Christina Aggar

PhD candidate

The impact on informal carers of a community based multidisciplinary intervention for frail older persons

Supervisors: Ian Cameron and Sue Ronaldson

As a result of current trends in health and social care policies(1), the increasing emphasis on the shift from institutionalised care to home-based care has implications for informal carers and community nurses. In the context of aged care in the community setting, nurses are required to provide high levels of intensive and complex care for chronic and acute conditions as well as providing support to the informal carer(2,3).

Informal support is an important part of the total care provided to frail older people and essential to the implementation of patient interventions(4,5). Multidisciplinary home-based interventions for frail older people are increasingly being implemented and evaluated and whilst it is widely recognised that care giving can have adverse effects on the caregiver’s physical and mental health(6), examination of informal carers’ experience is rarely considered in the evaluation of patient interventions. As the population ages, the role of the informal carer will become more significant and so a concern for their well-being and provision of appropriate support is of importance, particularly in terms of them maintaining their role and quality of care for the frail older person(7).

The aim of this study is to compare the effects on informal carers of a community based multidisciplinary intervention to the usual care of frail older persons living in the community. A cohort study of informal carers of older people who are participating in a community based multidisciplinary intervention to facilitate a reduction of their frailty and help them remain in the community will be undertaken. A background questionnaire delivered at baseline will determine socio-demographic characteristics, care giving tasks and care duration. The impact on informal carers will be measured using three validated assessment tools(8,9) developed to assess various dimensions of the care giving experience including changes as a result of care giving, caregivers in need of intervention and anxiety and depression levels. Measures will be gathered at baseline, 6 months, 12 months and a follow-up at 15–18 months. An opportunity to discuss care giving experience in a semi-structured interview will be offered to carers at 12 months following the baseline questionnaire.

Significance

Evaluation of the impact on informal carers of a community based multidisciplinary intervention will increase our understanding of aspects of their care giving by providing insight into carers’ perspectives, highlighting complexities and daily realities of care. It is anticipated that the findings of this study will facilitate nursing initiatives and strategies to support and help identify at risk informal carers of frail older people, enabling them to continue in their caring role.

It is also hoped that my research will raise the profile of informal carers of frail older people and create an awareness of their care giving situation and to provide direction for future nursing research towards establishing more detailed information on informal carers’ experiences of patient interventions.