Caregiver respite on health reform agenda

Government is looking to strengthen respite and community support for family caregivers as part of wider reforms to Barbados’ mental health and elderly care systems.

Acting Chief Medical Officer Dr Arthur Phillips said caregiver respite is among the key issues being addressed and will be discussed during the second phase of the new Geriatric Hospital.

He made the disclosure during Monday evening’s Ministry of Health and Wellness and Inter-American Development Bank public consultation on the Health Services Resilience Programme at the Lloyd Erskine Sandiford Centre.

Phillips was responding to Kyla Branch, an executive board member of the Barbados Alzheimer’s Association, who spoke about the challenges faced by informal family caregivers looking after people with mental health conditions and dementia.

“Certainly, the issue of caregiver respite is one of the key things that is being addressed through the wider mental health reform discussion,” Phillips said.

“So it [is] not just in terms of Roseville Halfway House, but more generally in terms of the mental health systems and the community orientation.

“That’s clearly one of the discussions. It will also come up when we speak about the second phase of the geriatric hospital at Waterford.”

Phillips said the objective should be to allow people requiring care to remain at home, or as close to home as possible, for as long as they can.

“Where people can stay in the community with supports, where they can come into a facility to allow respite, where their family members can have support, that is better for everyone, including for the client,” he said.

The Acting CMO said remaining in familiar surroundings could also reduce the likelihood of patients becoming confused or getting worse.

He also stressed the importance of providing more healthcare in community and primary care settings, particularly where early intervention could change how a disease develops or help manage it

Branch had urged health planners to ensure caregivers were not overlooked as Government undertakes its US$175 million Health Services Resilience Programme.

“We spoke a lot in terms of the infrastructure; we mentioned, obviously, the bridge to independence for the catchment group . . . but, of course, the impact on the family, the impact on the caregiver, a lot of the times it’s the informal caregiver who is impacted,” she said.

She argued that caregiver considerations therefore needed to be incorporated into discussions surrounding the new health infrastructure.

Branch also called for greater attention to dementia as Barbados’ population ages and stressed that dementia should form part of the country’s wider approach to non-communicable diseases.

“We have to put preventative measures in place,” she said. “We didn’t focus a lot in terms of NCDs particularly today, but I also want to urge everyone to recognise that dementia is an NCD.”

“We can’t just wait for the specialist intervention.”

Phillips agreed that preventing NCDs and preventing or managing dementia are becoming more closely linked.

Consultant Leisa Perch said caregivers were already being considered in the environmental and social assessment being undertaken for the Health Services Resilience Programme.

She said that consideration extended beyond the care caregivers provide to include their ability to maintain access to relatives receiving treatment.

“That does take bearing on how buildings are designed, how our emergency protocols will be designed, and some of the support mechanisms and the digital health component and other aspects of the program,” Perch said.

She said the intention was to ensure caregivers were “part of the process and not just on the side of the process”.

Perch also acknowledged the need to distinguish between professional caregivers and relatives or others who provide unpaid informal care.

“It is sometimes the . . . group that we forget,” she said.

(SM)