Christmas  brings families together, offering an opportunity to recognise when older relatives might need additional support. But while attention often focuses on the person receiving care, the pressures experienced by those providing it can go unnoticed.  

Research reveals a gap on both sides. Almost one in four (24%) adults aged 65 and over in England have unmet needs for help with everyday personal care or mobility, while nearly four in five (79.4%) unpaid carers surveyed reported feeling tired as a result of caring.

This is the two-sided care gap. Older people may not be receiving all the support they need, whilst unpaid carers manage significant pressures of their own. 

The Christmas care gap: Key findings at a glance

With Christmas approaching, Sentai is highlighting the importance of recognising these challenges and starting conversations about support that help older relatives maintain independence while ensuring carers aren’t overlooked. 

These findings show that the need for support extends beyond practical help with everyday tasks, highlighting the impact caring responsibilities can have on the health and wellbeing of those providing that support.

Source: (Survey of Adult Carers in England 2025–26)

 

Beyond the Christmas visit: What support would help at home?

Spending time together over Christmas can give families an opportunity to notice changes they might otherwise miss. Everyday tasks such as shopping, preparing meals, or getting out of the house may have become more difficult for an older relative, particularly if family members don’t see them regularly. 

The Health Survey for England 2024 found that shopping for food was the practical activity older adults were most likely to struggle with or need help doing (22%), followed by routine housework or laundry (21%). For personal care and mobility, getting up and down stairs was the most common difficulty, affecting 23% of adults aged 65 and over.

The need for support also increases with age. Almost two in five (37%) adults aged 80 and over had an unmet need for help with personal care or mobility, compared with 18% of those aged 65–69. For practical activities such as shopping and household tasks, unmet need rose from 13% to 24% across the same age groups.

Almost two in five (37%) adults aged 80 and over had an unmet need for help with personal care or mobility.

These changes do not automatically mean someone needs professional care. Instead, they can provide a starting point for a gentle conversation about what would make everyday life easier, what support they would welcome and how they would like to maintain their independence.

There are also practical ways of supporting older people to live independently at home, without taking away their control over everyday decisions. 

The hidden pressures on unpaid carers

When a family member starts providing regular care, it can become part of everyday life so gradually that the impact on their own wellbeing is easy to overlook.

The Survey of Adult Carers in England 2025–26 found that almost four in five (79%) carers surveyed experienced tiredness associated with caring, while 67% reported disturbed sleep and 64.8% experienced feelings of stress. The proportion reporting stress has risen from 59% in 2016–17, highlighting how persistent this pressure has been.

Almost four in five (79%) carers surveyed experienced tiredness associated with caring.

The time commitment can also be substantial. More than a third (35%) of carers spend at least 100 hours a week looking after or helping the person they care for, equivalent to more than 14 hours a day.

Caring responsibilities aren’t always obvious, either. From managing appointments to checking in throughout the day, the invisible care load can quickly add up. 

The pressures of unpaid care also tend to fall disproportionately on women, who make up 59% of unpaid carers in England and Wales. For many, caring responsibilities sit alongside paid work, raising a family and managing a household, creating an additional layer of pressure that can be particularly difficult to navigate during the Christmas period. While the festive season brings families together, it can also  highlight how much responsibility some relatives are carrying throughout the year.

More than a third (35%) of carers spend at least 100 hours a week looking after or helping the person they care for, equivalent to more than 14 hours a day.

The impact can even extend to carers’ finances. Carers UK’s State of Caring 2025 report,based on a voluntary survey of more than 10,500 carers, found that almost half (49%) had cut back on essentials such as food, heating, clothing or transport, while 74% were worried about their future financial security.

This highlights that the care gap affects more than the person needing support. Without the right help, unpaid carers can face mounting pressure on their own health, wellbeing and financial security.

Unpaid care in the UK: Regional differences

The proportion of people providing intensive unpaid care varies considerably across the country. ONS Census 2021 data found that the North East had the highest proportion of residents providing 50 or more hours of unpaid care a week of any English region, at 3.4%. The North West (3.1%) and West Midlands (3.0%) also recorded higher proportions than the England average of 2.7%, while the figure was lower in the South East (2.4%) and London (2.3%). Wales recorded 3.6%.

The differences are also evident when looking at deprivation. In England, 4.0% of people living in the most deprived areas provided at least 50 hours of unpaid care a week, compared with 1.9% in the least deprived areas.

This suggests that the demands of intensive caring are particularly concentrated in some communities. While these figures cover unpaid care for people with a range of health conditions and support needs, rather than specifically older relatives, they add another dimension to the pressures facing families who provide care.

These findings highlight why conversations about care need to consider both sides: the support someone needs to remain independent, and the impact of providing that support on family members.

The Christmas conversation: How to talk to elderly parents about accepting help

For families who live apart, Christmas may be one of the few opportunities to spend extended time together. It can be a chance to notice changes in an older relative’s everyday routines, but knowing how to raise concerns without undermining their independence isn’t always straightforward. They may worry about causing offence, while their relative may be reluctant to admit they need help.

