Intended for healthcare professionals

Clinical Review

Assessing and helping carers of older people

BMJ 2011; 343 doi: (Published 19 September 2011) Cite this as: BMJ 2011;343:d5202
  1. I D Cameron, head1,
  2. C Aggar, PhD student2,
  3. A L Robinson, professor of primary care and ageing3,
  4. S E Kurrle, head4
  1. 1Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Ryde, NSW 1680, Australia
  2. 2Sydney Nursing School, University of Sydney
  3. 3Institute of Health and Society, Newcastle University, Newcastle, UK
  4. 4Curran Ageing Research Unit, Hornsby Ku-ring-gai Health Service, Hornsby, NSW, Australia
  1. Correspondence to: I D Cameron ian.cameron{at}

Summary points

  • Identifying carers is important because many do not recognise themselves as such, and care responsibilities can affect their health and financial and social aspects of their lives

  • Comprehensive carer assessment may not be feasible but doctors can identify carers, briefly assess their needs, develop a care plan in collaboration with the carer, and refer where needed

  • Key areas to ask about include physical and mental health needs of the carer and care recipient, information needs, financial status, levels of carer burden and stress, and the positive aspects of caring

  • Asking the question “Overall how burdened do you feel?” is a useful, quick way to assess carer distress

  • Provide specific interventions to carers where indicated, including education, information, counselling, and support

  • To help the carer, provide the care recipient with specific interventions, including regular service provision, aids and equipment, and respite care

  • Monitor carer on an ongoing basis and provide support after residential placement or bereavement

Carers are an essential source of support to older people and take responsibility for most of their care needs. Although many carers find aspects of the caring role satisfying,1 caring responsibilities can lead to a decline in their own physical and mental health1 2 3—especially when caring for those with dementia4—and adversely affect their employment and education prospects, financial position, and ability to participate in social and community life.2 It is therefore important to identify people who have an important informal caring role. An assessment of the carer and his or her individual needs, and of the caregiving situation, can improve the health and wellbeing of the carer and ensure the provision of timely and appropriate support services.1

Sources and selection criteria

As well as using our personal reference collections, we searched the Cochrane database and reviewed guidelines from the National Institute …

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