Assessing the mental health needs of older people
Policy on carers
- There are approximately six million family carers in the UK. Most support an older spouse or parent.
- Recent legislation has placed considerable emphasis on assessing the needs of, and providing support to, carers - particularly those looking after a relative with dementia. Specifically:
- The Carers and Disabled Children Act 2000 gives local authorities discretion to meet carers needs with any service that will genuinely help them to continue to care and maintain their well-being. It also empower local authorities to make direct payments to carers.
- The Carers (Equal Opportunities) Act 2004 extends carers' rights to receive as assessment, access social care services and direct payments, and obtain support from health services if the carer's ability 'to provide care might be enhanced by such services'.
There are approximately six million family carers in the UK. Most support an older spouse or parent. A quarter are older people themselves, primarily spouses. Since the NHS and Community Care Act 1990, the contribution that carers make to supporting elderly and disabled people in the community has been increasingly recognised and responded to. Even in policies that do not directly address the needs of carers, their role is identified as important. For example, the National Service Framework for Older People states that: 'carers needs should be considered as an integral part of the way in which services are provided for older people'. (61)
There is particular recognition of the needs of the significant number of carers of people with dementia; it has been estimated that 75 per cent of all those people with moderate to severe dementia living in the community have a family carer. Caring for a person with dementia is widely evidenced as highly physically and emotionally stressful, and for some it results in the development of mental ill health, particularly depression.
In addition to enhancement of the local authority's duty to assess the needs of carers (see Section 5), recent legislation enshrines the rights of carers to access services. The Carers and Disabled Children Act 2000 has given the local authority discretion to meet carers' needs with any service that will genuinely help them continue to care and maintain their health and well-being. This gives much greater scope to be flexible and innovative in the way that support is provided to carers. The Act also empowers local authorities to make direct payments to carers to meet their own needs and to provide voucher schemes for short-term breaks to allow carers the flexibility to manage their own package of support.
The Carers (Equal Opportunities) Act 2004 builds on existing rights.
In summary these are:
- The right to an assessment - carers who provide regular and substantial care are entitled to a carer's assessment, which will look at their needs as a carer.
- The right to services - carers can also receive services in their own right under the Carers and Disabled Children Act 2000.
- The right to intermediate care - carers can receive free intermediate care services, and equipment up to the value of £1,000, for up to eight weeks following the discharge of a patient.
- The right to request direct payments, cash payments in lieu of social care, and vouchers in lieu of break services.
The Act aims to extend carers rights by:
- Giving carers new rights to information - Section 1 of the Act places a duty on local authorities to inform carers of their right to a Carer's Assessment when that authority is assessing the needs of a disabled adult.
- Ensuring that work, life-long learning and leisure are considered when a carer is assessed - Section 2 of the Act will mean that when a Carer's Assessment is being completed, it must take into account whether the carer works or wishes to work, any courses the carer is taking or wishes to take, and any other leisure activities the carer undertakes or wishes to undertake.
- Giving local authorities new powers to enlist the help of housing, health, education and other local authorities in providing support to carers. Section 3 states that if a local authority requests another authority to plan services, that authority must give that request 'due consideration'. Of particular relevance to carers of older people with mental health problems is the potential for the local authority to request services to be provided by the local primary care trust or health trust if the carer's ability 'to provide care might be enhanced by such services'.
Carers UK provides clear and accessible information on legislation relating to carers and their rights, and services for carers.
The Department of Health booklet Who cares? Information and support for carers of people with dementia is also available online.
For information and advice for carers of people with dementia, see the Alzheimer's Society website.
The government has published explanatory notes on the Carers (Equal Opportunities) Act 2004.
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