Our Before the Worry survey highlights some of the reasons these conversations can be difficult. More than half (53.3%) of people were concerned that an older loved one might fear losing their independence if they accepted support. A similar proportion (50.9%) worried that they might not want to become a burden, while just less than half (48.4%) were concerned that they would resist support altogether.

These concerns can create a difficult cycle. Families may hold back from raising the subject because they do not want to upset their relative, while older people may avoid asking for help because they fear losing control or putting pressure on those around them. As a result, conversations about support can be delayed until circumstances become more difficult, with 22.5% reporting being concerned that an older loved one might only accept support after a crisis.

The findings highlight the importance of approaching these conversations with understanding, rather than making assumptions or waiting until there is an urgent need. Support can be introduced as a way to make everyday life easier while allowing someone to remain in control of their choices.

Families don’t need to wait for a crisis to start thinking about support. These five questions offer a starting point for understanding what an older relative wants, what they may be finding difficult, and how they would feel comfortable accepting help. 

 

Five questions to ask an older relative this Christmas

1. “What's something you'd really like to keep doing for yourself?”

This starts with what matters to your relative, rather than what they might be struggling with. It could be making their own meals, getting out to see friends or managing their usual daily routine. Understanding what they value can help families find ways to protect their independence.

2. “Are there any things that have become harder, where a little help would make a difference?”

Some older people may find it difficult to admit they need support, particularly if they feel it means giving something up. Focusing on small, practical ways to make everyday life easier can make the conversation feel less daunting.

3. “Do you ever avoid asking for help because you don't want to put us out?”

An important question to ask gently. Some older relatives may keep difficulties to themselves because they worry about becoming a burden. Reassuring them that asking for help is not an inconvenience can make it easier to speak openly about what they need.

4. “When we offer to help, is there anything that makes you feel uncomfortable about accepting it?”

Rather than assuming why someone might turn down support, give them the opportunity to explain. They may be concerned about losing control over decisions, disrupting their routine or feeling less independent. Understanding those feelings can help families offer support in a way that respects their preferences.

5. “What would make you feel supported while still being in control of your own day?”

This brings the conversation back to what your relative wants. Whether it is occasional help with household tasks, more regular contact or a little reassurance, support should be shaped around their priorities rather than imposed on them.

Peter Otto, CEO of Sentai: “Christmas can be the moment families realise an older relative might benefit from a little extra support. But the conversation shouldn’t begin with what someone can no longer do, it should begin with what they want to keep doing. 

“Accepting help can sometimes feel like losing control, or becoming a burden to the people you love. Families don't need to find every answer in one conversation, but making it clear that support is available, without judgement or pressure, can make it easier for someone to open up.”

Helping elderly parents live independently at home

The conversations started over Christmas should not end when the decorations come down. For families who cannot visit regularly, finding ways to stay connected and share caring responsibilities can help ensure older relatives continue to feel supported throughout the year.

For older people finding everyday routines more difficult, small reminders and regular conversation can help make day-to-day life more manageable. Sentai's voice-based companion supports this through conversation and reminders, helping older people keep track of everyday tasks and routines.

Regular contact can also offer reassurance to both older relatives and their families. Through Sentai's family app, relatives can send voice messages and receive daily activity updates, helping them stay connected and maintain awareness of how an older family member is getting on, even when they cannot visit in person.

Designed to complement existing support rather than replace human care, Sentai offers another way to encourage independence while helping families feel more connected and reassured.

The starting point is to understand what the older person wants, what they find difficult and what would help them continue living life on their own terms.

Discover how Sentai helps older loved ones stay independent and families stay connected.

Learn more

 

Methodology and sources

This page brings together published government statistics, research from Carers UK and findings from our Before the Worry survey to explore unmet support needs among older adults and the pressures experienced by unpaid carers. The research was reviewed to identify relevant findings about everyday independence, caring responsibilities and family concerns. No new primary research was conducted specifically for this page.

The sources use different survey methods, sample sizes, populations and reporting periods, so their findings should be interpreted in context and are not directly comparable. Percentages and estimates are presented as reported by the original sources, with limitations noted where relevant.

Unmet support needs: Figures on activities of daily living and practical activities are from the Health Survey for England 2024: Social care receipt. Findings relate to adults aged 65 and over living in private households in England. Unmet need means a respondent needed help with an activity but had not received help with it in the previous month. The survey excludes people living in care homes or hospitals.

Impact on unpaid carers: Figures on tiredness, disturbed sleep and stress are from the Survey of Adult Carers in England 2025–26. Respondents were unpaid adult carers known to local authorities who were caring for an adult receiving social care. Results are self-reported and do not represent every unpaid carer in England or the UK.

Financial pressure: Findings on the financial impact of caring are from Carers UK’s State of Caring 2025, a voluntary survey of more than 10,500 carers. These results should not be interpreted as population-wide estimates for all carers.

Regional unpaid care: The regional comparison uses ONS Census 2021 unpaid-care data for England and Wales. It describes the proportion of residents aged five and over providing unpaid care, not the proportion caring specifically for older relatives. The figures do not directly measure unmet need, carer wellbeing or access to support.

Sentai family concerns: Findings on concerns about an older relative losing independence, becoming a burden or resisting support are from our Before the Worry survey of 2,000 UK adults, conducted from 30 September to 2 October 2025.