Carers

Question 1

Define care

Answer 1

Set of tasks- helping with personal hygiene, continence management, help eating, mobility, advice, personal assistance
Can be emotional love and concern
Emotional commitment may be essential for the delivery of tasks

Question 2

Defining Carer:

Answer 2

A person who provides long term help to a disabled person, usually a member of their immediate family,
Extended to include social care staff, who work in residential and day care services
Now we distinguish between family careers, paid careers, and staff careers
Formal and informal care

Legal recognition in invalid care allowance 1975

Question 3

Informal care

Answer 3

Family care although can be highly organised

Question 4

Formal care

Answer 4

Paid healthcare

Question 5

Care providers

Answer 5

Family and friends of the disabled person more likely to be women than men, many in patients employment or retired
NHS divide health and social care
Local authorities provide residential, day and domiciliary care, means tested charges for services,
Often specialised charities for certain different disabilities
Private sector care- nursing homes - staff carers, abuse and neglect incidences

Question 6

Problems with staff carers

Answer 6

Neglect abuse
Poor pay due to the way the expenditure is profit based.
Poor staff recruiting
Accountability

Question 7

Care dilemmas

Answer 7

Treating someone with a serious cognitive impairment with autonomy vs ensuring they receive basic personal care
Allowing people to take risks vs protect from exploitation and danger
Allowing people to make choices vs the need to protect from poor diet, alcohol and smoking

Question 8

Who receives family care

Answer 8

Women more likely carers than men
Mostly aged between 45-62 fewer over 65
46% paid employment as well, 27% retired 13% looking after home and family
92% white 8%BME

Question 9

Problems with the term Carer

Answer 9

Many say the help and support provided is part of familial obligation
Support within families is reciprocal - disabled person may be receiving care as well as providing designating one person as the Carer is misleading
Carer suggests the person is in constant need thus incapable of leading an independent life may not be true

Question 10

Care by spouses partners

Answer 10

Feeling exposed and vulnerable, insufficient information
Changes in employment and income
Change in relationship and family responsibilities
24hour on call with limited personal resources to plan changes
Stress is greatest in early stages of disability, and toward the end of life. Associated with the number of hours engaged.

Question 11

Caring for a child

Answer 11

Parents of disabled children are from all social classes but are more likely single parents living in poverty
Caring for a disabled child is usually more time consuming and costly than other children and hence can limit parental employment opportunities and subsequent retirement income
This can have a disproportionate effect on parents who have low incomes or who are members of ethnic minorities and hence restricted in accessing local health and social services

Question 12

Care of a disabled child - other impacts

Answer 12

Stigmatisation of parents as responsible for the creation of a disabled child
Stigmatising parents as neurotic as a consequence of their child for producing such a child
Analyses of the burden for families providing care for their disabled members and the impact on the income, quality of life, and mental health of family members
Recognition that families are diverse, flexible and capable of adaptation to unforeseen events such as the birth of a disabled child and the care of a disabled adult

Question 13

Young carers

Answer 13

Personal care domestic work, and translating
Can suffer isolation from own age group less education
Worry and stress common

Question 14

Elder neglect

Answer 14

Carers can have problems
Dementia patients left at home all day
Household too much alcohol consumed
Carers who get angry at the burden of caring
Dementia patients who are violent to carers
Carers can’t meet the needs of the patient
Older people living with a Carer who has a severe personality disorder

Question 15

Official support for carers

Answer 15

Financial support 
Respite care 
Domiciliary support 
Social and psychological interventions 
The national caring and confidence training scheme

Question 16

Warrior carers

Answer 16

Access to services often depends on family carers skill in acting as an advocate. Those who can’t perform this role will get less access to services

Question 17

User involvement in health care

Answer 17

Making decisions about own healthcare 
Commissioning and designing services 
Teaching professionals and developing learning materials 
Staff requirement 
Evaluating services 
Governance (non executive roles)

Question 18

Making decisions - patients can play a role in their health care by:

Answer 18

Understanding the causes of diseases and the factors that influence health
Self diagnosing and treating minor self limiting conditions
Selecting the most appropriate treatment for acute conditions, in partnership with health professionals
Managing treatments and taking medications appropriately
Monitoring symptoms and the effects of treatment
Being aware of safety issues and reporting them
Learning to manage the symptoms of chronic disease
Adopting healthy behaviour to prevent the occurrence or recurrence of disease.

Question 19

Health literacy

Answer 19

The ability to make sound health decisions in the context of everyday life - at home, in the community, at the workplace, the health care system, the market place, and political arena

• functional arena
• interactive skills
• critical skills

Question 20

Key objectives of health literacy interventions

Answer 20

To provide info and education
To encourage appropriate and effective use of health resources
To tackle health inequalities

Question 21

Patient input

Answer 21

Patient shares the decision making but also the responsibility and risks of the decision

Question 22

Self management self care

Answer 22

Enables patients

1) manage their illness medically - for example taking medication or adhering to a selfish diet
2) carrying out normal role and activates
3) managing the emotional effect of their illness

Question 23

Self efficacy - bandura

Answer 23

An individuals belief in their capacity to learn and perform a specific behaviour
Confidence and ability is key to empowerment and motivation
Interventions for self care: building confidence and equipping patients with knowledge and skills

Question 24

Self management done by

Answer 24

Well trained clinicians, nurses, pharmacists
Patient empowerment techniques
- coaching 
- prompt cards 
- diaries or topic lists 

Decision aids give patients a more accurate depiction risk

Question 25

For an effective patient-professional partnership you need:

Answer 25

An understanding of the patients perspective
Ability to educate them about protecting their health and preventing reoccurrence or occurrence of disease
The ability to communicate information on risk probability
The ability to share treatment decisions
The ability to provide support for self care and self management
The ability to work in multidisciplinary teams
The ability to use technology to assist patients in becoming more engaged in their health
The ability to manage time effectively to make all this possible

Question 26

Health and social care act 2012

Answer 26

No decision about me without me
Applies to individual patient care
Applies to service development and change
Applies to local and national level
The act strengthens the collective voice of the patient

Question 27

Decision making in NHS

Answer 27

Patient involvement
There is no consensus about what public involvement means
There is fundamental difference within local health economies and between those who value work and those who remain skeptical about it
Professionals may consider public involvement to be too compromised by the lack representation or knowledge of uses or too risky because of the vulnerability of users

Question 28

Commissioning groups -

Answer 28

duties to involve patients carers and the public have to consult the public on their annual commissioning plans and involve them in any changes that affect patient services

Question 29

Health watch

Answer 29

The act provides for the establishment of health watch England
In addition there will be local health watch organisation
Practice patient involvement groups
Lay members/ advisors