more about how families, neighbours and friends can care for each other in old age, frailty, and dementia into the nurse education agenda, I'm told that you can't get a quart into a pint pot. (For decimal people, that means they are telling me there's no room for it.)
The problem with that is that the numbers show we will as nurses be spending more and more of our time supporting carers who are struggling to look after older people at home. Hospitals need to discharge 'medically fit' older people home, and if the patient or their family can’t afford to pay for a care home place or for home carers, they are in a long queue at the door of the social work department, waiting for assessment and their share of a diminishing resource. While the months tick past and that is being sorted out, they have to do it all for themselves. Even when the social work assessment has taken place, they may still end up doing it all themselves.
The majority of nurses are women and so are the majority of carers. Carers lose out in the job market because of the constraints created by their caring role. The ensuing financial damage can lead to difficulty in accessing care for themselves in later life. It’s a vicious cycle that disproportionately affects woman.
The kicker in all of this is that a massive quantity of benefits that carers could pick up lies unclaimed every year. Local charities that support carers tell me that families of people being discharged from hospital are not told about how carers can be supported by them. Why? Because the nursing staff don’t know about it or don’t think it’s important.
I attend a group for carers of people affected by dementia. The local information that they can provide for each other is substantial. They explain to each other what the different levels of urgency are for care provision in the local authority area. They explain how to get a doctor to establish competence and what to do about driving. They describe how to go about filling out the forms for carers allowance, or attendance allowance and what the difference is. Advance directives, wills, powers of attorney, how to get access to free stuff, it’s all there in the conversation shared by carers in the middle of a crisis. They explain why some social workers in their particular area don’t understand self-directed care, and which ones do. There’s more.
You might think as a nurse caring for older people this is too much to have to take on. Why don’t we leave it to the specialist dementia nurses?
The answer is – that is not going to be enough, and you need to prepare now for the oncoming storm. It will help you and your family and friends, as well as your patients.
It is too much to find out and learn? Well, don’t worry. It would help if you knew more and were in a position to share it. In the absence of that, the least you can do is make sure the family know how to find their local carers’ organisation. For more information and support visit Carers UK and the Carers Trust. You can also telephone 0300 772 9600 or email info@carers.org
Write it on the back of your badge. Your patients and their families deserve it.