Psychosocial support for carers in palliative care
Healthcare professionals can support carers by encouraging them to take care of themselves, training them to care for the patient, assisting them with practical matters, and providing (or facilitating) emotional and spiritual support if needed. Good communication with healthcare professionals is very important to carers; they are part of the care team and should be kept informed of what is happening with the patientMitchell, 2013.
Encourage carers to take care of themselves, and to:
- take adequate rest, and exercise
- maintain social contact with family and friends
- accept help from others including family, friends, and nursing and community services, sometimes with the aid of a roster
- set up self-protective rules (eg limiting visitors to certain periods of the day, limiting the length of visits, avoiding answering phone calls at designated times)
- schedule regular time-out to participate in activities they enjoy
- find and accept respite care for the patient before the burden of care becomes too greatChristakis, 2003.
Healthcare professionals can offer practical support to carers by:
- assisting them to access information (see Resources for carers in palliative care)
- facilitating advance care planning for the patient
- encouraging them to ensure the patient’s financial and legal documents are in place, such as an enduring power of attorney (or similar) for financial matters, and a will
- helping them to apply for financial assistance
- teaching them practical skills (eg nursing care, including managing medications and subcutaneous drug administration)
- arranging nursing and other community support services, including volunteers
- organising respite care; all carers should be encouraged to register with their local carers association to find out what support is available
- helping them to prepare for the patient’s death, including making funeral arrangements (see Preparing for the last days of life).
Encourage carers to talk about their feelings with someone they can confide in, for example, a family member, friend, counsellor or support group. A carer with a higher level of distress may benefit from periodic consultations with their general practitioner, psychologist or counsellor. Another option may be early referral to a specialist palliative care service that offers specialised psychosocial supportNijboer, 2001. Carers may be eligible for Medicare-supported consultations through a Mental Health Treatment Plan.
It can be helpful to give a carer the opportunity to discuss existential or spiritual concerns that have arisen while caring for a patient with palliative care needs. Drawing on what has generated meaning and provided comfort in the past can be helpful for both patients and carers. Carers may wish to discuss these issues with pastoral care staff.