Why physiotherapists need to start taking care of caregivers 

Caregivers of people living with serious illness or disability carry a profound and often invisible burden, yet they remain consistently overlooked by healthcare systems and under-supported in research. This post explores what meaningful caregiver support looks like in rehabilitation settings, and why physiotherapists have a responsibility to see and equip the people standing quietly at the bedside.

When we talk about recovery from serious illness or disability, we almost always focus on the patient. The treatments, the milestones, the setbacks. But standing just behind every patient is someone else entirely. Someone who rarely makes it into the medical notes, rarely gets asked how they are doing, and almost never receives the support they need.

That person is the caregiver.

A recent editorial published in The Lancet Respiratory Medicine (March 2026) puts it plainly: for every patient admitted to an intensive care unit, there is often at least one other vulnerable person present – the family member or caregiver at the bedside. And the data on what that experience does to them is sobering.

Between 20% and 40% of families and carers of critically ill patients develop anxiety, depression or post-traumatic stress symptoms during and after an intensive care unit (ICU) stay. Anxiety alone affects up to 70% of caregivers during admission, with post-traumatic stress disorder affecting between 30% and 55%, sometimes persisting for months after a loved one is discharged.

And it doesn’t stop at mental health. The burden caregivers carry extends to their physical health, their social lives, their ability to work and their financial security. Fatigue and isolation are common companions. Yet as the Lancet editorial observes, caregivers “often carry an invisible burden and are overlooked in research and unsupported within fragmented health support systems.”

Physiotherapists see it every day in the hospitals and in the clinics. The spouse who hasn’t slept properly in weeks. The adult child who has rearranged their entire life to drive their parents to appointments. The friend who shows up every single day, smiling, asking nothing for themselves.

Caregivers play an essential role in supporting individuals with disabilities. They can provide emotional, practical and educational support that is vital for effective rehabilitation.

What do we mean when we say caregiver? A family caregiver is a family member — a spouse, child, friend, or unpaid neighbour. It is someone who provides care to a person with a chronic illness or disability who needs help with daily living tasks: bathing, dressing, taking medication, getting around the home.

In rehabilitation settings, caregivers’ role goes even further. They provide emotional, practical and educational support that is vital to a patient’s recovery. They are the ones implementing the home exercise programme the physiotherapist’s designed. They are helping with transfers when the physiotherapy session has long ended. They are encouraging their loved one to keep going when motivation dips.

The World Health Organization’s (WHO) Global Disability Action Plan explicitly recognised caregivers as essential to supporting individuals with disabilities. But recognition without resources is hollow.

Healthcare professionals must provide families and caregivers with the proper resources and assistance to deliver care effectively

Drawing on best practice in rehabilitation, meaningful caregiver support needs to work on several levels:

• Education and understanding: Caregivers need to understand what their loved one is going through. They need to receive real information about the condition, the rehabilitation process, expected outcomes, and warning signs to watch for. When caregivers understand the goals of treatment, they become active, informed partners rather than anxious bystanders.
• Practical skills training: Knowing what to do is not enough. Caregivers need to know how to do it safely and confidently. This means training in assisting with transfers and exercises, managing medications and using assistive technology correctly, whether that is a walking aid, a communication device, or any other tool that supports independence. Ideally, this training happens within therapy sessions, where there is professional guidance and space to ask questions.
• Emotional support and permission to struggle: Caregivers need to hear, clearly and repeatedly, that low mood is not weakness. That finding this hard is not a failure. They need encouragement to maintain their own relationships, to seek support themselves and to prioritise their emotional health. Acknowledging small wins matters enormously, both for the patient and the person caring for them.
• Ongoing, coordinated support beyond discharge: The Lancet editorial calls for multidisciplinary, sustainable structures that support caregivers not just during a hospital stay but well into the aftermath. Discharge is not the end of the story. In many ways, it is when the hardest work begins.

Recovery does not happen in a clinic. It happens at home, in the ordinary moments of daily life, supported by people who love the patient and have agreed, often without being asked, to give enormous amounts of themselves.

As health professionals, physiotherapists have a responsibility to see those people. To include them in conversations, equip them with skills and information, monitor their wellbeing, and advocate for the systemic support they deserve.

The Lancet says it well: if health care is truly for all, no one should be left behind.

That includes the person standing quietly at the bedside.

Caregivers are not peripheral to the rehabilitation process – they are central to it, and the outcomes of their loved ones depend in no small part on how well supported they are. Recognising their contribution, attending to their wellbeing and advocating for systemic change is not optional for health professionals; it is part of the job.