by Nigella Howarth
It is 2am and my phone is ringing. It’s an elderly relative. She’s feeling confused, is unable to find me and needs reassurance. I agree to pop round as it is only five minutes away.
Cup of tea made, reassurance given and my relative safely tucked back into bed, I arrive back home at 4am. Too awake to go back to sleep, I start on my to-do-list.
The day ahead looks manic. I have four client visits and a couple of meetings. All have the same degree of urgency and all need to be finished today.
I arrive at the office at 7.30am. My relative’s carer texts me. My relative’s apparently really very confused and saying she hasn’t seen me in days. I explain I had visited during the night and I asked for GP to be called to rule out another infection.
At 9am the GP phones, ‘You need to bring your relative to the surgery’. The appointment time clashes with a planned meeting for work. A quick reshuffle of appointments and I’m back home to accompany relative to the doctors, who is now running an hour late.
Antibiotics prescribed, quick return home, drink made and return to work. Now I’m running two hours late into an already manic day.
Starting again
By 4pm I have caught up. All visits and meetings are attended, so I sit down to complete the admin. Another text arrives. My relative has been out looking for me, as I’m not at home. I ask the carer to reiterate I am at work and I will be round when I finish.
I quickly write-up my day and complete the urgent actions. Everyone around me is packing up for the day but I know my day is just about to start again.
I arrive and am greeted by an angry relative. ‘Where have you been all day? Why have you not been to see me? I have had no company all day and felt lonely!’
While I know this isn’t factual I can’t help but feel guilty. Dinner made, shopping done, housework done, lots of reassurance given, the carer arrives so I make my exit.
I arrive back at my own house at 7pm and wonder how long I will have before I am called out again. By 1am, I had received two phone calls but now all is quiet. It’s time for me to sleep before starting the cycle again. Sadly, sleep is not my friend tonight and I lay awake thinking of all those things I have yet to do.
Always on call
My caring role is now creeping into my work role. There is no opportunity to switch to being a social worker as I am always on call as a carer. I don’t notice how tired I have become as I’m too busy coping to pay attention.
I am relating to family carers in a way I have never done before, I can empathise deeply with their situation and need to remind myself at times to remain focused on the client and not try to rescue the carer. I have to take sudden days off and reschedule appointments, which makes me feel guilty but I would feel worse if I did not look after my own relative.
This type of cycle in my work and home life continued for six months. I never knew when the next phone call would be or what would happen next.
I received random phone calls from the police checking my welfare as I had been reported as a missing person. Doctors phoned for an update on my relative’s health, and mental health services reiterated ‘She does have capacity’. Carers phoned, ‘She won’t let us do anything she only wants you’.
What can help you
Following further ill health, my relative said she no longer felt safe at home, and she moved into a care home, which she said she loved.
It was a sigh of relief to know that she would be safe and well looked after, and that I could go back to being just a visitor and not on-call 24/7, but alas my hopes were short lived.
The care home had phone lines in every resident’s bedroom, so I continued to get calls during the day and night, needing reassurance and emotional support.
Being a social worker and family carer is very hard. Having that level of emotional attachment to someone but trying to ensure their needs are met and they receive all of the correct services is a struggle.
Balancing all of their appointments on top of your own daily work can be really stressful, especially when they constantly decline support from anyone but yourself.
But so many people do this on a daily basis its finding out what can help you and seeking support where needed.
What I took from my experience was to be honest with other professionals about the dual roles’ impact on yourself and request flexibility. You need to make sure your employer knows you are a family carer and request flexibility with your hours.
Workplace carer groups are a lifeline, as is ‘me’ time. Saying ‘no’ should never be a weakness.
The ability to do this is essential to sustain everything you do.
Nigella Howarth is a pseudonym. She is an adults’ social worker.
A trauma-informed approach to social work: practice tips 
Problem gambling: how to recognise the warning signs 
Find out how to develop your emotional resilience with our free downloadable guide 
Develop your social work career with Community Care’s Careers and Training Guide 
‘Dear Sajid Javid: please end the inappropriate detention of autistic people and those with learning disabilities’
Ofsted calls for power to scrutinise children’s home groups
Seven in eight commissioners paying below ‘minimum rate for home care’
Facebook
X
LinkedIn
Instagram
My heart goes out to you. My mother has lived with me for 22 years, 2 years ago she was diagnosed with vascular dementia and her health and her mind have deteriorated. I am a local authority social worker and have worked for the same authority for over 25 years, but I am unable to get the help we need because “she lives with family”. Like your relative, whenever any assessments are done, she will not engage telling them “my daughter does that”. Yes I do, but you know what, I am tired, I have done a full days work and I neither need nor want to be coming home to start again.
She does not even want to be at home, she wants to be in a Care Home, because she is socially isolated and her mobility is not good. She struggles with the stairs in our house and I cannot afford to move to a bungalow where it would be easier for her.
I advise friends, do not take your elderly relative into your home, because then you are abandoned, it is the “get out” for them. I am now on anti depressants and there are times when I feel like running away and phoning the LA and telling them, she is your responsibility now. But she is still my mum.
I came into social work as I was a carer- initially to elderly relatives who lived in the same house. However, my relative did have a carer 3 times daily. Having children plus a husband with bi polar I was well aware of the stresses of caring and being ignored by ‘professionals’ who did not want to see the impact caring was having on my family life. I vowed that when I qualified, I would see the situation from the carer’s point of view. Over the past 22 years as a social worker, I have tried to be honest with those relatives who want to take over the care of their loved one – that at times your life is not your own, that you may feel resentment as the rest of the family expect you do everything as you are good at coping and very organised. But by all means seek help from LA and organisations such as Age UK and make sure you get as much respite care as your LA can give.
I totally support everything you have said in your article, Nigella. My husband and I care for two ladies in their mid 90’s, my mother and her sister. Both have very poor mobility, they fall and they have different types of dementia.
My mother lives seven miles away and my aunt 160 miles away. Our house is grossly unsuitable for people with mobility problems, as there are four flights of stairs. My mother can ring up to 12 times a day when she is anxious. My aunt does not ring so often but when she does, it is often in the early hours of the morning.
Like you, once awoken, I cannot get back to sleep. I’m afraid that occasionally, in order to preserve my own life (lack of sleep raises your blood pressure, and mine is already being treated by medication) I switch off the phone for the odd night.
I agree with Liz that there is huge pressure emotionally to bring elderly relatives into the care of your own home, but once done, you will get even less help. Luckily for us it is impossible, otherwise I am sure we would have fallen into this bear trap by now.
I am staggered at how much adult services social work has changed since I did it in the 1980’s. My mother is bravely and actively requesting residential care and does not meet the criteria. Given that she is doubly incontinent, confused, anxious and can hardly move, it makes you wonder exactly how bad it has to be for someone before their wishes and feelings are respected. Also, how can someone on Pension Credit be assessed to contribute more than the value of their Attendance Allowance towards their home care? My aunt on the other hand (different LA) has been offered funded respite care for two weeks in a nursing home. She refused to go, but the offer was there.
I was an ASW for 15 years and am well used to having to make difficult decisions about people’s lives. However, I find the criteria used for making mental capacity judgements bizarre. It is blatantly obvious to all of us who are close to my aunt that she lacks capacity, but the visiting professionals whose job it is to assess this pop in for 30 minutes and then say that she has capacity.
I wish you well, Nigella, and hope very much that your situation improves. Juggling a full time job with caring is a nightmare and until someone has done it, it is hard to understand the constant conflicting demands.