Controlling caregiving

Caregiving relationships create a particular vulnerability: the person providing care often has significant, sometimes total, control over daily life. This includes medication, mobility, meals, visitors, and money. It can also include when someone washes, goes to the toilet, goes out, or who they speak to on the phone.

Of course, most caregiving involves no abuse. But where it does, the caregiving relationship itself can become the mechanism of control, because the person being cared for can depend entirely on the person controlling them. Care can be withheld as punishment or offered as a reward. A person may fear losing their home or their carer if they complain, and may feel guilty or grateful, which makes it harder to speak out.

This also makes it hard for others to spot. The carer is often present at every visit, answers questions on the person’s behalf, and is seen by professionals as devoted and indispensable. Small restrictions can be explained away as safety measures, so a pattern may go unnoticed for years.

This is a theme that runs through much of Court of Protection work: distinguishing between a caregiver making difficult decisions in someone’s genuine best interests, and a caregiver using the role itself to dominate, isolate, or punish. Useful questions include whether a restriction is proportionate and no more than needed, whether the person’s own wishes were sought, and whether the carer is open about the arrangements or resists outside contact.