"You don't look for it"-A study of Swiss professionals' awareness of young carers and their support needs

Being a Young Carer in Portugal: The Impact of Caring on Adolescents' Life Satisfaction

Caring for an ill or disabled relative can present significant challenges that may exceed the personal resources of the caregiver. Young carers (YCs) often take on this role, providing support to family members or friends, which can have far-reaching effects on various aspects of their lives. This study involved 235 adolescents, 106 YCs, and 129 non-carers (NCs), who completed questionnaires assessing life satisfaction, satisfaction with social support, family functioning, academic functioning, and caregiving activities. Tests of group differences (MANOVA and MANCOVA controlling for age) showed YCs had more caregiving activities than NCs (as expected) and, critically, significantly lower life satisfaction. Hierarchical regressions with the YCS subsample showed academic functioning, social support, and the negative impact of caregiving were associated with life satisfaction, and that the negative influence of caregiving was linked to family functioning and the quantity of caregiving activities. For NCs, academic functioning, satisfaction with social support, and family functioning were associated with life satisfaction. In conclusion, caregiving in adolescents appears to be linked to lower life satisfaction, but this effect is determined by their social support, academic functioning, and negative impact of caring, which in turn depends on their family functioning and amount of caring activities.

Visibility as a Key Dimension to Better Health-Related Quality of Life and Mental Health: Results of the European Union Funded "ME-WE" Online Survey Study on Adolescent Young Carers in Switzerland

This paper examines the health-related quality of life (HRQL) and mental health of adolescent young carers (AYCs) aged 15-17 in Switzerland, based on data collected within the Horizon 2020 project 'Psychosocial support for promoting mental health and well-being among AYCs in Europe' (ME-WE). It addresses the following questions: (1) Which characteristics of AYCs are associated with lower HRQL and with higher level of mental health problems? (2) Do AYCs who are less visible and less supported report a lower HRQL and more mental health issues than other AYCs? A total of 2343 young people in Switzerland, amongst them 240 AYCs, completed an online survey. The results show that female AYCs and AYCs with Swiss nationality more often reported having mental health issues than their male and non-Swiss counterparts. Furthermore, the findings show a significant association between receiving support for themselves and visibility from their school or employer and the HRQL. Moreover, AYCs who reported that their school or employer knew about the situation also reported fewer mental health issues. These findings can inform recommendations for policy and practice to develop measures aimed at raising the visibility of AYCs, which is the first step for planning AYC tailored support.

Does It Matter Who You Provide Care for? Mental Health and Life Satisfaction in Young Adult Carers Associated with Type of Relationship and Illness Category-A National Student Survey

There is limited knowledge on how caring contexts impact young adults providing informal care for persons with chronic conditions. This study examines associations between outcomes in young adult carers (YACs) and type of relationship (e.g., close or distant family member, partner, or someone outside the family) and type of illness in the care-receiver (e.g., mental, physical illness/disability, or substance abuse). A total of 37,731 students (age 18-25, mean 22.3 years, 68% females) in higher education in Norway completed a national survey on care responsibilities, hours of daily caring, relationship and type of illness, mental health problems (Hopkins Symptoms Checklist-25) and life satisfaction (Satisfaction With Life Scale). More mental health problems and lower life satisfaction were found among YACs compared to students without care responsibilities. The poorest outcomes were reported by YACs caring for a partner, followed by YACs caring for a close relative. Hours spent on daily caring was highest when caring for a partner. Poorer outcomes were reported by YACs caring for someone affected by substance abuse, followed by mental health problems and physical illness/disability. At-risk groups among YACs should be acknowledged and offered support. Future studies are needed to investigate the potential mechanism for the associations between care context variables and YAC outcomes.

Professionals' Awareness of Young Carers in Schools: Results from a French Survey

Few studies have investigated professionals' awareness of young carers (YCs). Therefore, the main aim of this study was to explore school professionals' awareness of YCs. The secondary aim was to compare professionals' responses according to their occupation. A total of 2658 professionals took part in this study by completing an online questionnaire. The results indicated that the mean for the perceived age for care beginning was 10.3 years old, with parents being perceived as the most frequent care recipient. The main caring activities reported were domestic chores, emotional support and sibling care, while care provided directly to the care recipient was perceived as less frequent. Many suggestions for improving the identification, referral and support of YCs were seen as relevant, but professionals were less supportive of suggestions for adjustments within schools. The key training needs centered around better identifying YCs and developing better knowledge of their difficulties. Differences were observed according to occupation, with administrative staff and teachers having less accurate perceptions than school counsellors as well as social and health professionals. This study shows that it can be difficult for school professionals to imagine a child providing care. Specific training, therefore, needs to be proposed according to school professionals' occupations.

