Health policy

Families are the bedrock of long-term care, but policymakers have traditionally considered them “informal” caregivers, as they are not part of the formal paid caregiving workforce. As chronic and long-term care systems have become more complex and as more demanding tasks have been shifted to families, this view is no longer sustainable. The care transition process offers a critical opportunity to treat family caregivers as important care partners. Enhancing their involvement, training, and support will contribute to reducing unnecessary rehospitalizations and improving patient outcomes.

Department of Health strategy for supporting informal carers 'Carers at the Heart of 21st Century Families and Communities' (2008), which addresses government short-term commitments and a 10-year plan. The key principles are summarised and reactions from carers and organisations are reviewed. A case study of a community learning disability nurse supporting a mother and her learning disabled son is included. [(BNI unique abstract)] 

As the baby boomer generation ages, the need for laws to enhance quality of life for the elderly and meet the increasing demand for family caregivers will continue to grow. This paper reviews the national family leave laws of nine major OECD countries (Canada, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, and the United Kingdom) and provides a state-by-state analysis within the U.S. We find that the U.S. has the least generous family leave laws among the nine OECD countries. With the exception of two states (California and New Jersey), the U.S.

Chronic obstructive pulmonary disease (COPD) is a progressive illness that changes the lives of patients and their spouses dramatically. The aim of this paper is to show how spouses of COPD patients integrate their tasks as informal carers with their role as spouses and the tensions and challenges involved in this. The study draws on qualitative interviews with spouses of COPD patients, recruited from the patient pool of ambulatory pulmonary services of two hospitals in Oslo, Norway. The spouses described their great efforts to re-establish normality and continuity in their everyday lives.

How do carer support programmes meet the needs of those caring for dependent mentally ill older people? Julie Hall reviews the evidence.

Population forecasters have predicted that the proportion of people in the UK aged 65 years and older will rise significantly in coming decades. This shift in demographics will put increasing pressure on the National Health Service and providers of social care. However, older people do not rely only on care provided by the state; informal care of the elderly is often supplied by family and friends. Therefore, the relationship between formal and informal care and the reaction of informal carers to institutional changes is an important policy issue.

Risk is a central defining feature and area of concern in adult social care provision, but what do we actually know about how service users, carers and practitioners define and manage risk? This question is increasingly important as current policy advocates greater service user choice and control through a range of self-directed support mechanisms, and statutory duties and professional boundaries are challenged.

Much policy and practice attention has been focused on the participation and involvement of informal carers in service assessment, provision and review. The advent of the National Carers Strategy, the Community Care Delayed Discharge Act, Carers and Disabled Children Act and latterly the Carers (Equal Opportunities) Act have all played their part in giving greater significance to carer involvement. The role of professional cooperation and willingness to see carers as equal partners is a key factor in achieving these objectives.

The healthcare problems of individuals are often solved without the intervention of professionals through family caregiving. Population ageing, a shortage of professionals and cost-control in the healthcare sector1, increase the importance of family caregiving in most west-European countries, where comparative research has shown that national governments no longer take full responsibility for care services.2 The involvement of family caregivers, however, is not without problems.