Carers identified?

Recommendations

Page last updated: 2010

The recommendations have been grouped according to the following headings.

Draft identification policies and protocols

The following policies and protocols to identify carers during all stages of care be distributed widely to public and private sector mental health services for comment and feedback on the feasibility of introduction on a progressive basis.

Policies

Identification and participation of carers in a partnership approach will be acknowledged and respected as crucial to the facilitation of early intervention, treatment and recovery of people with a mental illness.

Carer identification and levels of participation in ongoing care will take account of social and cultural differences and will be reviewed with consumers and carers on a regular basis.

Carer levels of identification and satisfaction with their engagement will form part of the regular reporting of all mental health services.

Protocols

Identification of carers in primary care settings

  1. The following protocols to identify carers be discussed with the Royal Australian College of General Practitioners (RACGP) for consideration during the 2010 review of Standards.
    • Provision of general information encouraging self identification on electronic and paper notice boards including posters and leaflets.
    • New Patient Forms to identify carers.
    • Utilise normal practice appointment consultations.
    • Practice newsletters to feature articles regarding carers.
    • Utilise patients' personal health checks to identify if they undertake care for another person.
    • Have a named member of staff responsible for maintaining the practice's procedure for identification of carers – a carer specialist or champion.
  2. Medicare Australia be asked to consider the placement of messages to assist with the identification of carers on benefit cheques issued during Carers Week held annually in Australia.
  3. Pharmacists be asked to consider the placement of messages to assist with the identification of carers on all folders containing repeat prescriptions during Carers Week held annually in Australia. Top of page

Identification of carers in assessment settings

  • Generic information encouraging self identification by carers be provided in waiting areas on electronic and paper notice boards including posters and leaflets.
  • New patient questionnaire data systems be expanded to include carer identification by a series of questions phrased in a positive manner designed to encourage consumers to recognise who their carers are and the importance of their ongoing contribution.
  • Triage processes ask appropriately worded questions emphasising the positive aspects of family/carer participation in all aspects of care.
  • Interviewing doctor/nurse ask appropriately worded questions to determine identification of carers and their level of involvement.
  • A specific member of staff be allocated responsibility for maintaining procedures for identification of carers – a carer specialist or champion.
  • Information packs be provided for both consumers and carers that include rationale and encouragement for identification of carers.
  • 'Carer corners' be established in waiting rooms.
  • Identification of Carers during Formal Admission to a Public or Private Mental Health Service.
  • Generic information encouraging self identification by carers be provided in waiting areas on electronic and paper notice boards including posters and leaflets.
  • Colour coded forms inviting consumers to identify carers and nominate the level of involvement be included in all admission procedures. Forms to be completed as soon as practicable and audited on a regular basis.
  • In circumstances where a consumer refuses to identify their carer(s), the Mental Health Service will review this status at regular intervals during the episode of care in accordance with Australian and state/territory jurisdictional and legislative requirements.
  • A specific member of staff be allocated responsibility for maintaining procedures for identification of carers – a carer specialist or champion. This may be a carer consultant/liaison officer/family support worker with the following responsibilities. Top of page

Staff support and training

  • Liaison point between staff, consumers and carers, for example, assistance with completion of admission protocols regarding identification of carers; advocacy for individual carers with staff/services.
  • Information and linkage to alternative options for information and support for carers such as referral to carer support organisations.
  • Provision of carer specific perspectives to staff meetings.
  • Assistance with carer assessments.
  • Specific point of contact following discharge for carers.
  • Ensure accreditation and reporting systems in health and community sectors incorporate the National Standards for Mental Health Services and, in particular, Standard 7 relating to the identification and participation of carers at all areas in service delivery.
  • Consumer information packs to include a rationale and encouragement for identification of carers, including the identification of children who are carers.
  • Services to report on the provision of information packs to carers.
  • Staff to receive 'carer sensitivity' and skills development training. Top of page