Young carers and educational engagement: Quantitative analysis of bursary applications in Australia

Young carers support family members affected by disability or a health condition. The Young Carer Bursary Program aims to support young carers' education. This paper analysed data from consenting bursary applicants (2017-2019) to investigate relationships between wellbeing, educational attendance, home study and other factors. Descriptive statistics, correlation and regression analysis determined significant issues, relationships and influential factors related to young carer (N = 1,443) wellbeing and education. Sixty-eight percent were aged between 13 and 18 years and attended secondary school. One third of the sample reported that they were the main carer in their family and 29% reported receiving no support. Female applicants from single parent households who were the main carer attended educational settings less often. Eighteen percent (n = 267) rated their wellbeing as poor/very poor. Better wellbeing was associated with increased educational attendance (r_s  = 0.33, p < 0.001) and home study (r_s  = 0.34, p < 0.001). Wellbeing was associated with main carer status, caring for a parent, having a disability, being older and having few supports. Educational attendance was associated with main carer status, higher care load and fewer supports. Home study was associated with having a disability, caring for a sibling, caring for more than 11 hr per week and having fewer supports. Important factors about the age, life situation and challenges experienced by young carers identified in this paper indicate that further research into preferred supports and effectiveness of the bursary in improving educational engagement is warranted.

Oncology healthcare professionals' knowledge, attitudes, and practices regarding young carers

OBJECTIVE

Increasing numbers of youths are facing a relative's cancer. In this context, some are required to provide significant support and are called young carers (YCs). However, little is known about how these youth are viewed and supported by health professionals. The aim of this study was to investigate the knowledge, attitudes, and practices of oncology healthcare professionals regarding YCs.

METHODS

Thirty-one oncology professionals working in France (adult and pediatric departments and homecare services) participated in semi-structured interviews.

RESULTS

The results indicated that almost all professionals had already met a YC and could identify several situations in their professional context. Their knowledge of YCs appeared to influence their attitudes and practices. They perceived this situation in a rather superficial way when their discourse and ideas were explored in-depth. They mentioned some ideas for improving support for YCs, but also many barriers.

CONCLUSION

The results highlight a moderate level of awareness. Thus, it is necessary to enhance providers' awareness and knowledge of YCs.

PRACTICE IMPLICATIONS

Awareness campaigns and training programs need to be developed for oncology healthcare professionals to help them better identify, understand, and support YCs and their families. This type of action would positively impact patient care.

The Young Carers' Journey: A Systematic Review and Meta Ethnography

Despite growing international interest, the caregiving body of literature lacks a recent understanding of young carers’ experiences and their contact with the health care system. We conducted a systematic review of qualitative studies to (1) synthesize more recent qualitative evidence on young carers’ experience, and (2) to identify how these young carers interact with the health care system in their caregiving role. Using a meta-ethnographic synthesis, a total of 28 empirical studies met inclusion. Key findings helped inform an overarching framework of the experience of young carers as illustrated by a journey map. The journey map is a visual depiction of the stages these young carers go through when in a caregiving role framed by three themes: (1) encountering caregiving; (2) being a young caregiver, and (3) moving beyond caregiving. The caregiving experience is perceived by young people as challenging and complex, which could be improved with more informational navigation and emotional support. Understanding these experiences provides insight into gaps in health services and potential solutions that align with the stages outlined in the journey map.

Study progress, recreational activities, and loneliness in young adult carers: a national student survey

BACKGROUND

Young adults (18-25 years) with informal care responsibilities have received limited attention in the research literature, and little is known on how caring responsibilities are related to functioning across different life domains. In the present study we examine associations between care responsibilities and study progress, recreational life, and loneliness in young adults in higher education.

METHODS

A national survey was conducted among Norwegian students in higher education (the SHoT2018-study). The response rate was 30.8%. The current sample is a subsample of the respondents, including young adults 18 to 25 years old, comprising 40.205 participants (70.2% women, mean age 22.0 years, SD = 1.7). Participants reported whether they had regular care responsibility for someone with physical or mental illness, disabilities, or substance misuse. They also answered questions on study progress, number of hours studying, physical exercise, involvement in organized volunteer student activities, number of close friends, and feelings of loneliness. Data were analyzed by Chi-square tests and logistic regression analyses, adjusting for age, sex, and chronic illness.

