Dr Rosemary Anderson
Chair, International Counselling Association

Gavin Macgregor
North of England Manager, Carers UK

Grace Wiltshire
Carer Support Manager, The Pituitary Foundation

A carer is someone who provides care to a relative or friend who needs help because of a physical illness or disability, a mental illness or disability or a learning disability. Carers UK is a charity and organisation of all carers, from parents to those caring for elderly relatives. It offers independent information and advice on all aspects of caring as well as doing campaigning work. Carers UK asks carers about their experiences and translates the message to government, social services and local and health authorities. A recent campaign focused on involving carers in the planning of hospital discharges. This is particularly important when patients are first diagnosed but also when caring long-term. The carer is highly knowledgeable and the services can ignore the expertise the carer has, to the detriment of the patient.

Carers often do not know what benefits they are entitled to and as a result of the third Carers' Rights Day in December 2002 many more carers have claimed. From October 2002, carers over 65 years can submit a claim for Invalid Care Allowance (ICA). In order to qualify for ICA, carers must:

• Care for at least 35 hours a week;
• Earn less than £75 per week;
• The person you care for must receive Attendance Allowance if over 65 or the middle to higher rate of the care component of Disability Living Allowance (DLA); and
• If you are a student you must study for less than 21 hours a week.

Pensioner carers, or those on Job Seekers Allowance or Incapacity Benefit, were entitled to ICA but it has been renamed. From April 2003 ICA has been called the Carers' Allowance. If you are on Income Support you can receive a carer premium but disabled people who get a severe disability premium to help towards their care can lose the premium if their carer gets the Carer's Allowance. The organisation is addressing the problems faced by those over 65. When the person you are caring for is getting social care, home help or respite care they have a community care assessment or children's assessment. The carers' assessment, carried out by social services, provides an opportunity to say what you find difficult and gain information about carers' support services. Carers' physical and emotional needs should be taken into account, as should problems associated with work or time for other family members.

In Rosemary's session, she defined stress as "a non-specific effect on the body, which usually occurs when we have no control over a situation or feel we have no control over a situation". Control is fundamental to stress. Mental stress usually occurs when our perceived ability to cope with a situation does not match our perceived demands of the situation. Chemicals used to measure stress can be found in relatively high levels in carers. With fight or flight syndrome, the pituitary gets the adrenaline working, which affects the automatic nervous system. The Adrenal glands make more adrenaline, changing the body chemistry and causing more cholesterol production. This lowers the immune system. Long-term stress means the body has no time to recover and can lead to hypertension and high blood pressure.

Carers should exercise for twenty minutes three times a week, although ten minutes is better than nothing, as the endorphins transmitted when you exercise make you feel good. Stress can make you feel low and lead to depression but with decent diet, sleep and exercise you will deal with stress better. It can be therapeutic to share thoughts with others. You may feel guilty but if you aim to carry on caring you cannot afford to "go under". See a friend or join a carers' group. Take time out to relax. The key is prioritising time for yourself.

You can get information on benefits from Citizens Advice Bureaux, Welfare Rights Units, disability associations and from the Department of Work and Pensions. In addition to providing information on benefits, Carers UK can also help with information and advice about carers' assessments and other aspects of caring. Telephone the Carers Line on 0808 808 7777 or visit the web site at www.carersonline.org.uk.