Service provision

This article explores the role of the district nurse in supporting family and friends who act as informal carers for patients who wish to die at home. The district nurse can support carers by promoting patient comfort, assessing carer needs, using communication and counselling skills, providing timely information, planning for anticipated needs, and co-ordinating and liaising with appropriate services and professionals. This requires the district nurse to develop a trusting carer-nurse relationship.

There are an estimated 6.4 million people in the UK1 currently caring for a child, friend, neighbour, partner or parent or a combination of these. Carers look after family and friends who are disabled, frail or ill. They work alongside professionals, volunteers, care homes, special schools and community groups often caring for people in their own home. The hours of care that they provide for ill, frail or disabled people often comes at a cost to their own health and well-being. The impact on a carers’ health and well-being, finances and relationships cannot be underestimated.

Feminism rather than gerontology characterises this book but the substantive issues lie within the field of gerontology and the shift in the boundaries of paid and unpaid work at the end of the twentieth and in the early twenty-first centuries. Cash payments for care are a possible method of ensuring care and citizenship. The chapters raise issues of long-term care funding, the positions of users, caregivers and care workers in the care relationship, how care work could be professionalised and support for informal carers.

In the past 20 years there has been considerable growth in the provision of palliative care services. The shift in emphasis from hospice and hospital care to the development of community services has been significant. This enables people to be cared for at home and is in keeping with Government agenda. While this may be beneficial for the patient and fit in with the wishes of the family, it is likely to put heavy demands on the coping resources of individual carers.

After a damning report [The state of social care in England 2005-6] which revealed the increasing burden on friends and family members who support people with care needs, Amy Taylor, Mary Garboden and Simeon Brody look at the reasons behind the crisis and whether it is retrievable. 

The changing role of users and carers in the care system is examined. The four main user groups are identified as those with physical disabilities, learning disabilities or mental health problems and older people. The growth of the Disabled Living Movement since the 1970s has radically altered thinking and policy, but changes in practice have been slower. Normalisation theory has dominated service development for those with learning disabilities. Difficulties in implementing a care in the community policy for mental health are discussed.

This is the fifth report in the Audit Commission’s series looking at ways to promote the independence and well-being of older people, the previous reports have focused on: ● what independence means for older people (Ref. 1); ● what local authorities, working with other agencies, can do to promote independence and well-being for all of their older citizens (Ref. 2); ● ways of doing this for older people who have become frail (Ref. 3); and ● the role that assistive technology can play (Ref. 4). 2 Many frail older people rely on care provided by relatives or friends.

The aim of the present paper was to examine some views and experiences of dementia among older South Asian people, as well as their families and carers, and to explore central issues of service support. Data were collected in Scotland through interviews with 11 professionals working with South Asian people with dementia, and four case studies of South Asian people with a diagnosis of dementia, as well as their families and carers.

INTRODUCTION: Informal caregivers are important resources for community-dwelling frail elderly. But caring can be challenging. To be able to provide long-term care to the elderly, informal caregivers need to be supported as well. The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly.