Introduction

Now more than ever, involving family caregivers is a necessary part of working with older people and adults with disabilities in all practice settings. As our population ages, more people with chronic and disabling conditions are choosing to live at home or in the community, launching their family members and close friends into action as caregivers.

We now know that family caregiving impacts the physical and mental health, finances, career and other family and social relationships of the caregiver. However, few programs offer caregivers an assessment of their own situations to assist them in providing quality care. Restrictions on resources may influence an agency’s response to caregiver needs, but much depends on how we view caregivers in general. Are family members seen merely as a resource, or as people with needs and rights of their own?

Achieving a high quality of care for people with chronic or disabling conditions depends on accepting a family-centered perspective. The success of most care plans—from hospital discharge to everyday care in the home—often rests on the shoulders of the family caregiver. If the family caregiver becomes sick or can no longer cope with caregiving tasks, the care recipient suffers. If the strain on a caregiver becomes too great, care in the home may be seriously compromised and nursing home placement may result. Successful care, whether from hospitals, home or community-based settings, depends upon knowing the needs of both the care recipient and the family caregiver.

Establishing caregiver assessment as a basic component of practice across care settings requires a fundamental change in thinking and practice. In September 2005, the Family Caregiver Alliance’s (FCA) National Center on Caregiving convened the National Consensus Development Conference for Caregiver Assessment. The conference brought together widely recognized leaders in health and long-term care to advance policy and practice on behalf of family and informal caregivers. Through the consensus development process, conference participants agreed on the central importance of incorporating an assessment of caregiver needs in everyday practice and service delivery settings. These leaders also agreed on basic principles and practice guidelines for caregiver assessment. Their work to advance a family-centered approach to working with older people and adults with disabilities infuses all sections of this toolkit.

Our intent, with this toolkit, is to build on the work of the National Consensus Development Conference and facilitate implementation of assessment of caregiver needs in service delivery settings. We hope that this toolkit will serve two purposes: (1) sharpen your awareness of caregivers as an at-risk population, whose own needs should be determined by an assessment; and (2) add to your knowledge and skills, helping to equip you for developing and implementing an appropriate caregiver assessment process in your practice setting.

This toolkit is not designed to address the broader policy and administrative issues involved in the development and implementation of caregiver assessment. Federal and state-level policy strategies and recommendations to establish caregiver assessment as a basic component in health care and home and community-based care settings are discussed in the National Consensus Development Conference Reports Volume I and Volume II.

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