RESULTS

Compared to students without care responsibility, young adult carers (n = 2228, 5.5% of study sample) were more likely to report delayed study progress (OR 1.20, p < .001), higher average number of failed exams (e.g., having failed three times or more, OR 1.31, p = .002), more feelings of loneliness (OR 1.26, p < .001), and slightly fewer friends. Those with limited care responsibility (≤ 1 h daily) were more likely to participate in organized volunteer student activities, whereas students with 2 h or more of caring per day were less likely to participate in leisure student activities. Both study progress and feelings of loneliness were related to care responsibility in a response-dose pattern, with worse outcomes for those with 2 h or more of daily caring responsibility. All comparisons were adjusted for age, sex, and chronic illness.

CONCLUSIONS

Study progress, recreational activities, and loneliness among young adults are associated with informal caring responsibilities. Professionals in the educational system as well as health personnel should be sensitized to the needs of young adult carers and necessary support made available.

Growing up with a Chronically Ill Family Member-The Impact on and Support Needs of Young Adult Carers: A Scoping Review

This scoping review provides an overview of the impact of growing up with a chronically ill family member on young adults (18-25 years old), and their specific needs. Young adults represent an important life stage involving a transition to adulthood, during which individuals' family situations can affect their future. We searched relevant studies following the guideline of Arskey and O'Mailley's methodological framework and the PRISMA statement guidelines for scoping reviews in PubMed, PsychInfo and reference lists to identify articles for inclusion. Studies from 2005 to 2020 were included in this review. Of the 12 studies, six qualitative studies, five quantitative studies and one mixed method study were included. Eight studies discussed the impact, including consequences at a physical and mental level, at their personal development and future perspectives, but also positive effects, such as being capable of organizing their lives. Four studies discussed the needs of young adult carers, including emotional needs, support needs with regard to stimulating autonomy (arising from internal conflicts) and developing their own identity, and the concerned attitude of involved professionals. An unambiguous definition of the target group and further well-designed research are needed to improve clarity about the role of support, so that future professionals can adequately address the needs and wishes of young adults who grow up with an ill family member.

Are there young carers in oncology? A systematic review

Objective

This systematic review aims to investigate the support children provide in the case of a relative's cancer.

Methods

Searches were performed on four electronic databases (Embase, PsycINFO, PubMed and ScienceDirect) to identify studies that report on the support provided by children to a relative diagnosed with cancer. Two researchers independently evaluated the eligibility of the studies and cross‐checked them for accuracy. The Crowe Critical Appraisal Tool (CCAT) was used to assess the quality of the studies included.

Results

Out of the 10948 articles screened, 30 were included in this review. Results highlighted that cancer provokes changes in families, such as shifts in roles and increased responsibilities for the youth. Children often provided significant support to their sick relative and family members, including practical, emotional, and medical support such as household duties, medical assistance, companionship, and distraction. However, they were designated as young carers in only one study. The support provided was associated with negative effects such as stress and fatigue, and with positive effects such as increased empathy and independence. Children wished to support their family but also named several needs, such as time for themselves and the opportunity to enjoy their childhood.

Conclusion

The results of this systematic review highlight the importance of taking into account the support provided by young people facing the cancer of a relative and designating them as young carers. Much remains to be accomplished to officially recognize their role and to support them properly.

Caring in mind? Professionals' awareness of young carers and young adult carers in Switzerland

Findings from international research emphasis the need of these young people to be identified and recognised. Therefore, a nationwide quantitative study of professionals' awareness was conducted in the Swiss context. Data were collected from professionals working in education, healthcare and social services. The study examined professionals' familiarity with the terms used to describe young people with caring responsibilities; their ability to identify the population in their professional context; their perception of the relevance of the issue; their ability to support them; and their own training needs. Potential study participants were contacted via email. Data were collected using an online survey, which was open for 14 weeks during the period of September to December 2016. Survey data from 2,311 professionals, who reported being regularly in contact with young people with caring responsibilities in their occupational context, were included for analysis. Of all terms presented in the survey, young carer (YC) was the term most familiar to all professionals. Among healthcare and education sector, the percentage of professionals familiar with this term was higher than that among professionals from social services. Professionals from social services were the most likely to consider the issue relevant to their work, those from education were the least likely. Professionals who were familiar with the terms describing YC were more likely to consider the issue relevant to their work. Study results showed that more than half of the respondents had not identified young people with caring responsibilities, and that the ability of participants to identify YC was related to their occupational sector. The perceived ability to support YC was related to their reported ability to recognise them. In order to enable professionals to support YC, raising awareness, providing training for professionals and a national network of existing organisations should be well considered.

