Service provision

Even for patients receiving complex, intensive medical care for serious and life-threatening illness, family caregiving is typically at the core of what sustains patients at the end of life. The amorphous relationship between physicians and the families of patients at the end of life presents both challenges and opportunities for which physicians may be unprepared. Families play important roles in the practical and emotional aspects of patient care and in decision making at the end of life. At the same time, family members may carry significant burdens as a result of their work.

This article suggests that the literature on care, which originally was heavily influenced by a gendered perspective, has now taken on other important variables. However, it is argued that if we look at the particular impact of the marketisation and privatisation of long-term care, we can see that gender is still a useful perspective on the production of care, especially paid care.

The huge role of unpaid family carers is outlined in this essay, together with examples of good practices by NHS organisations to support their needs. The authors point out that with declining NHS resources there will be even more reliance on family carers. 

Background: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. Aim: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. Design of study: Qualitative study. Setting: Four South Asian communities in Leicestershire and West Yorkshire. Method: Focus groups and in-depth interviews were used to assess male and female carers, supported by a literature review.

This paper presents some of the key findings from a study about supporting carers in employment. It describes the qualitative experiences of family carers for older people who are in paid employment, paying particular attention to their views on assessment and service provision. The perspectives of other key stakeholders, including staff from statutory and independent sector agencies, are also considered. Support for carers in employment is one of the five priority action areas underpinning the National Strategy for Carers (DoH, 1999).

BACKGROUND: Attention is currently focused on family care of stroke survivors, but the effectiveness of support services is unclear. We did a single-blind, randomised, controlled trial to assess the impact of family support on stroke patients and their carers.

This article presents the results of a survey of patients’ and carers’ views about a community matron service in England. Key themes identified by patients and carers included the reliability of the service, the confidence it gave to patients and carers, improved links with GP services, and anecdotal evidence that the service helped to avoid admission to hospital. The authors believe the survey demonstrates a positive view of the community matron service which justifies continued investment in the role.

This briefing paper draws attention to the experience of black and minority ethnic carers in the context of mainstream service provision and recent policy developments such as the National Carers Strategies, service user and carer involvement and the personalisation agenda. It acknowledges that marginalisation is often a consequence of lack of support for both carers and black and minority ethnic communities in health and social care. The paper highlights the diversity of carers from these ethnic backgrounds and the multifaceted impact of discrimination.

People with learning disabilities are increasingly outliving their parents. To avoid traumatic and inappropriate transitions from the family home in later life, services need to improve their relationships with families. Practical examples are given of how families are being supported to face the future. 

As the location of long-term care of elderly people moves to homes and communities, and responsibility for care shifts to families, understanding the experience of people in this situation is necessary to ensure that support is appropriate, accessible and effective. The present paper explores informal caregivers’ and recipients’ relationships with formal support, drawing on thematic and narrative analysis of 30 in-depth interviews with self-identified family caregivers conducted over a year in a mid-size city in Ontario, Canada.