A carer is a person who provides unpaid support and care for someone who has an illness, disability, mental health problem or addiction. The carer might be caring for their parent, child, partner, grandparent, grandchild, other relative or friend. Caring may be short-term or long-term, and full-time or part-time. Carers are usually women, but can even be children caring for parents. These people are all around us and may be struggling in this role as they often have to combine this role with other roles (usually working or parenting).
Someone might not consider themselves a carer if they:
• feel it’s their duty or responsibility to care for the person
• are providing support that is not practical or physical, e.g. they might be providing emotional support
• believe that a carer is someone employed by social services.
Caring for someone may have both positive and negative impacts on the carer. For example, caring can be very rewarding and satisfying through:
• increasing the carer’s confidence, particularly in supporting others, dealing with people, dealing with services, and so on
• increasing the carer’s empathy and understanding of other people
• giving the carer a new perspective on – and new appreciation for – their own life
• helping the carer feel closer to friends and family
• bringing or enhancing a sense of purpose.
However, there may well be huge challenges for the carer:
• Stress and worry may be present, about the health and the future of the person they are caring for, and about day-to-day practical issues such as appointments, medications, safety, money etc. These worries may make it really difficult for the carer to ‘switch off’.
• The carer’s family relationships and partnership may break down under the stress of caring, leading to increased isolation.
• The carer may feel isolated and even become lonely, through having less time to socialise, and to pursue hobbies and interests. If they have left employment in order to be a full-time carer, then they will no longer have colleagues. They may feel that friends don’t understand what they’re going through.
• The carer’s health may suffer if they have less time to care for themselves, eat healthily, exercise, and go to their own health appointments.
• The carer may be unable to complete their education or focus on their career.
• The carer may find themselves in financial difficulties, through having to pay for extra care, or for medical and travel costs. This situation is likely to be exacerbated if they have left their job to care for the person. Any benefits may not cover all the costs, and they may be unaware of benefits they are entitled to.
• Emotionally, the carer may find themselves feeling resentful of, or getting angry or frustrated with, the individual. They may then feel guilty for doing so.
• The carer may experience low self-esteem through always putting themselves last, perhaps from not completing education, from not working and therefore losing a part of their identity, or from feeling like they’re not a good-enough carer.
• These problems can lead to depression and to unhelpful coping strategies such as alcohol or drug misuse, under- or over-eating, self-harm and suicidal behaviours.
Researchers have explored the key factors associated with well-being among those caring for children with cerebral palsy. Key predictors of carer distress were:
• the child having lower levels of mental and physical health
• the child having higher levels of behavioural problems
• poor family function.
The impact of these distress predictors was more moderate in carers with higher self-esteem and a sense of mastery over the caregiving situation.
Three other research studies also found evidence of carers experiencing anxiety and/or depression:
• 63% of women and 38% of men caring for someone with cancer showed evidence of at least moderate levels of anxiety and depression.
• 27% of carers for people with heart failure experienced significant depressive symptoms.
• 23.5% of those caring for someone with Alzheimer’s disease showed clinical levels of anxiety, and 10.5% could be diagnosed with depression.
Factors that may moderate the extent to which anxiety and depression are experienced by carers have been found to include:
• how capable the cared-for person is at caring for themselves
• how much control the carer feels they have over the condition
• the complexity of the caregiving tasks
• how much time the carer devotes to the caregiving role
• the carer’s own health
• the quality of the relationship between the carer and the patient
• the degree of support available to the carer.
Physical care needs are often (but not always) more clear-cut than mental care needs. If a person is caring for someone mentally but not physically, they might have thoughts such as:
• ‘I’m not really a carer.’
• ‘I’m not helping much.’
• ‘I don’t understand what they’re going through.’
• ‘I don’t know what I’m doing.’
• ‘Am I doing the right thing?’
The carer may encounter concern over the individual’s safety and risk, both from others and in themselves. There might also be more stigma or worry about potential stigma when supporting someone with their mental health, and the relationship between the carer and individual may be more impacted, for example:
• The individual might push the carer away or say upsetting things to them.
• The individual might resent the carer.
• The individual might feel like they don’t want the carer to look after them (e.g. if they are an addict).
It can also be harder to access support services for mental health.
However, physical caring may be more physically draining and may involve:
• modifications to the house (stairlifts, hoists, etc.)
• manual handling
• personal care
• support with physiotherapy exercises.
In order to support carers, it is important to try to:
• Ensure that you are meeting the carer’s needs. Since most of their time will already be spent focusing on the person they care for, do ensure that the support isn’t accidentally focused on them as well.
• Explore what is important to the carer, finding out who they are outside of their caring role (hobbies, interests, goals etc.).
• Open up conversations about self-care and gently challenge arguments against self-care. Look at where and how they could prioritise themselves and/or delegate caring tasks.
• Explore the carer’s anxieties and worries, and any irrational thoughts (e.g. ‘I’m doing it all wrong’, ‘People are judging me’ and ‘I’m not a good enough carer’).
• Encourage the carer to build up a support system, and signpost them to organisations such as:
- The Carers Trust and Carers UK.
- Turn2Us and Citizens Advice for carers needing financial guidance and support.
- Rethink Mental Illness (offers local peer-support groups) may be useful for carers who are experiencing – or looking after someone with – mental health difficulties.
- The NHS Social Care and Support Guide website may also be valuable.
We probably all know someone who is a carer to some degree. So, when we meet them, let’s sit and talk to them for a while to see how they are. And, if you’re a carer, then do try to look after yourself, mentally and physically, and ask for help if you need it.
Source:
Launder, A. (2022). Counselling Carers [lecture]. Counsellor CPD. Counselling Tutor. [23/09/24].