The awareness, visibility and support for young carers across Europe: a Delphi study

Background

Across Europe, young carers (YCs) and their need for support receive limited attention in the media, policy and empirical research, even though, similar to adult carers, they also provide care to ill family members. The Delphi study, a qualitative research methodology, which provides the focus for this article, had the overall aim of exploring existing successful strategies to support YCs. Compared to YCs, even less is known about adolescent young carers (AYCs), a group that is in a critical life transition phase. The study forms part of an EU Horizon 2020 funded research project on AYCs aged 15–17 years old.

Methods

A two-round Delphi study was conducted with 66 experts on YCs from 10 European countries. Topics included: (i) visibility and awareness-raising of YCs at local, regional, and national levels, (ii) current interventions to support YCs, and (iii) future strategies to support YCs.

Results

Experts reported a lack of visibility and awareness about YCs in general, and AYCs in particular. Although awareness is slowly increasing in most countries, with the UK ranked highest, experts acknowledged that it remains challenging to identify YCs in many countries. Furthermore, the level and type of support available for YCs differs, with most countries mainly offering support on a local level. Diverse views were expressed regarding future strategies to support YCs. Experts highlighted the importance of specific legislation to formalise the rights of YCs, and the issue of whether young people should be safeguarded from caregiving or if this should be considered part of regular family life. They also emphasised the relevance of available integrated support services for YCs, including schools, family, health and social care.

Conclusions

In most European countries, there is a lack of awareness and visibility on YCs. Identification of YCs is a crucial first step and there is need for a common definition of YCs, together with greater opportunities for young adults to identify themselves as YCs.

Invisible population: Understanding recruitment barriers of a nurse-led support programme for families with caregiving children in Austria

Aims

To evaluate why no families could be recruited for a nurse-led and family-centred support programme in Austria which aimed to prevent an age-inappropriate caring role for young carers.

Design

A qualitative study incorporating qualitative e-interviews and telephone interviews.

Method

Twenty-one interviews were conducted with statistically significant project stakeholders (N = 17) and with adult family members of children with caring responsibilities (N = 4). Data collection and analysis were guided by the "Social Marketing Framework." Relevant statements were assigned to the main categories: product; price; promotion; place; and working with partners.

Results

The lack of awareness towards young carers, the unfamiliar, open outcome approach of the intervention, the inappropriate language used in promotional materials and the families' fear of stigma while seeking support were identified as central obstacles for successful recruitment of families and implementation of the support programme.

Expectations and Prospects of Young Adult Caregivers Regarding the Support of Professionals: A Qualitative Focus Group Study

There is a lack of service provision for young adult caregivers (18-25 years of age). This study aims to describe the expectations and prospects of young adult caregivers regarding support from health and education professionals. A qualitative focus group design was used. Twenty-five young Dutch adults (aged 18-25 years) who were growing up with a chronically ill family member participated in one of seven focus groups. Qualitative inductive analysis was used to identify codes and main themes. Two overarching themes with five sub-themes emerged from the focus group discussions. The overarching themes are: the 'process of approaching young adults' and the 'types of support these young adults require'. The process of approaching young adults contains the sub-themes: 'recognition, attention, and listening', 'open-minded attitude', 'reliability', and 'respecting autonomy'. The types of support this group requires contains the sub-themes: 'information and emotional support'. Health and education professionals should first and foremost be aware and listen to young adult caregivers, pay attention to them, have an open-minded attitude, respect their autonomy, and have the knowledge to provide them with information and emotional support. Further research could yield comprehensive insights into how professionals can meet these requirements and whether these results apply to male young adult caregivers and young adult caregivers not enrolled in a healthcare-related study program.

The emotional and mental health needs of young carers: what psychiatry can do

AIMS AND METHOD

To review the literature on the emotional and mental health needs of young carers of parents with mental illness and the extent to which such needs are recognised and supported by professionals. Three databases were systematically searched from 2008 to 2018, and five studies met the inclusion criteria.

