Carer and Social Support Aims and Objectives: " To determine the level and characteristics of informal care provision in Australia, and its future trends. " To appreciate the social and economic contributions which carers make to the community. " To identify the benefits and burdens of being a carer " To identify the needs of carers and families of patients with chronic illness " To identify some of the available services for carers " To identify some of the barriers to the utilization of these services and how then can be overcome. Definition of a carer: " People who provide care and support for a parent, partner, child, relative or friends who has a disability, is frail-aged or who has physical or mental illness. The extent of informal care in Australia: " There are 2. 3 million carers in Australia, 600, 000 of which are primary carers (that is caring takes up the majority of their day).

" 5% of all households contain a carer. The characteristics of carers and those being cared for: " 39% of carers are "children" looking after their parents " The "child" is usually middle aged (50% 35-49, 39% 50-64), 77% are daughters, 35% are employed fulltime, 18% are employed part-time, 30% are co-resident with their care recipient, the parent is usually older than 75 years, and 80% are usually mothers. " 23% of carers look after their spouses; 69% of those are wives looking after husbands, most are co-resident, 10% work fulltime and 5% work part-time; 45% of the recipients are aged between 60 and 74 years old. " 20% of carers are parents looking after their children; 90% of those are mothers aged less than 50 looking after sons (64%) mostly aged between 0 and 14 years (50%) but a significant proportion (33%) are aged 15-29 years.

They are almost always co-resident and 35% of the mothers looking after their child are still in the workforce. The future trends of caring: " Future caring in Australia will be majority influenced by the following trends: 1. Australia's ageing population will see an increase in the number of people with chronic physical and mental illness and disabilities. 2. There is a shift of emphasis from institution to home-based care 3. There will be a decrease in the pool of family carers due to an associated decrease of fertility rates and increase in the participation of women in the workforce.

4. There is a decrease in the level of commitment within families to provide care associated with changes in the family structure, higher rates of family breakdowns and an increase in growth of step families. The advantages and disadvantages of the major health, social and economic effects of caregiving: Disadvantages: " 58% of carers have worse physical health than non carers and suffer from problems such as fatigue, back problems mainly from heavy lifting, and sleep disturbance. " More than 50% have worse mental and emotional health compared with non carers reporting greater levels of anxiety, stress and depression, greater social isolation due to the demands of caring, and a sense of loss due to the changed personality of the recipient.

" Many carers have financial problems as only 59% hold paid work and primary carers were less likely to be employed. " Carers suffer from relationship strains such as those caring for parents felt more strain with their own partners whilst caring. " Many primary carers have had to change their lifestyle due to their caring role and subsequently lost touch with friends and social support networks. Advantages: " One of the major benefits of caring includes a sense of responsibility for a loved one. Many found their role fulfilled spiritual and cultural beliefs for which they were proud of. " Caring can strengthen relationships as 33% of carers felt closer to their care recipient.

" Carers develop new skills " The health system relies on carers for optimal well being in chronic illnesses due to early hospital discharge, lack of appropriate services, and an increased reliance on hospital outpatient care. Carers save the economy around $16 billion annually and therefore reduce the demand on the health care system. The needs of carers: " Carers need better government funding to assist carers as carers use up their personal savings looking after loved ones. " There needs to be a restructuring of the Medicare system to better meet the long term needs of the elderly and disabled, and the creation of a more flexible range of options for home and community-based care.

" There needs to be better communication with professionals and better education and training that recognizes the carers emotional attachment to the patient (fear and anxiety in performing procedures on loved ones complicates learning of new tasks); programs to train could be based in hospitals, community agencies, schools and colleges, homecare agencies, managed care companies. " Carers need emotional support and advocacy to obtain needed services for their relative and themselves, and help with negotiating financial assistance (frequent denials of services and reimbursements, inconsistent interpretations of policies and eligibility). " Carers need respite through services that can tailor for their needs " Many carers want to be involved in decision making that affects the patient and themselves and they would like more follow-up at home. " There's also a need for education for professionals to include understanding the needs of family care givers (family dynamics, build communication and negotiating skills). Services and Support for carers: a.

Financial support (Carer Payment and Carer Allowance) Carer Payment o Persons who provide constant care for person who has physical, intellectual or phys iatric disability who receives a service pension or social security income support. o Paid fortnightly. Can be paid over max 63 days of respite o $429. 40/fortnight for single (358.

40 each for couple) o Income test - if couple earn $204 combined for full payment, and less than $2056 or no payment Carer Allowance o An income supplement paid to someone who provides daily care and attention to a person with a disability o Must be Australian resident (both carer and recipient) o $87. 70 per fortnight o No income test b. Services to help with caring Community care services o Gardening, cooking and cleaning, bathing and dressing Commonwealth Care link centres o New national initiative to assist anybody who needs information and contact details about community care services and aged care home in their local area. Aged Care Assessment Teams o Assess what services the person being cared for needs, and can make referrals to community care services, help access a Community Aged Care Package, aged care home or respite care. Home and Community Care o Help to continue to live at home - gardening, cleaning, home modifications, bathing, dressing, preparing meals, nursing o Commonwealth and state governments provide funds to state and non-government organizations e. g.

St Vincent's, to provide services. o Don't need a referral o Most require a small contribution of funds Community Aged Care Packages o Individually tailored packages of care services which help people with lots of difference care needs to stay living at home by coordinating the different services they need. o Also provided by a variety of organizations in the local area. o Needs to be through ACAT o Must pay - $5. 16/day (17.

5% pension) o Day Therapy Centres o Physiotherapy, occupation and speech therapy, podiatry and other therapy services Respite Care o Holiday for the carer and the person being cared for - NOT crisis care. o Commonwealth carer respite centres - information services. o Can include day care, in home respite care or residential respite care for people who intend to return to the community. o Require assessment by ACAT o Can be asked to pay maximum of $25.

08 day o Carer support groups eg Alzheimers Association. Used services % Unmet need % Not needed % Transport 24 12 64 General home help 24 13 63 Community nursing 14 6 80 Specific home help 13 11 76 Meals - on - wheels 7 7 76 Home maintenance 7 17 76 " Only a half to two-thirds of need is being met " The main reasons for not receiving a needed service were lack of knowledge, reluctance of the care recipient, or the carer was "considering making inquiries." 1/5 counseling or therapy, 1/10 training course in relation to the caring role. " 12% had used respite care of any kind in last 12 months (day care, in the home or residential) " 26% percent reported a need for respite. Lack of information and reluctance of the care recipient were the most common reasons for unmet need. " 8% belonged to carers's support group. " 93% of carers and care recipients had seen their general practitioners in the previous 6 months for problems or tests related to the care recipients conditions.

- only 16% had been assessed by an aged care assessment team. " Information about services: 25% GP, 21% allied health professionals, 20% government agencies. " 14% informal contacts, 13% medical specialists, 10% support organization, 8% media. 19% no information. ) Barriers to the utilization of services by carers: " Not seeing self as a "carer" and therefore not asking for help " Lack of knowledge that services are actually available " Professionals not knowing about or not informing carers about services " Lack of flexibility in service provision so that these don't meet the needs of some carers " Privately provided services may be too expensive to access Overcoming these barriers: " Greater public awareness of services " Early identification of the needs of carers and early intervention " Better financial aid tailored to the needs of carers.