Family carer experiences, roles and support needs: implications for dietitians in rehabilitation

The engagement of family carers as part of the rehabilitation nutrition team may improve patient outcomes; however, research is needed to explore the role and needs of carers. The purpose of this longitudinal qualitative study was to determine the nutrition and food-related roles,experiences and support needs of female family carers of community-dwelling malnourished older adults admitted to rehabilitation units in rural New South Wales, both during admission and following discharge.Four female carers were interviewed during their care-recipients’rehabilitation admission and two-weeks post-discharge. The semi-structured interviews were audiotapes, transcribed and analysed reflecting an interpretative phenomenological approach by three researchers. Three inter-related‘drivers’were developed and discussed:responsibility,family carer nutrition ethos and quality of life. A key finding was that although carers may recognise nutritional problems and assume primary responsibility for nutrition support even in the rehabilitation setting, they may fail to engage with formal nutrition support for a variety of reasons including a fear of financial implications or a belief that dietitians would not provide individualised assistance. Further, carers may hold strong nutritional beliefs that are incongruous with an evidence-based approach, leading to the use of inappropriate nutrition strategies. Findings revealed that carers may have a principal focus on quality of life as both a nutritional strategy and outcome for their care-recipients. Broadly, the findings of this study challenge current dietetic practice, revealing that‘family care’should be integrated with‘formal care’in the rehabilitation setting. Suggestions for practice were developed based on the findings; however,intervention research is needed.