POLICY RECOMMENDATIONS

The creation of a sustainable caring environment is an important task for policy makers. The involvement of localised Carers (for the most part family members) is essential for sustaining communities. Where possible, it is desirable to provide care for an older person in their own home. Current government policy supports the concept of older people remaining in their homes (Cross, 2009), with policy documents and reports such as National Action Plan for Social Inclusion 2007-2016 (The Office for Social Inclusion, 2007) and Towards 2016: Ten year Framework Social Partnership Agreement 2006-2016 (Department of the Taoiseach, 2006) emphasising community care. This is an admirable aim, ensuring that those who are in need of care will have the opportunity to be provided with it in their own homes and communities if they so wish. While a number of relevant policy documents have been developed in the past, it is widely acknowledged their measures have been hampered by huge implementation problems. They have also been limited in terms of their reliance on untested assumptions about caregiving, stress, and social support, and their ignoring of the full gamut of social science research on these concepts. However, whilst every effort should be made to facilitate community care, it is essential that policy makers are aware of the toll that

caregiving exerts on Carers, particularly older adult caregivers. If policy makers are to continue to rely on the caregiving resources of families of older adults, it is essential that provisions are made that can sustain older adult caregiving efforts for longer. Establishing properly funded peer support resources that provide real aid and assistance to people coping with caring for a loved one will ease the burden of stress on these individuals.

The Health Service Executive in Ireland recommends that adults over the age of 65 are immunized against Pneumococcal disease and influenza (National Immunisation Office, 2008). In order that optimal immunisation results are obtained when vaccinating Carers, supports should be put in place to ensure that all caregivers, but in particular elderly caregivers, feel supported or that they have someone or somewhere to go to if they need help or respite, in order that they can benefit the most from vaccinations. The establishment of abovementioned support networks for Carers could increase the success rates of these vaccination programs for older adult caregivers. Currently and in the coming months, a major health concern is the administration and distribution of a vaccine against the H1N1 virus, also known as “Swine flu”. Adequate resources of social support for caregivers would potentially increase the effectiveness of such an immunisation scheme, prolonging health and reducing healthcare burden on services which are to become more stretched in the future due to demographic changes.

CONCLUSION

Carers experience chronic stress as a result of caregiving. This stress has the potential to negatively impact on their health. Older adult caregivers, for example spousal caregivers, are especially vulnerable to these negative health outcomes. Research has demonstrated that social support is one means through which these negative health effects could be reduced or lessened. Policy makers should not neglect to acknowledge the enormous contribution that caregivers make to their communities, as they aim to maintain and increase quality of life for care recipients, by maximising dignity and independence of the care recipient while simultaneously reducing the resource burden on state-funded care services. The present paper has provided the research background to simple measures such as social support provision that could improve the effectiveness of existing health strategies and policies such as immunisation.

REFERENCES

ADER, R. & COHEN, N. (1993) Psychoneuroimmunology: Conditioning and Stress. Annual Review of Psychology,44,53-85.

ARNO, P. S., LEVINE, C. & MEMMOTT, M. M. (1999) The economic value of informal caregiving.

Health Affairs,18,182-188.

BARON, R., BYRNE, D. & BRANSCOMBE, N. R. (2006)Social Psychology,Boston, MA, Pearson and Allyn Bacon.

BERKMAN, L. F. & SYME, S. L. (1979) Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents.American Journal of Epidemiology,109,186-204. CLYBURN, L., STONES, M., HADJISTAVROPOULOS, T. & TUOKKO, H. (2000) Predicting caregiver burden and depression in Alzheimer's disease. Journal of Gerontology B Psychological Sciences and Social Sciences,55,S2-13.

COHEN, S., DOYLE, W. J., TURNER, R., ALPER, C. M. & SKONER, D. P. (2003) Sociability and susceptibility to the common cold.Psychological Science,14,389-395.

COHEN, S., TYRRELL, D. & SMITH, A. P. (1991) Psychological stress and susceptibility to the common cold.New England Journal of Medicine,325,606-612.

COHEN, S. & WILLIS, T. A. (1985) Stress, social support, and the buffer hypothesis.Psychological Bulletin,98,310-357.

