title: Understanding informal carers' experiences of caring for older people with a hip fracture: a systematic review of qualitative studies.
abstract: This systematic review aimed to reconceptualize experiences from a variety of papers to provide direction for research, policy and practice.
  
  
  
  Meta-ethnography was used to inform the review, and 21 studies were included.
  
  
  
  The analysis identified a core theme of "engaging in care: struggling through", as carers, who wanted to be involved in caring, learnt to live with the intense and stressful impact of caring and changes to their life. The core theme is represented through three themes (1) Helping another to live, (2) Adapting ways of living and (3) Negotiating the unknown.
  
  
  
  The discussion identified a focus on carers of people suffering from a hip fracture, the willingness of informal carers to engage in caring and the intense experience of adapting to changes in relationships and dependency alongside a steep experiential learning curve. Tensions exist in negotiations with complex health care systems as carers do not feel their expertise is valued and struggle to find and understand information. Implications for Rehabilitation Including relatives/carers in the umbrella of care within a family-centred approach. Involving relatives/carers within shared decision-making about care requirements and rehabilitation goals. Utilizing forms of experiential learning to help the development of relatives/carers skills in relation to their role as carer. Providing opportunities for carers to explore ways of sustaining their own health through self-compassion.
authors.affiliation: a Culture and Society Research and Study Centre, National Scientific and Technical Research Council. (CIECS-CONICET-UNC), Córdoba , Argentina.
authors.forename: Lorena
authors.initials: L
authors.lastname: Saletti-Cuesta
authors.affiliation: b Kadoorie Critical Care Research and Education Centre, Oxford University Hospitals, NHS Foundation Trust , Oxford , UK.|c Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick , Warwick , UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tutton
authors.affiliation: d Trauma Unit , John Radcliffe Hospital, Oxford University Hospital, NHS Foundation Trust , Oxford , UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Langstaff
authors.affiliation: b Kadoorie Critical Care Research and Education Centre, Oxford University Hospitals, NHS Foundation Trust , Oxford , UK.|e Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science , University of Oxford , Oxford , UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Willett
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D006620:Hip Fractures / Q000523:psychology / Q000628:therapy*; D006801:Humans; D012944:Social Support; D013315:Stress, Psychological
keywords: Review; ageing; caregiver stress; caregiver-informal; decision-making; hip fracture