Barriers and facilitators determining carer support subsidy usage by carers of older people in Northland, New Zealand.

Abstract

There are various support systems available for carers in their diverse and significant roles. With the increasing population of older people, support service use needs to be reviewed to confirm it is meeting increasing needs. To avoid carer burnout or carer stress it is extremely important to allow carers adequate time out from their caring roles. The Ministry of Health provides a ‘carer support subsidy’ to enable full-time carers to have a break (Ministry of Health, 2013). Evidence-based studies examining carers’ issues and support system reviews are rare in New Zealand compared with other countries (Jorgensen, Arksey, Parsons, & Jacobs, 2009). Therefore, understanding carers’ experiences with the carer support subsidy and determining the barriers and facilitators that influence the use of the subsidy may help to improve service provision. This study used a qualitative approach to determine these barriers and facilitators and applied the interpretive method to understand the factors influencing the use of the carer support subsidy. Purposive sampling was selected for this study and participants in the NDHB area who had currently been allocated a carer support subsidy were selected. Eight semi-structured interviews were conducted and the transcribed interviews were analysed using a general inductive method to generate themes. The major themes that emerged regarding the barriers experienced by carers of older people in using the carer support subsidy were information, self-reliance, service and support systems. The major themes that emerged with regard to the facilitation of use of carer support were support systems, service delivery and openness. Support from family and community directly links with subsidy use and enhances it. Service providers being supportive and having adequate knowledge about the services also has positive effects on subsidy use. Being open about their needs and actively seeking help allows carers to use the carer support subsidy effectively. Recommendations for health professionals and service systems are: improving information delivery; providing easy access to support; using clear and transparent processes; and improving understanding by health care professionals of carers’ needs. When developing strategies for this subsidy, more emphasis needs to be given to the improvement of understanding in the community about carers, their needs and the importance of taking breaks.