4 The family, illness and care
Families are not only important in establishing healthy lifestyles, they also play a crucial caring role in cases of illness or disability. Over recent years in the UK, rising numbers of people are living alone and there is an increasingly ageing population. Both these changes raise questions about whether the family is viable as a basis for informal health care provision.
Illness in the family can affect the whole family. The onset of illness in a family has both practical and emotional consequences that may affect individuals as well as the family dynamic (the way the family works and who fulfils particular roles). Additionally, the role the family assumes in informal care for its members influences the care they receive.
If, for example, a father has been the main earner in a family, and becomes ill for a long period of time, the family income may drop. Family members may resort to a poorer quality diet, use little heat in the home, and reduce or abandon holidays and family outings. The mother and older children may possibly seek additional paid work. If an elderly and infirm grandmother can no longer look after herself in her own home, she may move in with the family of one of her offspring, disrupting bedroom accommodation and family interactions. Apart from these practical consequences, illness brings physical and emotional stresses. Watching a loved one in pain, coping with a depressed spouse and dealing with the physical exhaustion of being available 24 hours a day, all take their toll on family life as well as on the individual who is ill.
In UK society, if family members are able to care for their relatives, they are usually expected to do so unless professional caring is necessary. Family members make many practical interventions to support the health of their relatives, whether children, spouses, parents and grandparents, or the wider family. This is because family relationships are often the closest relationships people have, and carry with them high levels of responsibility. When people are ill they usually expect that those they are closest to will rally round and support them. When a family member becomes ill other family members tend to feel responsible for that person and feel that they are morally obliged to care for them. This is most evident in the care of people with a long-term illness or disability. It can be surprising to discover that in England and Wales about six million adults care for a family member with a long-term illness or disability (White, 2013). It is estimated there may also be approximately 150,000 children in England and Wales who care for their ill or disabled parents in some way (Social Care Institute for Excellence, 2005). Research undertaken by Professor Saul Becker points to a hidden army of young carers with the number being four times that officially recorded. You will read more about his research in the section about young carers.
Caring is a complex emotional task. Sometimes the experience of caring is extremely rewarding. It may satisfy deep needs by helping some people to achieve the sense of success and satisfaction that may not be available to them in other ways. Sometimes, however, carers find the experience of caring difficult and depressing, and might become resentful of the fact that they had no choice but to take the role on. Care obligations can lead to exhaustion, disrupt normal family relationships, and leave people feeling isolated (Carers UK, 2012). Giving a thankful child a cuddle and applying some plasters to a cut is one thing; providing 24 hour care to a disabled and irritable elderly parent is quite another.
Recently, concerns have been expressed about what might happen if family carers begin to find their task too demanding, especially as the percentage of the population over 60 is set to increase. The audio case study below provides a helpful illustration of the issues carers can face.
Transcript: Case study: Sheila, the carer
Of course, if the number of people over the age of 60 increases, then so do the number of cases of illness associated with old age. One of the most distressing illnesses of old age is Alzheimer’s disease, which often places extreme pressures on family carers because of the damage not just to the individual sufferer but to the relationships she or he has.
Around 500,000 people have Alzheimer’s disease in the UK (Alzheimer’s Society, 2012). Although it can sometimes affect young adults, it is more likely to develop in older people and affects around 20 per cent of the population aged over 80. The problem is a worldwide one, although it has greatest impact on developed countries, partly due to their ageing populations.
The next activity contains an information box which explains Alzheimer’s disease, followed by an interactive activity to check your understanding.