ABSTRACT
Much has been written about carer burden and carers’ feelings of exclusion from the professional care team but little attempt has been made to identify a conceptual framework to give meaning to the carer role. This position is paradoxical in view of the centrality of carers in community care and their potential to advocate for appropriate services for the people they care for. This chapter argues that the current carer position needs to be understood in its historical and political contexts and with reference to recent research, introduces a conceptual framework to enhance the positive potential of the carer role. Carer Position Most carers are also relatives (CNA, 1997), but friends and neighbours may also provide care. The 2001 population census in England (Office for National Statistics, 2002) records around 6.8 million carers of which approximately 1.5 million are providing care for a relative or friend with mental illness or some form of dementia. Community care statistics reveal that one-quarter of all adults assessed during 2001/02 by mental health services were identified as having an informal carer (ONS/DoH, 2002). Research into schizophrenia (Johnstone et al., 1984; Birchwood and Smith, 1987; Hogman and Pearson, 1995), depression (Kuipers, 1987), manic depression (Hill et al., 1998) and dementia (Levin et al., 1983; Gilhooly, 1987; Twigg, 1992) report carer sacrifices in health, family and social life, employment, leisure and finances. The proportion of carers whose health is adversely affected by caring responsibilities increases with the increased number of hours spent on caring (Office for National Statistics, 2002).
