Caring for Carers

Article | Dr Marie Anne Essam, Clinical Lead and Ambassador for Social Prescribing

What is a ‘Carer’?

Informal carers – often family members, sometimes friends and neighbours – are the backbone of support for many vulnerable adults and young people. Some of these people will be officially recognised by social and medical services, their names recorded as a ‘go to’ in the event of a crisis; many just get on with it, and don’t even see themselves as providing mission-critical compassion, company and assistance for the person in question. A badge they sometimes prefer to wear is quite simply, “I look after someone”.

Caring Affects Health

Caring is now recognised as a ‘social determinant of health’ by Public Health England. This means there is evidence to show that what anyone who cares, and anyone who cares for carers, will tell you is true: caring can detrimentally affect your health.

Pouring yourself out on behalf of another, having your phone handy 24/7 in case you’re needed, and making sure not only your own affairs but also those of another are attended to can be wearing. Musculoskeletal aches and pains can result from lifting and manoeuvring. Lack of sleep undermines many aspects of our health. Worry, stress and social isolation affect our mental wellbeing.

There are joys and privileges associated with the trusted role of carer, and I do not mean to take away from that.

This article aims to draw attention to the immense personal effort and cost that caring can involve, and to be a reminder to all of us, in any public arena, to look out for carers as well as the people they bring to appointments.

A True Story

I remember well a gentleman I met in the practice, who brought his disabled wife, in her wheelchair, to see me. I tried to engage him in a conversation about his own health, as he looked incredibly exhausted. “I’m just the pusher,” he replied. It took three visits for him to give in and let me take an interest in him too. And the result was transformational.

He accepted a Social Prescribing referral (read more about this in my previous articles for BSA Today) and the link worker not only supported his wife, but also gave him the time he needed to reprioritise his own health. He gave up smoking, he asked me to refer him for pulmonary rehabilitation for his chronic obstructive pulmonary disease, and he welcomed the help of a local charity that provided a volunteer to come and sit with his wife so he could have some time off.

The outcome was amazing. He stood up tall, smiled, joked and developed an admirable resilience, which proved essential as his lovely wife grew sicker and sadly passed away.

When I spoke to their daughter a couple of years later, after ‘my’ gent also died, she reflected that her dad had come back to life when he’d received care as a carer for her mum, and they’d enjoyed better quality time together despite the challenges.

A Call to Action

What can you do? Lots of things!

• As a Carer - Take a moment here to know you are appreciated. Thank you for your incredible, selfless, intuitive, compassionate, multi-tasking efforts on behalf of another. And do let your boss, your GP, your local social services, your Jobcentre and your local voluntary groups know that you are one of our very special people.

• All of Us - Ask if people care, and if they do pop an easily spotted alert on their record. Refer or signpost them to local or national carers’ charities. For more information, see the Help and Advice section of the Carers UK website.

• As an Employer - Know who has caring responsibilities, even occasionally, and be flexible and supportive as needed.

• As a Service Provider - Know who your carers are and be adaptable about appointments for both the carer and the person for whom they care. Life can be a juggling act and your understanding can make all the difference.

• In Health Services - Consider carers’ health checks and give them first refusal on flu jabs and so on.

• As a Business - Invest in groups and initiatives in your local community that support the very people for whom your employees and customers care. The fact that you recognise that employees have family and friends whose lives matter goes a long way in establishing a corporate social responsibility brand which sets you above your competitors.

• As an Observer - Look out for opportunities to recognise and applaud a carer. The mum of a child with significant invisible diagnoses who is embarrassing her in a supermarket queue will be blessed by your quiet “Well done” and warm smile when she’s used to receiving disapproving looks. Help a shopper who is pushing a wheelchair with their bags to the car. Give up your place in the line for the loo, or a seat in a café.

• As a Professional - Give carers the space to tell you how they are and be aware that, just occasionally, you will be the one to pick up on a possible adult or children’s safeguarding situation, because these tough human relationships don’t always go right. Watch for carer stress syndrome: burnout. It has surprised me how extreme that can be, when someone has given away so much of themselves that they are at risk of being very emotionally unwell.

Caring Through COVID

In Hertfordshire, I’ve been privileged to participate in carers’ forums, when we asked carers how we were doing as professionals (health, social, mental health and voluntary sector) caring for them. We had three groups: adults who care for adults, parents who care for children with special educational needs, and young carers who have in their home a parent or sibling with additional needs. It was humbling to hear how tough the pandemic had been for them.

Some explained that they’d had a contingency plan for everything – except a pandemic. Some parents felt relieved they did not have to navigate public transport to specialist appointments for their child, although they did wonder how much was lost in a ‘telephone review’.

Many carers were frightened – about infection, about supplies, about public services unable to provide the previous level of input for their loved ones. Relatives of those with worsening long-term conditions, dementia or mental health were phenomenally overstretched.

A Little Bit About a Lot of Help Available

Local branches of Carers UK provide advice, counselling, mentoring and advocacy for carers. There are groups for carers of every kind, including young carers, who are encouraged to connect with each other and enjoy some recreational time together.

These young people are mature beyond their years, and they’re a great treasure to their families and the society in which they grow up. Their schools and colleges need to understand and make allowances for them so they can fulfil their potential as well as caring.

Emergency breaks for carers are available in some areas, as are befriending and ‘sitting’ services. Many areas have a ‘carers’ passport’, which gives carers priority access, discounts and so on. It’s also a simple way of showing strangers and officials when you are in fact ‘on duty’.

In Closing

In my work as a GP, and as a clinical lead for social prescribing and carers with my local clinical commissioning group, it never ceases to amaze me how much we rely on the goodwill and commitment of carers. We need to do everything in our power to recognise them and support them.

Thanks to you all for reading this, and for the difference you make

Dr Marie Anne Essam

Clinical Lead and Ambassador for Social Prescribing

Dr Marie Anne Essam is a GP in Hertfordshire and works widely to develop and support social prescribing with regional, national and international development of the link worker role.

Contact her on info@equiptoempower.co.uk and be sure to follow her on Twitter: @marieannedoc.