Carer Strain: Recognising and Easing the Burden of Care
There has been a lot of research on Burden of Care, most of this has been linked to the impact of caring for a patient with a Mental Health disorder, but many of the findings will be relevant for carers in other situations.
What is Burden of Care?
Burden of Care or Caregiver Burden is a term used to describe the impact experienced by the carer. The online Psychology Dictionary defines Caregiver Burden as:
“The fatigue, stress, and all other psychological symptoms experienced first-hand by parents, siblings, and other family members.”
Some writers define Burden of Care in three separate ways - Objective, Subjective and Perceived. Objective burden of care focuses on the activity involved in caring. For example, providing personal care which might include dressing, washing and feeding someone. The subjective burden of care focuses on the feelings evoked by the caring role. For example, frustration, anger and anxiety. The perceived burden of care focuses on the impact of the caring role. For example, causing relationship strain or the fiscal impact of caregiving.
Factors that influence the impact on the carer have been identified as age of the carer, gender, educational level, income, health status, time spent per day caring for the family member, knowledge of their condition, their age, clinical symptoms, and level of disability in daily life. Other factors include environmental factors (such as finance and housing) and the quality of care received by health and social services.
Recognising the signs
Recognising the signs of carer strain in colleagues may not always be easy. Signs to watch out for include sleep difficulties, loss of appetite, poor concentration, performance dip, uncharacteristic errors, emotional outbursts. Maladaptive coping strategies might also be noticeable, such as increased intake of alcohol or dependency on drugs.
There are self-evaluating screening tools available that would help to recognise and confirm that professional help would be beneficial. The Hospital Anxiety and Depression Scale (HADS) was developed for use in Hospitals by Zigmond and Snaith. The original intention was to devise a tool to measure levels of anxiety and depression in patients. Some researchers have adapted the HADS tool to measure anxiety and depression in community settings and for carers. Caregiver Strain Index (CSI) is a variation on this tool which can be used to assess individuals of any age who have assumed the role of carer. The Caregiver Strain Index (CSI) can be used to assess individuals of any age who have assumed the role of carer to quickly identify individuals with potential caregiving concerns. It is a 13-question tool that measures strain related to care provision. There is at least one item for each of the following major domains: Employment, Financial, Physical, Social and Time. Positive responses to 7 or more items on the index indicate a greater level of strain and identifies individuals who may benefit from more in-depth assessment and follow-up.
Assess your own wellbeing via the NHS Choices Website Social care and support guide - NHS (www.nhs.uk) or for more information click on this link: Carers' breaks and respite care - Social care and support guide - NHS (www.nhs.uk)
Signposting carers
Referring to a local carers centre:
Establishing a relationship between the Centre and the practice is important. When this is achieved, referrals will be a quick and seamless process. A list of local carers’ centres can be found at Carers Trust | Transforming the lives of carers
Health Support/Health checks:
Most GP practices now provide access to support sessions for carers. The GP can review the physical and psychological impact on general health caused by caring for another.
Statutory Assessment of Needs:
All carers have a right to have their views considered when the person they care for is being assessed. All carers who are caring regularly and substantially are entitled to a Carers Assessment from the Local Authority. To have access to local services, most Local Authorities will require that carers have an assessment first.
Financial Advice:
Financial advice is available from local third sector agencies (e.g. Age UK), carers’ centres or the Citizens Advice Bureau (CAB) if there is no local carers’ centre. The number of the local Benefits Agency could also be useful.
Respite from Caring:
Social Services Departments may be able to arrange for, or fund breaks for carers. Alternatively, this may also be available through a carers’ centre or voluntary agency. If there is a local carers centre in the area, they may include a carers mailing list showing events and available support.
Condition Specific Information:
Carers of people with certain conditions will be dealing with issues and can contact specialist agencies related to the condition.
