| 191 7 Discussion This study aimed to explore the relationship between carer burden in dementia and social care. We identified the relationship between accessing and using social care and carer burden whereby mainly negative experiences resulted in increased carer burden. Positive experiences with using and social care were reported but these could not be directly linked to carer burden. This study is the first to link caregiver burden to burden for social care workers. It was evident that providing informal care negatively impacted informal caregivers’ quality of life, in line with other studies (42). Caregivers strive to maintain normalcy for their loved ones living with dementia and take over responsibilities, despite this sometimes adds to their burden (43). Carer burden is a dynamic process, as caregiving tasks and support needs change over time as dementia progresses (44), and we did not ask about the duration of providing informal care and changing needs. However, there is some evidence suggesting that the use of homecare services by a person living with dementia may prevent the worsening of carer burden (45). Other studies reported that when social care services are used, unmet needs around quality of life remain (46). Taken together, this suggests that social care alone may not be sufficient to decrease carer burden and additional strategies are needed to address carer burden. Burden seemed to play a crucial role when informal caregivers sought support or social care, and it was often initiated after they reached a breaking point. Seeking help during a crisis might also be a barrier to accessing social care. It has been demonstrated that informal caregivers may not always be open to support initially, despite it being considered helpful when they do (47). Informal caregivers may also feel overwhelmed in times of crisis, making the challenges of navigating availability and access to social care services worse. Further research is needed to examine and identify how informal caregivers can be supported to start social care early, before informal caregivers become too burdened. When accessing social care, a lack of knowledge of available services and support is described as a barrier in our study and others (43). Whilst informal caregivers felt they lacked information and awareness in our study, social care workers observed that informal caregivers did not access the available information. There is mixed evidence on how informal caregivers perceived
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