Caring for someone – looking after yourself too

Most care in South Africa is given by family members, usually women, usually unpaid, and usually alongside other work. It is rarely described as a job, which is part of why the toll it takes goes unrecognised — by everyone including the carer.

Long-term carers have higher rates of depression, anxiety, disturbed sleep and physical ill health, and are less likely to attend to their own medical needs. This is not weakness or insufficient love; it is what sustained demand without relief does to anyone.

• Constant exhaustion, and sleep that does not restore.
• Irritability or anger towards the person you care for, followed by guilt.
• Losing contact with friends, and dropping things you used to do.
• Your own appointments, medication or symptoms going unattended.
• Feeling trapped, resentful, or numb.
• Drinking more, or relying on something to get through the evening.
• Thoughts of harming yourself, or of not being able to continue.

1. 1Accept specific offers, and make them specific when people ask. 'Could you sit with him on Thursday afternoon' gets a yes; 'let me know if you need anything' gets nothing.
2. 2Keep your own medical appointments. Tell your clinician you are a carer — it changes what they look for and what they can point you to.
3. 3Protect a small amount of time that is yours and is non-negotiable, even if it is an hour.
4. 4Share the load explicitly among family. Care almost always defaults to one person unless someone divides it deliberately.
5. 5Find others doing the same thing. Condition-specific support groups exist in South Africa for dementia, stroke, cancer and disability, and carers consistently report them as the thing that helped most.
6. 6Learn the practical skills — safe lifting, managing medicines, what to expect next. Competence reduces fear, and back injuries end more caring arrangements than exhaustion does.
7. 7Ask a social worker about respite care, home-based care services and the grants that exist. Clinics can refer.

• Keep one list of medicines, conditions, allergies and contact numbers, and keep it where anyone stepping in can find it.
• Sort out decision-making authority while the person can still grant it. Doing this early is far easier than the alternative.
• Look into the Care Dependency Grant and other social grants — many eligible families never apply.
• Tell the clinic you are the carer so you are included in appointments and instructions.

• ambulance10177Emergency Medical Services
• local_police10111South African Police Service
• sos112Universal Emergency (mobile)
• psychology0800 029 999SADAG Mental Health Crisis Line
• science0861 554 911Poisons Information Helpline