Distress among carers can be chronic and can deteriorate with the passage of time. The time spent looking after people by their carers is generally greater than envisaged for professionals under the European Working Time Directive and there is the danger of domestic care replacing former longstay wards! Stress experienced by informal carers (mostly female) looking after the mentally ill has been neglected by researchers until recently. Carers contend with abnormal behaviour. They are out of pocket, have less time for leisure, and suffer the various other losses inherent in their predicament, not least the loss of a healthy loved one. Males are often more difficult to care for than are females.

Negative symptoms, increases in suicidal ideation, prolonged illness, dependence on the sick individual in the past and a close relationship with the patient constitute other sources of strain. Relatives complain very little and receive little support or advice. Professional assistance has not improved significantly since deinstitutionalisation began. Family carers with poor coping strategies are at greater risk of experiencing depression and anxiety, and wounds in female carers of demented relatives take longer to heal and their peripheral white cells’ interleukin-1beta mRNA response is attenuated. The Carers Act 2000 in the UK entitles carers to their own separate assessments.

The British 2008 production, Carers at the Heart of 21st-century Families and Communities, held that carers would become viewed as expert care partners in the future and have access to integrated and personalised services to assist them in their role. They would enjoy a life of their own in parallel to that of caring, they would not face financial hardship and would be helped to remain mentally and physically well. They would be treated with dignity. Families may direct the anger caused by a chronic illness in a relative into founding a support group or to increase awareness among the public at large. Families may experience depression, fracturing of relationships or elder abuse.

As has been flagged for years,¹ the world has an ageing population. In 1991, Ireland had 403,000 people over 65 years of age and this could increase to almost 700,000 in 2026. Over 11% of people were at least 65 years old in 1996. In 2031, it is likely to be 18%. What are we as a society doing to prepare for these changes?

Reference

1. Falvey J, O’Shea B. Ir J Psychiatric Nursing 1983; 2(1): 30-3