Printed on: September 7th, 2026

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Carers: assessing and helping carers

Here are some statistics to focus the mind (British Geriatric Society – comprehensive geriatric assessment hub, accessed September 2025):

• Informal care is thought to be valued at £445 million a day – a similar amount to the costs of the NHS for a day
• After the age of 50y, the average person will spend more then 5 years providing informal care.
• 8% of UK households include someone who is an informal carer. 

This article was updated in September 2025.

The British Geriatric Society, in its comprehensive geriatric assessment hub (accessed September 2025), reminds us of the issues related to carer stress. Although written with those caring for older people in mind, this applies to many caring situations:

• The stress perceived may relate to:
  • Amount and type of care needed. 
  • Quality/dynamics of the relationship with the person being cared for prior to them needing care.
  • Carer’s health.
  • Support networks available to carer.
  • Community expectations and societal value placed on caregiver role.
• Carer stress can present in a number of ways, including sleep disturbance, anxiety, low mood or depression. 
• Carer stress can lead to resentment and, occasionally, harm and abuse.

The British Geriatric Society recommends a couple of tools that can be used to assess caregiver stress:

• Zarit.
• Caregiver Strain Index.

In 2020, NICE published guidance on how to support adult carers. Most of the guideline is relevant to those working in social care, but we have picked out areas where primary care may be able to play a role (NICE NG150 2020). 

An older BMJ review looked at the challenges of healthcare professionals attempting to comprehensively assess carer needs. It suggested that while we may not have the time or skills to do a comprehensive assessment, we could focus on these components (BMJ 2011;343:d5202):

• Identify and code patients who have a major caring role (don’t forget young people who have caring roles for adults).
• Briefly assess their physical and mental health needs.
• Know where to signpost carers for local advice and support, e.g. regarding house adaptations, benefits, legal advice, carer education, respite care. This role may now be undertaken by social prescribing link workers.
• Help the carer to plan for emergencies.
• Develop a therapeutic relationship with the carer that is effective at listening and offering support.

The 2021 census identified that there were 127 000 young carers (aged 5–18y) in England and Wales (BMJ 2025;390:r896). A study interviewed young carers to learn about their needs, and found that they valued the following 4 types of support (BMJ 2025;390:r896):

• Support for the person they cared for (usually a parent).
• Support for themselves.
• Mental health support.
• Support in school (understanding staff, time-out cards to leave early when needed).

In addition, young carers wanted:

• Easier access to services (e.g. referrals to appropriate services, help navigating what benefits were available, support when trying out a new service such as a young carers’ group).
• Having someone to talk to outside the immediate family so they could say things they couldn’t say to the person they cared for. 
• Trust and confidentiality: to be able to talk to people who understood what they were living with and for sensitive information to be well managed. Some of the parents also feared social services, and worried that child protection services might make interventions.
• To be included in decision-making.
• For people to be proactive but not intrusive.

The authors concluded that to improve the experience, young carers needed: 

• Improved support for those they cared for.
• Support for the whole family, based on strengths and needs.
• Accessible information about what support is available.

Remember, young carers (or their parents) can ask for a young carer assessment. This will focus on the needs and wishes of the young person, including time to do normal childhood things, schooling and homework, and needs of the person they care for. 

	Carers: assessing and helping carers Have you identified and coded your carers? Have you asked them how they are getting on and whether they need any support? Would you consider using one of the carer assessment tools highlighted by the British Geriatric Society (Zarit or Caregiver Strain Index)?
	Do you identify carers at new patient registrations and annual dementia/medication reviews? Do you have a practice policy for identifying and coding carers? Do you have resources for carers within the surgery? Do you know where your local carers’ groups meet and how to contact them?
	Useful resources: Websites (all resources are hyperlinked for ease of use in Red Whale Knowledge) NHS England – supporting carers in general practice: a framework of quality markers   Useful resources for carers: Carers UK (lots of practical advice and education for carers)  Carers UK - getting support if you are a young carer or young adult carer Sidekick (a text support service run by Action for Children for young carers (13–18y))