Any nurse, specialist or not, is in a great position to clarify that for them. As I share my experience, you’ll find lots of useful resources throughout this blog that you can share with others. 

The legislation

Many of us are family carers ourselves, as I was until my father died a year ago. Carers have overwhelming responsibilities but few automatic legal powers. The position in law is slightly different in each part of the UK with some country specific, and some UK legislation. Local knowledge is paramount.

In Scotland, where my father lived, the Carers (Scotland) Act 2016 gave me rights to assessment, support and involvement in planning services.  There is equivalent legislation in other individual countries of the UK, but UK-wide legislation offers further legal rights. For example, the Equality Act 2010 protected me from discrimination because of my association with a disabled person. The Carers Leave Act entitled me to up to five days unpaid leave. Employment legislation supports carers with flexible working and human rights laws. Carers are also entitled to have their wellbeing and rights considered when health and social care professionals make decisions. Nurses need to know this.

Looking after the carer

Some carers misunderstand their responsibilities, such as the need to support the person to exercise their own capacity to make decisions. But usually, carers’ most overlooked responsibility is protection of their own health. Ignoring that puts both the carer and their loved one at risk.

I see family members unaware of their own right to carer’s assessment, even if the cared-for person is refusing services. They’re entitled to training for caring tasks, emotional support, and involvement in discussions about care, with appropriate consent. Nurses should ask not only "How is the patient?" but also "How are you?".  Many carers believe they have a legal duty to care indefinitely. In most situations they don’t. 

Useful resources 

There’s no legal need to register as a carer or for a national carer card.  But it’s easier to access support if carers make themselves known to the GP, social services, and to any carers’ organisation in the area. They need to know that simply being “next of kin” does not automatically give legal authority to consent to treatment or access confidential records. I see this mistake again and again even in well-informed families. Make sure you, as a nurse, know about Powers of Attorney, guardianship and other statutory powers. We should feel comfortable explaining to people that even where a carer has those powers, decisions must always be made legally in the best interests of the adult and with consideration for the least restrictive option. A good way for any nurse to find out about it is to grant power of attorney for yourself to someone you trust. It’s never too soon.

Raising concerns

A carer may be at risk of abuse from the person they are caring for. Although there’s no statutory duty on every citizen to report abuse of a vulnerable person, as nurses working in health and social care we have clear responsibilities. This includes documenting and reporting concerns through safeguarding procedures, sharing information where someone may be at risk of harm, acting promptly rather than waiting for certainty and involving police immediately where there is imminent danger. The threshold is a reasonable concern that an adult with care and support needs may be at risk of harm, not proof that abuse has occurred. That adult at risk may be the carer. 

Carers can struggle with poor health, depression, financial hardship and a complete lack of support. Good safeguarding considers both parties. I had huge comfort and assistance from my local carers’ organisation. Their expertise and kindness transformed my world. Make sure you know about the local support available and how to refer carers to them. Not least, their free care for the carer will reduce the demands on your own services. Everybody wins.