When you care for someone, the relationship can be complicated.

You might love them deeply and want to do everything you can to support them. You may understand that their illness, pain, fear or frustration affects how they behave.

But what happens when the person you care for is also the person who is hurting you?

What Does Abuse Look Like in a Caring Relationship?

Abuse can and does happen within caring relationships.

It can include physical violence, but it can also be emotional or psychological.

It might involve shouting, threats, intimidation, controlling behaviour, financial abuse or deliberately making you feel frightened.

Abuse Can Be Difficult to Recognise When You Are a Carer

When abuse does happen in a caring relationship, whether there has been a history of abusive behaviour or it is something that develops for the first time, it can be particularly difficult to recognise, talk about or ask for help.

Sometimes there may be a pattern of behaviour that leaves you feeling worn down, isolated or as though you are constantly walking on eggshells.

And sometimes the situation is complicated by the needs of the person you care for. They may be living with dementia, a mental health difficulty, a neurological condition or another illness that affects their behaviour. They may be frightened, in pain, confused or angry about what is happening to them.

Understanding why someone behaves in a particular way can help you make sense of it. But it doesn't mean that you have to accept being harmed.

When You Feel Responsible for the Person You Care For

You might find yourself wondering whether what is happening is really abuse.

You may feel that you have no right to complain about the behaviour of someone who depends on you. You might even feel ashamed or responsible. Or tell yourself that you should be able to cope because you are the carer.

You may avoid inviting people in or going out because you don't want anyone to know. Perhaps there has been a lot of shouting at home, and you feel embarrassed about what has happened.

One of the things that can make abuse particularly difficult for carers to talk about is the sense that other people might not understand. You might even worry that people will blame you.

You might be frightened that someone will think you have failed as a carer. Or perhaps you are worried about what will happen to the person you care for if you tell someone. Who will look after them? Will they have to leave their home? Will their situation become even more difficult?

These concerns can make it very hard to speak openly about what is happening. And you may feel caught between caring for someone and protecting yourself.

You Can Care About Someone and Still Need Protection

Being a carer doesn't mean that you have to put up with behaviour that frightens, humiliates or harms you. But this can be one of the hardest things to acknowledge.

• You don't have to stop loving someone before you are allowed to say that their behaviour is hurting you.
• You can understand that they are struggling and still recognise the impact their behaviour is having on you.
• You can care about what happens to them and still need help yourself.

And asking for help doesn't mean that you are abandoning the person you care for. Sometimes getting support can be part of finding a way forward for both of you.

Getting Help and Support When Caring Has Become Harmful

If something in your caring relationship is making you feel frightened, controlled or unsafe, talking to someone can be a place to start.

You might choose someone you trust, your GP, a social worker or another professional involved in your care.

If you are in immediate danger or need urgent medical help, call 999.

If you are experiencing domestic abuse and are concerned about reaching out to your GP or social services, you might find it more comfortable to seek support through the ‘Ask for ANI’ scheme at your local pharmacy. Simply visit your pharmacy and ask for ANI (pronounced Annie). This is a code word for Assistance Needed Immediately, which will alert the pharmacist that you are being abused and require assistance. They will then invite you to a private consultation room. There, they will inquire whether you need immediate support from the police, and if so, they will provide you with a phone to call 999 or assist you in making the call. If you do not need emergency assistance but would like other support, they can help you connect with a domestic abuse helpline or local support service.

If you are not in immediate danger but are worried about what is happening, you can contact your local council's adult safeguarding team. They can listen to your concerns and talk with you about what support may be available.

Where Carers Can Get Support for Abuse

There are also specialist organisations that can offer advice and support.

• Victim Support provides free, confidential support to people affected by crime.
• Hourglass provides support for older people experiencing abuse and for those concerned about an older person's safety.
• Age UK also provides information and advice for older people and their families.

If contacting someone for help doesn't feel safe, it is worth telling them that. You can ask about ways of getting support that take your circumstances into account.

You deserve support too

Being a carer can sometimes mean becoming so focused on someone else's needs that your own gradually disappear from view.

If you are experiencing abuse, you may have become used to putting their needs first. You may have spent a long time trying to understand their behaviour, calm situations down or keep things going.

But your experience matters too. You deserve to be listened to. You deserve to be treated with respect.

And you deserve support if caring has become frightening, overwhelming or harmful.

You don't have to decide everything at once. Sometimes the first step is simply telling someone you trust what has been happening. And remember: you don't have to face it alone.