Caroline Abrahams is the Charity Director at Age UK.
In the week during which International Women’s Day falls I want to focus on an experience which, if not quite universal among older women, is extremely common, and that’s of being a carer. By this I mean taking on the role of looking after someone else, typically a partner or parent, on an unpaid basis. Some people are carers over a lifetime for their adult children with learning disabilities, while others, so called “sandwich carers”, find themselves caring both for younger and older relatives at the same time – an onerous responsibility indeed.
I am a carer myself, for my 92-year-old mum, who was fit and well until she had a tragic accident four years ago, robbing her of most of her mental capacity in an instant and making her dependent on others for all activities of daily living. I am now doing the “hardest yards” of caring, helping to care for her as she approaches the very end of her life. Like so many others, my caring role will come to an end when the person I am caring for dies. Then I will have to rebuild my life again.
I didn’t become a carer for my mum from a sense of duty, less still because of exhortations from some policymakers that “families must do more”, but because of a feeling of reciprocity. We have been the best of friends and my mum would have done anything to help me, whatever it took. Therefore, I wished and wish to do the same. It has been an amazing experience, one I took on willingly and with no regrets.
But I would also be the first to say that despite the tragedy that befell my mum I have been immensely fortunate to have been able to make the system work for her and for me, since I knew my way around it owing to my professional role. I have also been able to combine my caring responsibilities with continuing to work, because Age UK has been a marvellously sympathetic and flexible employer. Most people are not nearly so lucky in either respect.
What would most help older women, and men too, who care? Not one thing but a whole raft of measures. Above all a properly funded and effective system of social care would back up what unpaid carers do and make caring a less scary and lonely experience. I am thinking especially here of the legions of older people who care for a partner with dementia; something that is both extremely challenging and also often very isolating for them. Too many are left without the support they need, in the most heart-breaking of circumstances.
As Danny Kruger has observed in his recent report on the future of social care, produced with Demos, many people who need care get it from a combination of informal, unpaid support from family and sometimes friends, plus the input of formal care services. This is important because the debate about the future of social care often erroneously assumes it’s one or the other. This reality, that it’s both, reinforces the importance of formal services wanting and being able to work collaboratively with unpaid carers. From what we hear at Age UK, sometimes this happens but not always.
The same is also true of the local NHS. The vast majority of older people with care needs also have health needs, so if you are a carer for an older person you are highly likely to find yourself interacting extensively with GPs and their teams and district nurses and the like. Some health professionals are great at working with unpaid carers, but it’s not a given.
A more collaborative, properly funded approach between formal services and unpaid carers would also remove a disincentive to informal caring: that is the sadly legitimate fear that if you take on a caring responsibility you will be “dumped on” and formal services will back off, leaving you to it. We hear many examples of this at Age UK and while its wrong that it happens it is scarcely surprising, given that social services are stretched beyond endurance in trying to reach all those in need.
What I have just described is a form of “rationing” by formal services, something that manifestly happens in many other ways within social care too. Access to state-funded help with care is invariably a tortuous process, requiring resilience and staying power – often from the unpaid carer if the person needing care is unable to advocate for themselves, as was the case with my mum. Both NHS continuing healthcare and council care are underfunded and when applying for them it is not unusual to encounter barriers that may or may not seem fair or based in law – with few apparent opportunities to challenge them. This piles huge additional stress onto carers.
The fact is that the decisions about social care, or lack of them, in Whitehall eventually result in unpaid carers as well as the people for whom they are trying to do their best losing out financially as well as in terms of the quality of life they are able to lead while caring. The financial hit on unpaid carers who give up work to care is huge, often condemning older women to penny pinching in retirement. Capping very high care costs would help, but for full-time unpaid carers not enough on its own: the benefits paid for caring must go up too. They are currently below those for the unemployed – a travesty.
Then there’s flexible working. It is invariably in the best interests of a carer to stay in employment, both in terms of their quality of life and their finances. For older women like me, once caring ends you may be unable to get another job, leaving you in a real financial mess if you gave up work to care. The pandemic has seen a sea-change in attitudes towards and experiences of working from home and other forms of flexible working. I would like the Government to solidify this cultural change through amending the law to increase access to flexible working, from day one in a job.
When he entered office the Prime Minister promised to “fix social care” and he has repeated that pledge many times since. I sincerely hope we will see his promise bearing fruit later in the year and, if and when it does, that it fully factors in the need to support our carers, including our older women carers. And I believe most readers of this and other articles on ConHome would say they – we – deserve it.