The role of carers: reflections on a conversation with Dame Philippa Russell
Dame Philippa Russell, a National Ambassador for the Centre and a lifelong campaigner for disabled people and their families, recently spoke to us as part of the Conversation Series of events held by the Doubleday Centre Student Society. Here, Dr Calisha Allen, National Student Ambassador for the Centre, reflects on some of the topics explored during the event.
The role of carers has and is becoming increasingly complex and pertinent. This is due to an ageing population, increasing numbers of patients with multiple co-morbidities, and an increasing number of people with disabilities living longer and outliving their parents, thanks to advancements in modern medicine.
Carers have become an increasingly large and important source of care for our patients; therefore, it is important clinicians identify who the patient’s carers are. These go beyond formal paid carers and include support networks such as family or friends.
Carers come in many different forms and, importantly, are increasingly becoming older. Carers may themselves have healthcare needs in addition to caring for loved ones with complex care needs. Caring can create an isolating environment and many carers experience stress, anxiety and depression; additionally, 41% experience injury or poorer physical health due to their role as carers.
It is important to understand the role of the carer in relation to the patient, and to consider the health and wellbeing of the carer. One must be realistic about what the carer can provide, and if this can be sustained long term. Carers are responsible not only for the patient’s activities of daily living after hospital discharge, but also for managing the web of care from multiple community services.
What carers want is:
- early identification and recognition of their role;
- conversations about real lives, the family unit, their daily life and their true and sustainable capacity;
- integration of multiple sources of information and support.
How can we improve our practice?
Reflecting on my experiences as a foundation doctor and preparing patients and their carers for discharge, I ask how can we improve our practice?
Firstly, we must acknowledge the role of the carer in the patient’s discharge.
With the support of the MDT including the nursing, physiotherapy and occupational therapy teams, assess what the patient’s needs will be in the community. We often discuss the importance of planning discharge from the beginning of the admission. We need to include the carers in this process.
This will include signposting to community and third sector services early so they can explore these services before discharge. The discharge team then becomes the carer, patient, hospital staff and support from community services and the third sector.
On discharge, acknowledge that information retention in periods of stress can be hard. Write clear, patient and carer-friendly discharge summaries and include in them signposting to community and third sector support services.
Remember that in patient care, discharge is not the end of care, but the passing of the baton to the patient, their support network, community services and the third sector.
After patients leave our care, there is a multitude of excellent resources and services that they can access to improve care and the quality of life for both patient and carer. These can be simply signposted during next of kin updates, on the discharge summary and on our hospital websites.
I would like to thank Dame Philippa Russell for her excellent and enlightening talk as part of the Conversation series for the Doubleday Centre, on which this reflection is based.
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