Faculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK
Faculty of Health and Social Sciences, Bournemouth University, Poole, UK.
BMJ Open. 2019 Sep 3;9(8):e030590. doi: 10.1136/bmjopen-2019-030590.
Older informal carers play an increasingly important role in supporting others with long-term health conditions. This study aimed to explore in depth the perspectives of older carers (70+ years) supporting others with a variety of conditions and disabilities focusing on their thoughts and experiences about when they are unable to continue caring.
Qualitative with four focus groups.
Greater London, UK.
28 older carers (70+ years) recruited from the voluntary sector participated in this study. Most were women and many were spouses caring for partners with age-related conditions such as dementia, arthritis and visual impairment. Nearly a third were parents of adult children with severe physical or cognitive disabilities.
Thematic analysis identified two main aspects for carers when contemplating the future-when they are unable to care in the short term or long term if they die or can no longer manage. Themes included the following: the impact of age, health conditions and relationships on future planning; anxiety about future care; carers' ambivalence and challenges in broaching the subject; interventions that might help older carers talk about and plan for the future of those they care for.
Services need to be open to talking about this difficult topic. Our findings suggest that frank discussions about when older carers cannot care and having plans in place, whether these are financial or address other practical issues, makes it easier for all concerned. However, this issue is not easily broached and its timing and ways to access this support must be carefully and individually gauged. Future research with more diverse demographic groups is needed to improve understanding of these carers' perspectives. Research is also needed to develop interventions to support older carers to talk about and plan for the future.
年长的非正式照顾者在支持患有长期健康状况的人方面发挥着越来越重要的作用。本研究旨在深入探讨支持各种状况和残疾的年长照顾者（70 岁以上）的观点，重点关注他们在无法继续照顾时的想法和经验。
定性研究，采用四个焦点小组。
英国大伦敦。
从志愿部门招募了 28 名 70 岁以上的年长照顾者参与这项研究。他们大多数是女性，许多人照顾的是患有与年龄相关的疾病，如痴呆症、关节炎和视力障碍的伴侣。近三分之一是成年子女患有严重身体或认知残疾的父母。
主题分析确定了照顾者在考虑未来时的两个主要方面——如果他们在短期内无法照顾，或者如果他们去世或无法再照顾时的长期情况。主题包括以下内容：年龄、健康状况和关系对未来规划的影响；对未来护理的焦虑；照顾者在提及这个话题时的矛盾心理和挑战；可能有助于年长照顾者谈论和规划他们所照顾的人的未来的干预措施。
服务需要开放讨论这个困难的话题。我们的研究结果表明，坦率地讨论年长照顾者何时无法照顾以及制定计划，无论是财务方面还是解决其他实际问题，都可以让所有相关人员更容易接受。然而，这个问题不容易提及，其时间和获取支持的方式必须仔细和个别地衡量。需要对更多不同人口统计学群体进行未来研究，以提高对这些照顾者观点的理解。还需要研究制定干预措施，以支持年长照顾者谈论和规划未来。
