Do nurses and other health professionals’ in elderly care have education in family nursing?

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The policies of the Norwegian National Health Service emphasise the importance of collaboration between public health services and family caregivers as a necessary part of elder care, both now and in future 1. As in other countries, family caregivers in Norway play a significant role in providing care for the elderly, and the healthcare authority's goal is to maintain the stability of this effort 3. To achieve this goal, healthcare authorities emphasise that family caregivers’ contributions must be made visible and must be appreciated. In addition, healthcare authorities are focusing on ensuring that caregivers with demanding responsibilities have sufficient support.
There are many reasons why nurses and other health professionals should have knowledge of, and pay attention to, the family caregiver's situation. The Norwegian welfare state is normally characterised as the Scandinavian welfare model. Central to this welfare model is the principle that the basis of health care should be public health care 4. One of the central goals of the welfare state is to make all individuals free of involuntary dependence on their families. As a result, the elderly need not depend on their families, other informal caregivers or their own wealth when they need health care. Instead, the state is officially responsible for elder care. In Norway, research has shown that the general population, as well as the elderly themselves, believe that the primary responsibility for health care should rest on the welfare state 5. The elderly do not want to be dependent, or be a burden, on their families. However, despite strong support for the welfare state in Norway, families do provide extensive help and support for their members in need of care 7. Family caregivers provide comprehensive care and practical assistance to the elderly. This extensive contribution from the family presupposes that nurses and other healthcare providers must collaborate with family caregivers when caring for the elderly. However, caring for family members can be a great burden on family caregivers 8. Representatives of the public healthcare system, both nurses and other health professionals, therefore have a responsibility to ensure that providing care for a family member does not have a negative impact. In addition, the public healthcare system has a legal responsibility to facilitate the involvement in family caregivers if this aligns with both the patient's and the family caregiver's wishes 11. Last but not least, it is argued that holistic care for the patient should involve family caregivers 12.
Several studies, both Norwegian and international, indicate that family caregivers who care for the elderly at home find themselves in demanding care situations, which can be both physically and mentally challenging 8. However, there are also positive experiences associated with being a family caregiver 15. In this context, nurses and other health professionals can play an important role, as their interactions with family caregivers can have both positive and negative impacts on the family caregivers’ experiences 17. In elder care in Norway, as in other Western countries, there has long been a focus on home‐based service, as opposed to institutional care 20. It is reasonable to assume that this increased focus on home‐based service makes collaboration with family caregivers even more important.
Many different factors can influence nurses and other health professionals’ attitudes towards and interest in collaboration with family caregivers. In this context, education and participation in instructional courses are important. Few Norwegian studies have investigated what kind of professional knowledge nurses and other health professionals need to collaborate successfully with family caregivers, and whether they possess this knowledge.
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