CROSS, J. (2009) Care and caring in Ireland, North and South: Older people as both recipients and givers of care. Dublin, Ireland, Centre for Ageing Research and Development in Ireland.

DEPARTMENT OF THE TAOISEACH (2006) Towards 2016: Ten year Framework Social Partnership Agreement 2006-2016. Dublin, Ireland.

GALLAGHER, S., PHILLIPS, A. C., EVANS, P., DER, G., HUNT, K. & CARROLL, D. (2008a) Caregiving is associated with low secretion rates of immunoglobulin A in saliva.Brain, Behavior, and Immunity,22,565-572.

GALLAGHER, S., PHILLIPS, A. C., FERRARO, A. J., DRAYSON, M. T. & CARROLL, D. (2008b) Social support is positively associated with the immunoglobulin M response to vaccination with pneumococcal polysaccharides.Biological Psychology,78,211-215.

GLASER, R., KIECOLT-GLASER, J. K., BONNEAU, R. H., MALARKEY, W., KENNEDY, S. & HUGHES, J. (1992) Stress-induced modulation of the immune response to recombinant hepatitis B vaccine.Psychosomatic Medicine,54,22-29.

KIECOLT-GLASER, J. K., DURA, J. R., SPEICHER, C. E., TRASK, O. J. & GLASER, R. (1991) Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. 53,345-362. KNOPMAN, D. S. (2006) Dementia and cerebrovascular disease.Mayo Clinic Proceedings,81,223- 230.

MCGEE, H. M., MOLLOY, G., O'HANLON, A., LAYTE, R. & HICKEY, A. (2008) Older people - Recipients but also providers of informal care: An analysis among community samples in the Republic of Ireland and Northern Ireland. .Health & Social Care in the Community,16,548-553. MORIMOTO, T., SCHREINER, A. S. & ASANO, H. (2003) Caregiver burden and health-related quality of life among Japanese stroke caregivers.Age and Ageing,32,218-223.

MURASKO, D. M., WEINER, P. & KAYE, D. (1988) Association of lack of mitogen-induced lymphocyte proliferation with increased mortality in the elderly.Aging - Immunology and Infectious Disease,1,1-6.

NATIONAL IMMUNISATION OFFICE (2008) Adult Immunisation. Dublin, Ireland, Health Service Executive.

O'SHEA, E. (2006) Public Policy for Older People in Ireland: Review and Reform. IN O'DELL, E. (Ed.)Older People in Modern Ireland: essays in law and policy.Dublin, First Law.

PINQUART, M. & SORENSEN, S. (2006) Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,61,33-45.

REDINBAUGH, E. M., MACCALLUM, R. C. & KIECOLT-GLASER, J. K. (1995) Recurrent syndromal depression in caregivers.Psychology and Aging,10,358-358.

SOLOMON, G. F. & BENTON, D. (1994) Psychoneuroirnmunologic aspect of aging. IN GLASER, R. & KIECOLT-GLASER, J. K. (Eds.)Human Stress and Immunity.San Diego, Academic Press. THE CARERS ASSOCIATION (2009) Carers in Ireland: A statistical and geographical overview. Tullamore, Co. Offaly.

THE OFFICE FOR SOCIAL INCLUSION (2007) National Action Plan for Social Inclusion 2007- 2016. Dublin, Ireland.

UCHINO, B. (2006) Social support and health: A review of physiological processes potentially underlying links to disease outcomes.Journal of Behavioral Medicine,29,377-387.

UCHINO, B. N., CACIOPPO, J. T. & KIECOLT-GLASER, J. K. (1996) The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health.Psychological Bulletin,119,488-531.

VEDHARA, K., COX, N. K., WILCOCK, G. K., PERKS, P., HUNT, M., ANDERSON, S., LIGHTMAN, S. L. & SHANKS, N. M. (1999) Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination.Lancet,353,627-630.

WAITE, A., BEBBINGTON, P., SKELTON-ROBINSON, M. & ORRELL, M. (2004) Social factors and depression in carers of people with dementia. International Journal of Geriatric Psychiatry,19,

582-587.

WORLD HEALTH ORGANISATION (2008) Statistics for healthy life expectancy at birth. Geneva, Switzerland, World Health Organisation.

VOLUNTARY ORGANISATIONS IN CLIFDEN, CO GALWAY: