Early caregiver identification in hospitals in Scotland: Comparison of four models

Background: There are around 6 million carers (including 175,000 young carers) in the UK, a number that will rise by nearly 60% over the next three decades. The number of people depending on personal care assistance due to illness and injury in the UK is steadily increasing. Early informal caregiver identification in hospital settings is important to provide the best training and support.

Aim: The aim of this study was to examine different models of supporting early caregiver identification in four regional Scottish hospitals

Methods: The research methods were based on Pawson and Tilley's (1997) realistic evaluation whereby the processes, contexts and outcomes were examined. A questionnaire was completed by n=389 caregivers, n= 51 hospital based health professionals filled out a second questionnaire, and n=41 key informants took part in individual interviews and focus groups. In addition, data were collected about the caregiver focussed interventions and system change efforts.

Results: The pre-post-test revealed that all service models led to an earlier identification of carers during hospitalisation. However, the mechanisms to achieve this differed between the sites. All sites emphasised the importance of staff training and the importance of having a champion to progress early caregiver identification. As a result of intensified efforts of early identification and training caregivers felt better supported, staff reported being better equipped to readily identify and respond to caregiver needs, especially when caregiver support is built into discharge planning.

Conclusions: Different, context-specific models for early caregiver identification and preparation have differential benefits and require further exploration.