RESULTS

The key findings were that young caregivers had a significantly higher dose-response mortality risk than their peers; were at increased risk of mental health difficulties, especially where the ill family member was a parent and had mental illness or misused substances; were overlooked by professionals owing to a lack of awareness; but could derive benefits from their caring role when appropriately supported.

CLINICAL IMPLICATIONS

Young carers are at increased risk regarding emotional and mental health needs; this risk could be mitigated by professionals recognising the young carer's role and including them in their parent's treatment plan.

The Burden of Care: A National Survey on the Prevalence, Demographic Characteristics and Health Problems Among Young Adult Carers Attending Higher Education in Norway

Objective

The aim of the present study was to examine prevalence, characteristics and health outcomes among young adults (18 to 25 years) who provide informal care to family members or others with physical or mental illnesses, substance misuse or disabilities.

Design

The sample was obtained from a national survey in Norway from 2018 among students in higher education (the SHoT2018-study). The current sample comprise 40,205 participants, 70.2% women, mean age 22 years (SD = 1.7).

Outcome Measures

Participants answered questions on care responsibilities, mental health problems (The Hopkins Symptoms Checklist-25), insomnia (sleep questionnaire), somatic health (Somatic Symptom Scale-8), and life satisfaction (Satisfaction With Life Scale).

Results

5.5% of the respondents reported having care responsibilities. Caring was associated with being female, single, having divorced parents, being an immigrant, and having financial difficulties. More mental health problems, insomnia, somatic symptoms, and lower life satisfaction were found among respondents with care responsibilities. Number of hours of caring was associated with negative health outcomes in a dose-response pattern.

Conclusion

Professionals within health care, social services and the educational system should be sensitized to the needs of young adults with care responsibilities for family members or others with illness, substance misuse, or disabilities. The negative health problems among these young adult carers (YACs) should be acknowledged, and adequate support made available.

Who are „Young Carers”? Analysis of the Use of the Term in German Speaking Countries and Development of a Definition / Wer sind Young Carers? Analyse der Begriffsverwendung im deutschsprachigen Raum und Entwicklung einer Definition

Introduction

Children and adolescents with caring responsibility who are looking after a family member or a person close are often hiding from the view of the public. They are not well recognised from professionals from health care, education and social services. Several research as well as support programmes have been initiated within the last years. It became obvious that the term ‘young carers’ was translated in various ways into German and connected with different attributes. An integral understanding is yet of high relevance for the international dialogue as well as for the transfer from theory to practice.

Aim

The aim of this article is to analyse and conceptualize the use of different terminologies for ‘young carers’ by professionals when providing support for these young people. A definition for the target population was developed for German speaking countries that will provide the groundwork for the scientific and public discourse.

Methods

A concept analysis by Walker und Avant (2014) was conducted.

Results

The analysis illustrated the various use of terms as well as defining key characteristics – the presence of an ill person that needs support, the age of these young people, the tasks they perform as well as the involved high responsibility.

Discussion

Not all children of family members or persons close who have an illness or impairment perform a support role. Only part of these young people take on caring tasks and provide support on a significant level.

Conclusion

The analysis showed the need for a clarification of the terms used in German speaking countries for ‘young carers’. A commonly applied definition enables an identification of the target group by professionals and the persons concerned. Additionally, it facilitates the alignment to the proceeding international discourse.

Young carers and young adult carers in Switzerland: Caring roles, ways into care and the meaning of communication

Although there is already general recognition of the fact that many relatives provide unpaid care for family members, there is still little awareness that children, adolescents and young adults under 25 also provide such care. Until recently, the situation of young carers and young adult carers, as those young persons are referred to in international research, has not been in the focus of professionals, research and the public in Switzerland. Between September 2015 and October 2016, 30 interviews in seven cantons were conducted with 16 young carers aged 10-17 and 14 young adult carers aged 18-25. The interviews were recorded, transcribed and analysed following a grounded theory approach. This paper now presents the first qualitative data on Swiss young carers and young adult carers. It explores their sociodemographic backgrounds, the nature and intensity of caring tasks they carry out, their pathways into caring as well as the role of communication with family members, extended family, professionals and peers. Our findings provide a first insight in the lives of young carers and young adult carers in Switzerland and illustrate, as well, the challenges they face.