Age and Ageing Advance Access originally published online on May 18, 2006
Age and Ageing 2006 35(4):444-445; doi:10.1093/ageing/afl032
© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Do carers’ needs assessments make a difference? Results from the Forget me not study
SIR—The National Strategy for Carers (NSC) [
1] made commitments
that carers would have better access to information, care and
support. Subsequent legislation [
2] gave carers the right to
request a separate assessment of their needs and indicated that
the UK government ‘sees carers assessments as the gateway
to providing services to carers and wishes to see an increase
in their uptake’ [
2]. It is not known whether the introduction
of needs assessments has improved carers’ access to information,
care and support [
1]. Keely and Clarke [
3] found that only half
of 2,790 carers surveyed had heard of carers assessments, only
a quarter had received an assessment and only 14% said that
the assessment made a difference to them. Staff have also expressed
concerns that assessments might raise carers’ expectations
when no additional services are available and are time consuming
with no tangible outcomes for caregivers [
4]. This study used
local carer surveys and local service evaluations, across England,
to investigate whether the local provision of carers’
needs assessments were associated with better access to information,
care and support.
 |
Method
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In the Forget Me Not report 2002 [
5], the Audit Commission reported
a national study of older people’s mental health services
in 70 areas across England, which included (i) local service
mapping and (ii) a postal questionnaire survey of 5,391 carers,
identified via local statutory services and the Alzheimer’s
Disease Society. The local service mapping involved staff interviews
and resource mapping to identify a range of services available
and carers’ needs assessments. The postal questionnaire
comprised questions and statements about the help and information
carers were receiving (Table
1). Carers’ responses to
the seven survey items, which related to carer information,
care and support, were then compared between those areas which
had carers’ needs assessments and those that did not,
using univariate ANOVA tests.
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Table 1.. Carers’ responses to the postal questionnaire items about the help they had received/been offered (n = 5,391 carers)
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Results
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Access to information, care and support varied widely across
geographical areas (Table
1). For example, the proportion of
carers who had been told what help was available varied between
22 and 91% depending on the area surveyed. In some areas, only
a third of carers had been asked whether they needed any help,
only one in five had been told what was available, and in some
areas, none of the carers said they knew how to make a complaint.
Assessments of carers’ needs were available in 68.6% of
areas. Carers in areas where needs assessments were provided
were significantly more likely to say that they were asked whether
they needed any help (
F = 8.18,
P = 0.006), told what help was
available (
F = 12.55,
P = 0.001) and whether it would need to
be paid for (
F = 9.96,
P = 0.003), told about benefits (
F =
7.76,
P = 0.008), told how to complain (
F = 7.81,
P = 0.007),
introduced to someone whom they could contact if they were worried
(
F = 5.11,
P = 0.03) and that they were currently receiving
all the help they needed to have a break (
F = 6.73,
P = 0.01).
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Discussion
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In many parts of England, carers only have limited access to
adequate information and support. Carers in areas where there
were separate assessments of their needs had better access to
information, care and support, suggesting that these assessments
help deliver the key aims of the NCS [
1]. This study, the first
to examine the impact of UK carer needs assessments, indicates
that they provide tangible benefits for carers, and this lends
support to their broader implementation. As unmet needs have
been associated with caregiver burden [
6], carer needs assessments
may also help reduce carer burden and distress.
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Key points
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- Provision of carers’ needs assessments is a key part of the UK government policy.
- In some areas, only a third of carers were asked whether they needed any help.
- Carers’ needs assessments were available in nearly 70% of areas.
- Areas with carers’ needs assessments provided better access to information, care and support.
Martin Orrell1,*,
Claudia Cooper2 and
Sally Braithwaite3
1 Department of Mental Health Sciences, University College London, 48 Riding House Street, London W1W 7EY, UK Tel: (+44) 1277 302736, Fax: (+44) 1277 302739. Email: m.orrell{at}ucl.ac.uk
2 Department of Mental Health Sciences (Hampstead Campus), University College London, Rowland Hill Street, London NW3 2 PF, UK
3 North East London Mental Health Trust, Mascalls Park, Mascalls Lane, Brentwood, Essex, CM14 5HQ, UK
* To whom correspondence should be addressed
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Acknowledgement
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Thanks to the Audit Commission, and to the carers.
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References
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- Department of Health. A National Strategy for Carers. http://www.carers.gov.uk/pdfs/Care.pdf (1999) (Accessed 5 August 2005).
- Department of Health (2005) Carers and Disabled Children Act (2000) and the Carers (Equal Opportunities) Act (2004) Combined draft policy guidance. http://www.dh.gov.uk/assetRoot/04/10/23/31/04102331.pdf (Accessed 5 August 2005).
- Keely B, Clarke M. Carers speak out. Report on findings and recommendations. http://www.carers.org/barclays/Findings.pdf (2005) (Accessed 5 August 2005).
- Seddon D, Robinson CA. Carers of older people with dementia: assessment and the Carers Act. Health Soc Care Community 2001; 9: 151–8.[Medline]
- Audit Commission. Forget me not 2002: developing mental health services for older people in England. London, 2002. http://www.auditcommission.gov.uk (Accessed 5 August 2005).
- Nankervis J, Schofield H, Herrman H, Bloch S. Home-based assessment for family carers: a preventative strategy to identify and meet service needs. Int J Geriatr Psychiatry 1997; 12: 193–201.[CrossRef][ISI][Medline]
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