Aged Care

How can allied health professionals support the health and wellbeing of informal carers?

Dr Kristy Robson is a senior lecturer at Charles Sturt University. Kristy teaches across the clinical subjects and is the academic coordinator of workplace learning for podiatry at CSU. She also teaches in the areas of paediatrics, biomechanics, orthotics and healthy ageing. Kristy has extensive experience in healthy ageing research and enhancing mobility, particularly in older populations to maintain their quality of life. She is particularly interested in qualitative methodologies and community based participatory research approaches that value participants to have an active voice and contribute to practical solutions to problems that impact their communities within a co-creation framework.

Dr Kristy Robson discusses the role of podiatrists in supporting the growing need for informal carers to support older people; in response to increased health care demands.

The role of informal carers is critical with a significant proportion of people aged over 65 years living at home supported by unpaid carers.

With an ageing population, healthcare demands are increasing which is causing a greater shift from formal to informal care. Older people are more encouraged to remain in their homes for longer, but this requires additional support such as an informal carer workforce.

The shift toward informal care

The role of informal carers is critical with a significant proportion of people aged over 65 years living at home supported by unpaid carers. The reliance on informal care is likely to substantially increase over the coming years. It is well recognised that without informal carers and additional support provided by families, older people would be much more reliant on the aged care system which would further stress our already overburdened resources in this area.

This article’s focus

As the first article for 2022 in this series on the topic of aged care, I want to explore the often-hidden workforce of informal caregivers and their important role in Australia’s aged care system. It highlights the importance of allied health professionals in recognising the challenges associated with these roles and supporting the health and wellbeing of individuals undertaking these roles.

In this article I will focus on:

What is an informal carer?
What do informal carers do?
Why is it important to recognise and support informal carers?
What are the challenges that informal carers face?
What can allied health professionals do to actively support our informal carers?

Informing caring responsibilities are broad and focus on a range of different areas. Informal carers often have their own health issues, but these are regularly put to the side because the focus is often on the person being cared for. Given the significant reliance on informal carers in our aged care system, it is important that allied health professionals are able to undertake early identification of any health and wellbeing issues in this population group, so that appropriate strategies and support can be implemented.

As allied health professionals we need to identify if our clients are informal carers and understand and recognise the stressors associated with these unpaid roles.

We also need to consider the significant impacts to an individual’s health and wellbeing that are commonly associated with informal caring responsibilities, and support them to also age well.

In 2018 it was estimated that 2.65 million people (or one in 10 Australians) provided some level of informal care.

What is an informal carer?

An informal carer is someone who provides care in the context of an existing relationship such as a family member, friend or neighbour. Most informal carers are unpaid, although some may receive financial support. In 2018 it was estimated that 2.65 million people (or one in 10 Australians) provided some level of informal care. Informal carers are often supporting someone with a disability, medical condition, mental illness or someone who is frail due to old age.

What do informal carers do?

The core roles or tasks that informal carers provide include; assistance with self-care, mobility assistance and communication assistance. Commonly, informal carers are also responsible for the management of medications, facilitating medical appointments, transport, arranging banking requirements, providing emotional and social support, as well as dealing with any emergencies.

Why is it important to support informal carers?

Evidence shows that it is critically important to adequately support our informal carer workforce as they play an essential role in supporting people at home. Informal carers are often hidden clients themselves, with reduced attention on their own needs resulting in adverse physical and mental health consequences. Having appropriate support mechanisms that manage the challenges associated with their role can play a big difference to the overall health and wellbeing of informal carers. Ensuring informal carers are aware of and have access to support groups, coaching, education on the roles and responsibilities and have tailored support packages is important to help facilitate their roles.

What are the challenges for informal carers?

In addition to the limited numbers of informal carers, research has shown that caring responsibilities can create several challenges. Recent research has shown that one in 10 informal carers are feeling overwhelmed with the demands and responsibilities of their caring role.

Typically, they are trying to manage their caring responsibilities alongside their regular duties such as household tasks and managing their own health and wellbeing. This leads to high rates of stress and overburdening which can impact both the physical and psychological health of the caregivers.

Evidence suggests that overstressed informal carers use more healthcare services and prescribed medication compared to their non-carer counterparts. They also often have much higher rates of depression, perceived lack of coping mechanisms and poorer quality of life.

Caring responsibilities also can contribute to financial hardship and social isolation and exclusion.

Older carers often discuss additional challenges such as:

Neglecting their own needs, which jeopardises their own wellbeing
They find it difficult to express their own needs
Being able to access services for themselves when they are full time caring for someone else.
Older carers worry about the future when they cannot care

Older carers often fail to ask for support

Older carers are often very concerned about their own declining physical and emotional wellbeing. They also find it harder to access supports and maintain social contacts, which results in high levels of loneliness. Loneliness can be especially prevalent with caring with someone with dementia.

It is important to have open conversations with your client on the importance of focusing on their own health and wellbeing...

What can allied health professionals do to support informal carers?

It is important to recognise if your client has caring responsibilities so that you can understand the contextual challenges that they may be facing. Additional factors to consider include:

Carers often identify with positive health professional interactions when there is an understanding of their unique situation.
Being warm, genuine, accessible and approachable can increase carers feelings of acceptance, particularly when they are struggling.
Poor communication and a lack of empathy towards the competing priorities informal carers experience often leads to negative interactions with healthcare professionals.

It is important to have open conversations with your client on the importance of focusing on their own health and wellbeing, even though they may have feelings that their own health is a lower priority to the person they are caring for.

A focus on self-care is critical to enable sustained health and an ability to maintain their caring role, particularly in older carers. Self-care includes ensuring that carers can recognise and attend to their own physical, social and emotional needs, and if not, appropriate interventions need to be implemented and supported, or appropriate referral pathways should be considered and followed up.

A greater focus on supporting our informal carer workforce will enable better health outcomes, not only for the carer themselves but also the people they are supporting as part of their caregiving role. This in turn will actively contribute to the recommendations from the Royal Commission into Aged Care to enable more older people to remain in their own homes for longer.

Further resources