Continuing to care: the needs and roles of older carers of people with dementia

One characteristic of an ageing population is the increasing number of people with dementia. The vast majority are supported by family carers at home; this population is itself ageing and older carers constitute as ever larger proportion of the total number. Despite shifts in patterns of traditional reciprocity, intensive care is predominantly provided by spouses on a co-resident basis and daughters or sons on an extra resident basis. Care-giving for a PWD is widely evidenced as complex, stressful and demanding. Research identifies two broad categories of challenge: primary problems relating directly to the symptoms of dementia; and secondary problems related to the consequences of caring. Certainly dementia carers are at enhanced risk of experiencing poverty, social isolation, stress and a number of physical problems. Whilst research strongly suggests that carers actively benefit from a number of respite and specialist services, it is the oldest carers who provide the most intensive levels of care who receive the least. Developing responses which support caring dyads and are flexible are current deficits; narrow conceptualisations of 'need' and pathological constructions of caring also undermine the potential of the care system to offer effective support. Ethnic minority carers of PWD, carers of people with learning disabilities and dementia, and carers of relatives in long term care are particularly invisible subgroups of dementia caregivers increasing in both number and need.