Supporting Carers to Prioritise Wellbeing

This National Carers Week, we are shining a light on the role of carers in the wellbeing and lives of those they support. GPs and other Health Care Professionals play a key role in recognising and supporting carers to effectively manage their responsibilities while prioritising their own wellbeing.

While they provide vital support for those around them, carers will often struggle to prioritise their own mental health and put their own needs on the backburner. These are some strategies that GPs and other Health Care Professionals can employ to encourage carers to prioritise their wellbeing and connect carers to support.

Identify ‘Hidden’ Carers

While carers are often parents, spouses, or adult children, many carers won’t fit these roles and may not even identify themselves as carers or recognise they hold that role. Young carers (people with a caring role who are under 25) and carers who don’t have a family connection may not recognise themselves as carers and miss out on support and advice that they may need. Briefly asking patients questions like:

Is there anyone else you want involved in your care?
Who helps you manage your health day to day?
Do you have someone who helps you with tasks like managing your medication, cooking, or getting to appointments?
Is there anyone who helps you with personal care activities like bathing, dressing, or mobility?
Who do you rely on most for support when you’re not feeling well or need help at home?

Can help you identify who may play a carer role in the patient’s life. Simply identifying the person as a carer, and providing them with the language to understand and express their role in your patient’s life can encourage previously unidentified carers who may be struggling to reach out and seek resources and support they may not have realised they are entitled to.

Offer acknowledgement of their efforts

Carers provide a great deal of support that makes a huge difference to the lives of those that they are supporting. However, carers can often go unnoticed, and the focus of medical care is often focused appropriately on their loved one. Getting acknowledgement for the positive role their care is playing in the life of their loved one, and the impact of their care on the wellbeing of their loved one, from their loved one’s medical team, can go a long way in boosting the wellbeing of carers and build relationships that open the door to carers discussing their own needs. Let the carer know that you appreciate the vital role they play in the patient’s life. Acknowledgment goes a long way in making carers feel valued and supported.

Ask!

The focus of care is usually on the person who is presenting with the healthcare needs, and many carers may not have been asked about how they are managing. Research suggests many people, particularly men, are keen for an opportunity to talk about their mental health but are afraid of burdening others, judgement or simply don’t feel they have the opportunity to raise it. Finding a private space to directly ask how carers are managing can be the opportunity that some people are looking for to be connected to support.

Reduce the Stigma and Validate

Recognising their own needs, and the challenges in the caring role can create a lot of difficult emotions for carers. Carers often report feeling a sense of guilt or shame about admitting the challenges of the caring role or may be afraid that others will perceive them as seeing their loved one as a burden, and worry about being a bad parent, spouse, child or friend for admitting the challenges they are facing.

Asking directly about their wellbeing in a way that reduces the stigma can help carers to open up about the challenges and their wellbeing. Asking open-ended, validating questions such as:

“A lot [parents/spouses/children/friends] we see here talk about how overwhelming caring for someone can be at times. How are you doing?”
“It sounds like you do so much for your loved one. How do you feel about everything you’re juggling right now?”
“I can see how much you care about [your loved one]. Seeing someone we care about struggling [or being ill] can take a real toll. How are you holding up?”
“I wanted to let you know that this is a space for you as well as for your loved one. How are you managing with everything?”

Asking direct questions like this, and listening without judgement, is one strategy that may assist in helping carers to focus on their own wellbeing. Carers may also need some validation, support and encouragement from you to prioritise their wellbeing. Carers may express feeling that they are letting down their loved one or being ‘selfish’ validating this while highlighting the importance of self-care can help carers engage in self-care and support services.

Involve them in their loved ones’ care

Carers usually hold a lot of valuable information about what is happening for their loved one, and how their health is progressing. Carers also experience a lot of fear and will often feel unsure about what day to day changes in their loved ones’ condition means, what might constitute an emergency, and what to do if an emergency arises. While carers may be struggling with these issues, they may be afraid to raise it, or not have been afforded a forum to discuss their concerns. Spending time with carers in longer appointments or making time in appointments to discuss their loved ones’ condition, what it means for them and their loved one, red flags, and how to escalate their care, can assist in managing the anxieties of carers, and help them to feel that their concerns are heard.

Start small and troubleshoot

The caring role can be all-encompassing, and carers frequently struggle to have time to look after themselves. For some carers, finances may be an issue. Thinking about looking after themselves can feel overwhelming. Assisting carers to start small in looking after their wellbeing can help them have a sense of control. Rather than feeling overwhelmed with all of the things they need to do to look after themselves, encourage carers to start small with their self-care, with things such as:

Scheduling a doctor’s appointment for themselves at the same time as their loved one
Take micro-breaks of a few minutes away from their caring responsibilities to take a breather
Engaging in small joyful activities liking listening to their favourite music, or putting an audio book on when they are travelling
Establishing a relaxing bedtime routine
Doing regular stretches or walks
Calling a friend or loved one for a chat

Some carers may also not be aware of what resources may exist to assist them in taking a break, such as respite or home help services. Connecting or educating carers about services that may assist them to manage their caring responsibilities can also go a long way in encouraging carers to look after themselves.

Use non-clinical language and metaphors to make referrals

Carers sometimes will need to be referred to specialist programs or services help to manage their wellbeing. Some carers may be reluctant to accept referrals and feel that they are ‘making a fuss’. Using non-clinical language, validation and metaphors when making referrals, is one strategy that may assist in connecting carers to services.

In particular, research has shown that male clients are more likely to connect to mental health services when they are referred to as specific programs or using non-clinical terms such as ‘coaching’ or ‘strategies ’.

Using non-clinical, solution focused language has been shown to increase the likelihood of engagement with mental health referrals in some clients. Some phrases include:

“Caring for someone else can be really challenging. Can I connect you with a counsellor who I think can help coach you through this?”
“There is a program that helps people manage some of the same things that you are going through. Can I make a referral for you?”
“It sounds like this has been really tough for you. I’d really like to connect you with a counsellor, who can help with some strategies to help you navigate this.”
“This sounds really hard. Sometimes, you just need someone to talk to. A counsellor can be someone who’s not involved in the situation who can just listen. What would you think about me making a referral?”

Cost, and time can also be a barrier. Consider low-cost or free clinics that are able to offer telephone, video or after-hours appointments. It might be worthwhile if a carer would prefer to be connected to a carer specific program, if they have a preference about their practitioner such as gender, or what locations and times might be feasible for them to connect with someone.

Resources

GPs and other Health Care Professionals can also consider connecting carers to carer support services and groups, to help them to access carer-specific support and social support from others in similar circumstances. Some carers resources include:

Carers Gateway, carergateway.gov.au
Carers Victoria, https://www.carersvictoria.org.au/
Carer Help, https://www.carerhelp.com.au/
Young Carers Network, https://youngcarersnetwork.com.au/

About The Cairnmillar Institute:

The Cairnmillar Institute (CMI) is a leading not-for-profit centre for psychological services, education, and research. Dedicated to promoting Better Mental Health™, CMI offers a range of high-quality psychology and counselling programmes that focus on evidence-based treatments and education. CMI is committed to making a positive impact on the lives of individuals, families, and communities by providing innovative and accessible mental health care and education. CMI also offers free or low-cost counselling to carers and has a variety of practitioners available for appointments immediately across our 4 sites. Click here to request an appointment.