Intended for healthcare professionals


The need to “carer proof” healthcare decisions

BMJ 2016; 352 doi: (Published 24 March 2016) Cite this as: BMJ 2016;352:i1651
  1. Hareth Al-Janabi, senior lecturer in health economics1,
  2. Jean Nicholls, family carer,
  3. Jan Oyebode, professor of dementia care2
  1. 1Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  2. 2School of Health Studies, University of Bradford, Bradford, UK
  1. Correspondence to: H Al-Janabi h.aljanabi{at}

Such decisions may have important effects on family carers; decision making should formally consider them

Population ageing and fiscal austerity are set to increase the reliance on family carers, who already provide much of the support for people with long term health conditions. Although most carers are willing, providing care can be hugely stressful, affecting mental and physical health1 and resulting in social isolation and financial hardship.2 When under strain, carers are less likely to be effective, increasing the risk that the care recipient is admitted to hospital or a care home.3 Health systems could reduce strain on family carers by routinely considering carers’ needs alongside patients’ needs in everyday healthcare decisions—a concept we term “carer proofing.”

Healthcare interventions (such as a new treatment or a different way of organising care) can affect family carers in various ways (fig 1). Healthcare interventions may reduce the …

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