Identification of carers during discharge processes

  • Generic information encouraging self identification by carers be provided in waiting areas on electronic and paper notice boards including posters and leaflets.
  • Colour coded forms requesting consumers to identify carers and the level of involvement they want them to have be checked for completion.
  • Ensure carers have personalised information packs including:
    • Diagnosis;
    • Medication – dosage, purpose and possible side effects;
    • This is what you can expect;
    • Who to contact to discuss concerns; and
    • What supports are available to you locally, eg your GP, Carers Australia, ARAFMI.
  • Encourage the routine identification of carers, including children, in the development of relapse prevention plans emphasising the benefits of information sharing and support.
  • A specific member of staff be allocated responsibility for maintaining the Service's procedure for identification of carers to inform carers of continued points of contact for information and support.
  • Ensure accreditation and reporting systems incorporate the National Standards for Mental Health Services and in particular Standard 7 relating to the identification and participation of carers at all areas in service delivery.
  • Discharge letters, with the permission of the consumer and the carer, to identify carers, their willingness to continue in this role and an outline of potential support required.
  • Services to undertake regular satisfaction surveys regarding their level of engagement with carers. Top of page

Identification of carers in continuing care settings

  • Relapse prevention plans to emphasise the benefits of information sharing and support and contain a specific component for identification of carers. Carers need to give permission for their names and contact numbers to be included in the Plan.
  • Encourage the identification of carers in the development of Advanced Directives.
  • Ensure the development of Ulysses Agreements in situations where children are carers.

Information brochure for families and other carers

  1. The Information Brochure contained within the report:
    • be edited to a 'plain English' format; and
    • be edited by a graphic designer for transmission by email and to be web based; to enable wide distribution nationally to carers for consideration and feedback.
  2. The revised brochure be published in hard copy and placed on the DoHA website for national use.Top of page

Good practice checklist

The following 'good practice checklist for identification and engagement of carers' be adopted nationally by public and private services.
Carer identification and engagement - a good practice checklist for staff
Choice
Allow carers time to make choices about:
  • Taking on the role of carer;
  • Whether to continue caring; and
  • How much and what type of care, taking into consideration family and caring commitments, health, work education, social activities
Identification
  • Throughout the service admission and discharge process and at the earliest opportunity, ensure there are triggers in place to identify carers.
  • Be aware that carers may not view themselves as carers but as partners, parents, sons, daughters, etc.
Information
Actively seek permission from consumer to share information with the carer and provide carers with information about the following.
  • Discharge plan in writing and verbally.
  • Medical condition of consumer.
  • What is likely to be involved in caring
  • Benefits.
  • Financial implications of caring.
  • Other sources of help and other organisations, such as Carers Australia and self help groups.
  • Access to interpreters to enable effective understanding and communication.
  • Challenging decisions and complaints procedures. Top of page
Assessment
Involve carers in assessments, including those carried out by allied mental health professionals' and community nurses.
Planning for future service delivery
  • Ensure carers feel fully involved at all stages of service delivery including the decision to discharge the person and making sure practical arrangements are in place
  • View carers as partners, respect and listen to their views – longer term carers are likely to have considerable expertise and skill in how to care for the consumer
  • Acknowledge carers' individual needs, consider cultural differences, age, race, disability, health, religious background, sexual orientation, gender assumptions, geography
  • Ensure carers have been involved in drawing up, monitoring and reviewing policy and its implementation
  • Develop different types of consultation procedures
Support
  • Be flexible: provide services that carers want, when they want them
  • Ensure practical help is in place prior to discharge
  • Offer information on how to care safely: e.g. administering medications, dealing with difficult behaviour
  • Improve co–ordination between health and Centrelink and other government agencies to ensure carers receive a seamless service
  • Refer carers to support groups Top of page
Monitoring
Find out whether carers' outcomes were met by the service delivery process.

Methods of carrying this out could include:
  • Carer satisfaction surveys;
  • Audits of discharge documentation provided to carers;
  • Carer outcome measures; and
  • Review policies regularly in consultation with carer consultants, Carers Australia, ARAFMI etc.