Dementia Centred

By DSDC Guest

April 11th, 2018

Carers and Choice Modelling

There are as many as 788,000 unpaid carers in Scotland[1]. At the start of April 2018 the Carers (Scotland) Act 2016 came into force, meaning that carers will gain the right to better awareness of, and better access to, support in their local area.

Services for carers can be targeted – known as ‘specific carers services’, such as carers groups. However, some services are less overt and often a by-product of services received by the cared-for person – sometimes known as ‘carer allocations’, such as day care centres[2].

But in a context where resources are sparse, what services should be prioritised?

Different sources can be consulted to help local governments decide what services to provide. This might include:

1. Case studies and evaluations.  
What has worked well over long periods of time? The evidence for effective types of support inventions is mixed. For example, while respite care is often rated highly in terms of satisfaction, evidence of improvements in mental health, and particularly physical health, is less robust[3]

2. Feedback from consultations.
What do carers say that they want? Asking carers what services they would like to see in their local area shows that no single ‘ideal’ blueprint or service model exists (though if you know of one, Shona Robson would welcome a call).  Support is likely to be most effective when offered as part of a response to the family situation[4].

3. Surveys of service use.
What have carers engaged with in the past? The Scottish Health Survey shows that friends and family are a common form of support for carers in Scotland, with fewer engaging in formal carers specific services[5]. Whilst this survey information is very useful, it doesn’t shed much light on carers perspectives on new or alternative strategies to support carers.

A potential problem with the above approaches is that they mainly focus on existing support – what has already been done. How then do we come up with new and innovative options? One way to do this is through choice modelling. Choice modelling is a survey method that involves creating a series of options for carers to repeatedly choose between hypothetical scenarios. Not only can this help create flexible new types of support, but combined with data on the carers’ circumstances (for example, age, relationship), can inform the factors influencing different carers’ preferences for service use.

Choice modelling has already been used in marketing, environmental economics, transport and increasingly in health care[1]. It has the potential to increase personalisation at a planning level - a way of systematically using the views of carers to inform the types of services that local authorities choose to provide.

It’s still not a silver bullet – and its certainly not the only dataset that will be of use for the effective implementation of the Carers Act. But a better understanding of why carers engage with some forms of support and not others can help anticipate demand and prompt innovation in service design.

For more information please get in touch at nadine.thomas@stir.ac.uk or @nadinepthomas

If you live in Scotland and support someone over the age of 55, however big or small the unpaid caring role, you are invited to participate in a short online survey about carers choices. All input is greatly appreciated to help to build a better understanding of support systems for carers. Please follow the following link here to take part.


[1] http://www.gov.scot/Topics/Health/Support-Social-Care/Unpaid-Carers
[2] Twigg J (1992) Carers in the service system. In Twigg J (ed) Carers: Research and Practice. London: HMSO.
[3] http://www.lse.ac.uk/LSEHealthAndSocialCare/pdf/LitReview-Older-Effectiveness-final.pdf
[4] https://www.york.ac.uk/inst/spru/pubs/pdf/respiteEx.pdf
[5] http://www.gov.scot/Publications/2015/03/1081

 

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