Who Cares for Caregivers?
Syeda Emaan Aamir
Islamabad: Every morning begins with medication schedules, constant supervision and endless responsibilities. Every night ends with worry about what tomorrow will bring. Yet amid Pakistan’s growing conversation on mental health, one group remains largely invisible, the family members who spend years caring for loved ones with mental illness, dementia or disabilities.
Mental health experts say these caregivers are increasingly becoming the “hidden patients” of the healthcare system, silently battling stress, anxiety and burnout while ensuring the wellbeing of those who depend on them.
Across Pakistan, where formal long-term care services remain limited, families provide most of the country’s caregiving. For many, the responsibility lasts not for months but for decades.
Lives Built Around Care
For Nadia, a resident of Rawalpindi, caring for her daughter with a mental disorder has shaped every aspect of life for the past 30 years.
Her daily routine revolves around medication, emotional support and constant supervision.
The work is emotionally draining and physically demanding, yet she continues because her daughter depends entirely on her.
Like thousands of other caregivers across Pakistan, she says little attention is paid to the person providing the care.
Another caregiver, Kamran, has spent years looking after his father, who lives with dementia.
Beyond the physical demands, he says social attitudes often make the experience even more difficult.
People stare, ask insensitive questions or fail to understand the realities of dementia, leaving families feeling isolated.
“The hardest part is watching someone you love slowly change while knowing there is very little you can do,” he says.
Like many caregivers, Kamran admits his own health often takes second place.
The Cost of Constant Care
Mental health professionals say such experiences are becoming increasingly common.
Clinical psychologist Dr. Usama, who practices at the Pakistan Institute of Mental Health, says caregivers frequently experience chronic stress, anxiety, depression, sleep disturbances and emotional exhaustion.
“Caring for someone else often means neglecting yourself,” he says. “Caregiver burnout is not a sign of weakness. It is a natural response to prolonged emotional and physical strain.”
Psychiatrist Dr. Zainab agrees, describing caregivers as the healthcare system’s “second patients.”
She says years of continuous caregiving, financial pressure and social isolation place many family members at risk of serious mental health problems.
“The focus almost always remains on the patient,” she explains. “But if caregivers are overwhelmed, the quality of care inevitably suffers.”
The need for family caregiving is expected to grow.
According to Pakistan’s 2023 Population and Housing Census, the country has around 3.5 million persons with disabilities, representing approximately 1.6 percent of the population.
Most rely heavily on unpaid family members because rehabilitation centres, home-based healthcare services and long-term care facilities remain scarce.
As a result, relatives often sacrifice careers, financial stability and personal wellbeing to provide continuous care.
Experts say the burden extends far beyond physical responsibilities.
Managing medical appointments, behavioural challenges, financial pressures and uncertainty about the future can gradually affect caregivers’ emotional health.
Support Still Out of Reach
Unlike many developed countries, Pakistan has limited institutional support for caregivers.
Affordable counselling, respite care, home nursing services, caregiver support groups and workplace protections remain largely unavailable.
Mental health professionals say cultural attitudes also discourage caregivers from seeking help.
Because caregiving is widely viewed as a family obligation, admitting emotional exhaustion is often mistaken for weakness or lack of commitment.
International experience suggests stronger support systems can make a significant difference.
Countries including Canada, the United Kingdom and Australia provide combinations of disability benefits, home-care services, counselling and temporary respite programmes that allow caregivers to rest while ensuring patients continue receiving professional care.
While these programmes do not eliminate caregiving challenges, experts say they reduce emotional, physical and financial strain.
Caring for Those Who Care
Medical experts believe Pakistan’s healthcare system must broaden its understanding of mental health by recognising caregivers as an essential part of treatment.
They recommend expanding community counselling services, establishing caregiver support centres, improving access to home healthcare, developing respite care programmes and increasing financial assistance for families providing long-term care.
Public awareness campaigns, they add, are equally important to reduce stigma and encourage caregivers to seek support before burnout becomes severe.
According to Dr. Anthony Komaroff of Harvard Medical School, caregiving can be deeply meaningful but often carries significant emotional, physical and financial consequences.
The World Health Organization also emphasises that supporting caregivers ultimately improves patient outcomes because healthier caregivers are better able to provide sustained, compassionate care.
Recognising Invisible Workforce
Behind nearly every person living with mental illness, dementia or disability stands a family member quietly carrying responsibilities that often go unnoticed.
Experts say recognising caregiver burnout is no longer simply a matter of compassion—it is a public health necessity.
As Pakistan’s demand for long-term care continues to rise, ensuring the wellbeing of caregivers may prove just as important as treating the patients they support.
After all, when caregivers are supported, entire families become stronger, and so does the healthcare system that depends on them.
