The link between loneliness and caring

Caring is hard work. The hours are often long, and can even be 24/7. A lot of caring is unpaid.

But being a carer is perhaps a lot tougher than you might imagine, because caring can be lonely – and loneliness is devastating.

To see the full extent of this, consider two ostensibly separate reports published in the past month.

Carers NI released State of Caring 2022, which outlines the challenges facing unpaid carers in NI. Those challenges are many. Among unpaid carers (over 80% of whom are women, while almost a quarter of whom have a disability):

• 56% are in some form of employment and 18% are retired from work.
• 31% have been caring for 15 year or more, 16% for between 10-14 years, 25% for 5-9 years, 25% for 1-4 years, and 3% for less than a year.
• 46% provide 90 hours or more of care per week, 13% care for 50-89 hours, 23% care for 20-49 hours, and 19% care for 1-19 hours per week.

The report also has a section on loneliness, which we’ll come back to a minute.

The second report of note was published by the Department of Health (DoH). Wellbeing in Northern Ireland, 2021/22 looks, unsurprisingly, at public wellbeing – and, in particular, it examines four different aspects of wellbeing: self-efficacy, personal wellbeing, locus of control – and loneliness.

The key question is this: how do the levels of loneliness among the general population compare with loneliness among carers?

Loneliness in general

For the DoH’s wellbeing report, the main question people were asked about loneliness was “How often do you feel lonely?” Respondents could choose from five different answers: always/often; some of the time; occasionally; hardly ever; and never.

The latest figures show that 6.1% of people are always or often lonely, while another 14.1% are lonely some of the time.

Combining these two groups shows that 20.2% of people are lonely at least some of the time, a figure that is roughly the same as for 2020-21 (19.8%) but significantly higher than the three previous years (when it ranged from 17.0% to 17.4%) – although the report notes that its methodology has changed slightly in that time.

Females (22.6%) are more likely than males (17.5%) to be lonely always/often or some of the time. People with a disability are almost twice as likely to be lonely as those with no disability. Over half of those in poor or very health are lonely at least some of the time, compared with 11.8% of those in very good health, 16.7% in good health and 28.4% of those whose health is fair.

Age is also a relevant factor, but not in a clear-cut way. Over 75s are the group with the highest percentage of people who are lonely at least some of the time (22.6%) but next in line are those aged 16-24 (22.4%), while people aged 65-74 are actually less likely to be lonely than both the 25-34 and 55-64 cohorts.

But how about carers?

Loneliness among carers

In the DoH figures, the closest comparison to being a carer is having a dependant. According to the departmental figures, the relationship between having a dependant and feeling lonely is not straightforward. Only 15.5% of people with a child are lonely at least some of the time, as are 18.1% of those with an elderly dependant and 24.8% of those who have a dependant with a disability – whereas 22.2% of people without any dependants are lonely with that frequency.

However, having a dependant is not the same thing as being a carer.

The Carers NI report has its own section on loneliness.

“Nearly 30% of carers told our survey that they often or always feel lonely, and this was linked to difficulties getting breaks from caring (see below), the impact of the cost of living crisis, which has made the kind of social activities necessary to combat loneliness unaffordable for many carers; and the demands of being a carer, which leaves them with little time to see family and friends.”

Over 1,000 people answered the Carers NI question about loneliness, with 26.9% saying they are always/often lonely, 49.1% saying they are sometimes lonely, 14.0% saying they are hardly ever lonely, 7.0% saying never, and 3.0% preferring not to say.

To be clear, that figure of 26.9% should not be compared to the 20.2% of people in Northern Ireland who are lonely at least some of the time. That 26.9% relates to people who are always or often lonely. Among the whole population, this figure is 6.1%.

In other words, carers are over four times as likely to be chronically lonely compared to the general public.

Over three quarters of all carers – 76% - say they lonely at least some of the time, compared with just 20.2% of people in general.

Support

Loneliness is very bad. It is bad, per se, but its consequences are bad too. It affects physical health significantly. In fact, research shows that in the long-term loneliness has similar effects on health as obesity or smoking 15 cigarettes a day.

Carers NI’s report says: “Carers’ lives are usually very full-on. Day-to-day, they may be responsible for lifting, moving, washing and dressing the person they care for, helping them use the toilet, cooking all their meals and maintaining the home. It is a physically demanding job, especially for those who are caring for a long time or into their older years, when the physicality of a caring role is mixed with the declining health that often comes naturally with aging. In this context, it is no surprise that 1 in 5 carers reported their physical health to be bad or very bad, rising even further, to 24%, among those who have been caring for ten years or more, and to 25% among those caring for 50+ hours a week.”

When this is considered alongside the DoH figures showing how health and loneliness are related, it is little surprise that carers are at risk. Nor is it even a revelation – organisations in the care sector have been looking into loneliness for years.

The Carers NI report also says: “Nearly 40% of carers identified support to prevent or reduce loneliness as one of their top needs as a carer, while over 50% said being able to take regular breaks from caring would help them feel less lonely…

“Our findings point to a clear link between access to breaks from caring and better health outcomes among unpaid carers. While just 36% of all carers said their physical health was good or very good, this rose to 44% among those who had had a break from caring within the last 12 months.”

It is clear that carers need far more help to improve their lives. This is imperative. The case for better help for carers is made simply by looking at loneliness, the effects of loneliness, and the frequency with which carers find themselves to be lonely.

But it’s worth noting something further. Not only are carers under-supported, they are being exploited. As the Carers NI report says: “Unpaid carers save the public purse in Northern Ireland £4.6bn in care costs annually, very often at the expense of their own health, finances and social welfare. If they disappeared for even one day, the Health and Social Care system would collapse, but too often, the support they receive when making such an enormous contribution to society falls far short of what they need.”

Carers should have our gratitude, respect – and better public support.