They work without working hours, without pay and often without a single day of rest. They care for elderly parents, spouses who have suffered a stroke, children with disabilities, people with dementia, cancer and serious chronic diseases. They are the "informal caregivers", that is, the people who keep thousands of families in Cyprus upright and cover daily needs that would otherwise have to be undertaken by organized long-term care services.
Their work is not paid, but it has enormous economic value. According to a European scientific study, the contribution of these people, who are collectively called "informal caregivers", in Cyprus was valued at €526 million per year, an amount corresponding to 2.79% of GDP. At the same time, public spending on long-term care amounted to only 0.3% of GDP.
They limit or abandon their work, lose income and social security contributions, become physically and psychologically exhausted and in many cases reach retirement, having dedicated years to caring for a loved one, without corresponding social protection.
The issue is back in the spotlight, as a new intervention by the World Health Organization comes to strengthen the discussion that is already underway in Cyprus on the recognition and support of informal caregivers.
The WHO presented a new policy options framework for the recognition and integration of paid and unpaid care workers in the design of health systems with the technical document addressing 20 thematic policy areas, focusing on education, working conditions, social protection, gender equality and better coordination of health and social care services.
In Cyprus, the government's intention to recognize the years of contribution of these people for pension purposes has already become known.
As Marios Kantaris told "F" on behalf of "Thalpo – Network for the Empowerment of Informal Caregivers of Cyprus", the need for an integrated National Policy for Informal and Family Caregivers is imperative, in the context of the reform of long-term care.
95,000 people, 87 million hours
As Mr. Kantaris explained, the magnitude of unseen work is reflected in a scientific study by Peña-Longobardo and Oliva-Moreno, which examined the economic value of non-professional care in 33 European countries.
For Cyprus, the study estimated that around 95,000 people provided informal care, dedicating a total of nearly 87 million hours per year.
"However, these are older estimates, as the study was based on data from the period 2016-2017. With the aging of the population and the increase in long-term care needs, the reality may be even more demanding today."
Who takes care of those who care?
Caring for a person with serious health problems or loss of autonomy is not limited to a few hours of help. It can include personal hygiene, nutrition, transportation, supervision of medication, escorting to medical appointments, night surveillance and constant presence next to the person in need of support.
For many family caregivers, this daily routine lasts for years or even decades.
Many take on the role suddenly, after a serious diagnosis, an accident or the deterioration of the health of a relative.
They often have no prior education, don't know what services can help them, and lack affordable alternatives.
"A daily life that can be accompanied by stress, emotional exhaustion, social isolation, loss of personal time and constant uncertainty about the future."
In many cases, caregivers are forced to limit their working hours, give up job opportunities, or even leave the labour market.
The loss of income is not only about the present. It can lead to reduced insurance contributions and lower retirement earnings in the future.
Elderly caregivers are particularly vulnerable, as they often take care of spouses and face health problems themselves.
What informal caregivers are asking for
The recognition of their contribution, according to Marios Kantaris, cannot be limited to statements of appreciation or occasional information initiatives.
"Recognising the impact of informal care must be accompanied by concrete support measures," she said.
Among the basic needs highlighted are the recognition and separate assessment of the needs of caregivers themselves, access to information and training, psychosocial support and the development of temporary respite services.
The focus is also on employment and income protection, adequate care leave, flexible working arrangements and social and pension protection.
"Thalpo" links the recognition of informal caregivers to the overall reform of long-term care in Cyprus.
As Mr. Kantaris mentioned, the experience from the implementation of the GHS demonstrates the importance of an integrated approach to the organization of services. Long-term care, however, is not exclusively a matter of medical care. It includes social services, home support, community structures, personal care services, and social protection measures.
For this reason, the Network argues that Cyprus needs an organised, universally accessible long-term care system, with clear access criteria, adequate funding and effective coordination of the relevant Services.
"The family, however, cannot and should not be the only answer to the needs of long-term care," stressed Mr. Kantaris. Informal carers should be recognised as an integral part of the system, but not seen as a substitute for professional services.
Caregivers of the elderly should not be left out
A particularly important issue highlighted by "Thalpo" concerns the criteria by which the beneficiaries of future support measures will be recognized.
Informal care is not limited to the cases of people with a certified disability.
It also concerns people with dementia, cancer, chronic and degenerative diseases, the elderly with reduced autonomy and other categories of people who need long-term help.
In addition to recognition and social protection, "Thalpo" also raises the issue of institutional representation.
"Representation of people receiving care and representation of informal carers are not the same thing. Although their interests and needs are closely linked, they are not always the same," Mr. Kantaris pointed out.
For this reason, the Network calls for informal carers and the organizations that represent them to be institutionally involved in the formulation, implementation and evaluation of long-term care policies.
