Home-based assessment for family carers: a preventative strategy to identify and meet service needs.

OBJECTIVE: To identify unmet need for services among family carers and their frail or disabled relatives and to facilitate links to services.

DESIGN: Intervention study with a subgroup of carer dyads from a random statewide survey of family carers, followed by telephone 2 months post intervention.

SETTING: Carer dyads in general community; urban and rural Victoria.

PARTICIPANTS: All 186 identified carers were approached. One-third of the dyads were ineligible; of the remainder, 67 (53%) participated, matching refusals on sociodemographic characteristics. Carers were typically married, middle-aged women looking after parents or spouses. Almost half of the care recipients were aged > or = 80; most had multiple disorders and impairments. Follow-up rate was 94%.

INTERVENTION: One off, multidisciplinary home-based assessment of dyad by research team and regional aged care assessment service (ACAT).

MAIN OUTCOME MEASURES: "Unmet need': % dyads recommended new services; number services per dyad via ACAT; increases in service range; extension of pre-existing services. Service linkage: % dyads linked to new services; perceived usefulness of linkages.

MAIN RESULTS: Dyads recommended a new service (93%); increased range (73%); extensions (41%). Average two services requiring ACAT implementation; commonly respite care, aids and paramedical services. Recommendations related to impairment severity and carer stress. ACAT implemented recommendations (90% relevant dyads); links rated useful (75% relevant dyads). Three-quarters of the carers rated intervention as helpful.

CONCLUSION: A preventative programme of needs assessment for carer dyads has considerable potential; (a) identifying needs and engaging new services; (b) providing emotional support.