7 Old age psychiatry7.2 Principles of service provision
7.2.4 Working with carers of older people
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
Who is a carer
A carer is a partner, relative, friend or neighbour who gives unpaid help. Many people in this role do not call themselves a carer.
Their practical help can include meals, transport, personal care, support with medicines, and noticing changes in the person's mental state or how they manage day to day.
Assess willingness and ability separately. Someone may be willing but not able, or able but not willing. Being related does not create an unlimited duty to provide care.
What to find out from the carer
Area | What to establish |
|---|---|
Current tasks | What the carer actually does, how often, and how hard they find it |
Knowledge | How well they understand the illness, the treatment and the warning signs |
Health and burden | Their sleep, mood, physical health, work, finances and isolation |
Safety | Any conflict, abuse, neglect or exhaustion, and access to emergency support |
Contingency | Who helps if the carer becomes unavailable |
Information and decisions
Listen to carers. They can give valuable information even when the patient does not want information shared back with them.
Sharing information usually depends on the patient's consent. Without it, you can still offer general advice and support without revealing confidential details.
Being a relative or the next of kin does not by itself give anyone authority to make decisions. Check for an attorney or other lawful authority, and what it covers.
Involve carers in a way that supports the person's autonomy, including preferences that differ from what the carer wants.
Supporting safe care
Training should match the agreed tasks, such as recognising relapse or helping with medicines. Check the carer understands and that the task is still manageable.
A carer's assessment looks at the carer's own needs. It is separate from the patient's assessment and eligibility for services.
Respite and practical help can help the carer keep caring. Plans must still work if the carer becomes ill or wants to do less.
Safeguarding concerns need an assessment of both the person and the carer. Do not assume either is responsible just because they disagree.