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Thousands of people regularly care for an older relative around the UK. Although it is often a demanding task it can also be a rewarding one. But three recent cases of carers of older people have turned this perception on its head - and for all the wrong reasons.

Bernard Heginbotham was charged with killing his 86-year-old wife Ida earlier this month. Ida, who suffered from dementia, had been admitted to a nursing home after falling and he is accused of stabbing her in the neck during a visit. He was expected to appear before Preston Crown Court earlier this week and at 99 is believed to be the oldest person in British legal history to be charged with murder.


Last month, Susan Cayton was sentenced to life in prison for stabbing to death her 75-year-old housebound disabled mother. Cayton cared for Winifred Robinson on a daily basis in her St Helens home before the attack in September 2003. During the incident Robinson pressed her panic button connected to social services and the attack was recorded. Andrew Menary, QC, prosecuting barrister, told Liverpool Crown Court that Robinson "was not always grateful and the defendant seemed to be resentful of her".

Then last August, 81-year-old Audrey Hingston stabbed her 83-year-old husband Eric to death as he slept at their home in Plympton, Devon. At a news conference the following month she claimed burglars attacked him and appealed for witnesses. She later confessed to her son that she had killed him because she "could not take any more of his illness and having to care for him". Last month Hingston was jailed for two years for manslaughter.

While other factors may have been at play, of course such action can never be excused. Imelda Redmond, chief executive of charity Carers UK, says although caring for someone can be challenging, it is a mistake to blame the pressures of the caring role for these deaths. "It's not good enough for the carers' movement to say the people who killed those they cared for were 'under stress'. It does everyone a disservice because murder is murder."

Murders of older people by their carers are fortunately rare occurrences. But what pushes a carer to the point where - although they do not harm their relative - they feel so desperate they can no longer care for them? Redmond says it can be a gradual process as carers find themselves increasingly isolated as they are forced to stay in their own homes more and more.

Such isolation can be exacerbated when a carer does not have access to support or training. Action on Elder Abuse chief executive Gary FitzGerald says: "It can happen when carers don't have a place to go and say 'I'm not coping' without it being construed as a failure." He adds that callers to AEA regularly tell him they are frustrated with having to fight their corner. "Lots of carers feel they can't make services understand what their family is going through and people feel they have to beg for help."

Another problem is that when an older person is caring for someone of a similar age there can be confusion regarding who is the carer and who is being cared for, says Age Concern England community care policy officer Stephen Lowe. "It is not clear within the relationship and nor is it clear for services looking in on the relationship."

Anne Roberts is chief executive of Crossroads, an agency providing support to 35,000 carers a year in England and Wales. She believes some carers reach breaking point when their own needs, such as their health, change and impact on their ability to care. In particular, she says, this can affect carers who are old themselves.

One barrier to support services is whether someone actually identifies themselves as a carer. Roberts says many people believe they are looking after their parent or partner because they should do. It is not until something specific happens such as a crisis and they come into contact with social care agencies that they realise they are a carer. Health and social care professionals can add to the melange by not always recognising the carer's role. Roberts says: "People can find themselves caring for someone without the appropriate support." In order to have a carer's assessment she says carers need to be informed enough to know such help exists.


Support services are often targeted at the most able or most confident carers, which makes it difficult for those who aren't aware of their rights or who are less prepared to speak up for themselves to access them, says Redmond. She adds there is not enough recognition of the diversity of carers and this often leads services being "aimed at a stereotype of a carer".

To gain access to support services a carer has to be assessed by their council. However, although social services have a statutory duty to meet the cared for person's needs, this is not the case for the carer's own needs. Many believe the carer's assessment is geared towards identifying who the carer is rather than looking at their situation holistically and providing for both individuals.

Financial assistance exists in the form of the carer's allowance for those looking after a person in receipt of attendance allowance or disability living allowance for at least 35 hours a week. In October 2002, the rules for carer's allowance were changed and for the first time carers aged 65 and over could claim it. This was supposed to lighten carers' loads but some are not eligible because of the amount of pension they receive.

Social care professionals can help carers of all ages by removing some of the pressure of caring, says Redmond. This includes considering whether carers wish to continue to work or study: "There shouldn't be the assumption that they will give up everything because they are now a carer." Redmond recommends staff help carers contact their local support network, be that a carers' group, church or a branch of Alzheimer's support.

FitzGerald advocates introducing the concept of person-centred care, much like person-centred planning adopted by the learning difficulties field, into caring for older people. He says: "If we start to look at older people as individuals rather than just cases it will create more flexibility in services." Carers, he adds, must be considered part of the support system needed by an older person, and not external to it.

The growing shortage of care homes offering suitable respite is also a problem. To address this, argues Lowe, local authorities and government should make funding available for more respite care in the home.

Carers were given a boost earlier this month when the government announced its support for the private member's Carers (Equal Opportunities) Bill. The bill gives carers new rights to opportunities for education, life-long learning and work. Commenting on the bill, community care minister Stephen Ladyman said that carers should be able to take up opportunities which other people "often take for granted".

Now is the time for more carers' support services to reflect this drive. Perhaps this could prevent some carers being driven to breaking point.