Caregiver assessment of support need, reaction to care, and assessment of depression

Abstract

Like governments worldwide, New Zealand has concerns about the future provision of long term care. Deinstitutionalisation for younger people and 'ageing-in-place' initiatives supporting older people in their own homes, have increased the need for family members to provide support. However, the New Zealand government has now started to address informal carers’ needs by launching the Carers' Strategy and Five-year Action Plan and introducing the right to request flexible working arrangements for people with caring responsibilities. This article presents empirical evidence from 300 telephone interviews with carers conducted between December 2007 and August 2008. Data were collected using two well validated scales: Centre for Epidemiologic Short Depression (CES-D10) and Caregivers Reaction Assessment (CRA). Carers were also asked open-ended questions regarding their support and additional help needed. Analysis of participants’ scores on CES-D10 and CRA, showed significant correlation (p=<0.001). Carers between 30 and 59 years had the three highest stress and depression scores. The condition of the care-recipient appeared consequential, in the sense that carers of people with certain conditions (e.g. ADHD and autism) scored highly on both CES-D10 and CRA, indicative of high levels of both depression and stress. Carers commonly discussed the adverse effects of care-giving on identity, lifestyle, health and financial situation. Lack of information and appropriate assistance from Government agencies was also a concern. Respite care was frequently singled out as inadequate. Combining work and care was difficult with part-time work the only option, though seldom within a carer's chosen field and usually at lower pay. Overall, findings show New Zealand carers experience similar difficulties faced by carers in other countries. If the government wishes to successfully pursue initiatives like ageing-in-place, more resources are needed to adequately support carers. At present, this important sector of the population is undervalued and under provided for.