How do working carers burn out between their job and a sick relative's care? Read the early signs and practical steps employers can take to support them.
Every morning before coming to work, an accountant prepares her father's medication; he has been diagnosed with dementia. At lunch she phones the carer, and when she gets home in the evening she spends the night half awake because of her father's restlessness. A production operator hesitates to ask for leave to accompany his wife on her chemotherapy days because he thinks, "I've already taken a lot of leave this month." These employees often do not share what they are going through at work; they simply look a little more tired, a little more distracted and a little quieter. Working carers, that is, employees who regularly provide care for an elderly, sick or disabled relative, are one of the groups that organisations notice least but that carry the heaviest load. In this article, for employers, HR managers and team leaders, I look at the difficulties experienced by employees with a sick relative, the effect on business outcomes and practical steps for support.
Who Is a Working Carer?
This definition does not cover only people who care full time for a seriously ill relative. Each of the following situations can noticeably affect an employee's daily life and work performance:
- Caring for a mother, father or older family member who needs care because of old age, dementia or limited mobility
- Accompanying a spouse or relative with an illness that needs long-term treatment, such as cancer, heart failure or kidney disease
- Managing the care and treatment of a child with a disability or chronic illness
- Supporting a family member with a mental illness
- Being beside a relative during recovery after an accident or surgery
In Turkey, the strong social expectation that care be provided within the family, the culture of staying with the patient in hospital, and the fact that access to professional care services is not easy everywhere place this burden on the shoulders of working family members. Although the load is often concentrated on women, male employees are also taking on the carer role more and more often. I discuss the effect of the care load on women employees separately in my article on the double burden of working women.
Caring often begins not suddenly but gradually. First a doctor's appointment once a week, then grocery shopping, then daily medication tracking and night shifts... For this reason many employees do not even describe themselves as "carers"; they just say, "I'm helping my father." For organisations to notice this group, they must first accept that caring is an ordinary life situation, much like a period of parenthood.
Early Warning Signs in a Working Carer
Because people with a sick relative often do not voice what they are going through, it is important for managers to notice certain changes:
- Frequent lateness, leaving early or long phone calls during lunch breaks
- Absent-mindedness, forgetfulness and an increase in mistakes not seen before
- Staying away from social events, team meals and training
- Visible tiredness, weight changes or frequent illness
- Marked tension about overtime and shift change requests
- Saying "Everything is fine" and quickly closing the subject
These signs alone do not point to a care load; they can also be linked to other health or family problems. The manager's role is not to look for the cause or make a diagnosis but to notice the change and open the door a little for the employee. A sentence like "You've seemed a bit tired lately; is there anything we could make easier for you on the work side?" is often a sufficient start. Long-lasting tiredness and distancing from work can be signs of burnout; you may also like to look at my article on burnout syndrome.
The Hidden Load: Psychological Effects of Caring
Caring is work done with love and commitment; but when it goes on for a long time it can have a serious psychological cost. Common experiences among employees with a sick relative include:
- Chronic fatigue and sleep disorders: Night shifts, days spent in hospital corridors and a constant state of alertness.
- Guilt: The thoughts "I'm leaving them alone while I'm at work" and "I'm neglecting my job because of the care" are experienced at the same time.
- Anticipatory grief: In a progressive illness, watching a loved one change little by little can lead to grieving before the loss has actually happened.
- Anxiety and uncertainty: The course of treatment, the financial burden and the question of "when will it get worse".
- Social isolation: The time for friends, hobbies and oneself almost entirely disappearing.
- Anger and exhaustion: The load not being shared fairly within the family, the constant expectation of sacrifice and a responsibility that seems never-ending.
The general profile of employees in Turkey makes this load even heavier. According to Gallup's 2026 report, 66% of employees in Turkey say they experienced stress during a large part of the previous day, 27% sadness and 23% loneliness (Gallup, 2026; 2025 data). People with a sick relative add their own particular load on top of this average.
The end of caring does not always bring relief either. An employee who has lost a relative experiences, alongside grief, the effect of months or years of tiredness and an identity gap. For how the workplace can respond in this period, you may like to look at my article on grief at work.
The Effect of the Care Load on Business Outcomes
What employees with a sick relative go through is directly reflected in business outcomes:
- Short-term and unplanned absence: Hospital appointments, emergencies and disruptions to carer arrangements.
- Presenteeism: The employee is at work but their mind is at home or in the hospital. According to Deloitte's UK data, the largest cost item of poor mental health for employers is presenteeism (Deloitte, 2024).
- Burnout: Burnout has been found to be associated with later absence, presenteeism, job dissatisfaction and even serious injuries (Salvagioni et al., 2017). A carer who finds no chance to recover is particularly at risk in this respect.
- Withdrawal from career and leaving the job: When the care load increases, the employee may turn down a promotion, move to part-time work or leave the job. This generally means the organisation loses its most experienced middle-aged and older employees.
- Occupational safety: A sleepless and anxious employee being in a task that requires high attention is a risk that should be taken into account, especially in production facilities.
Supporting an employee with a sick relative means keeping your most experienced people with you in the hardest period of their lives.
Caring Within the Psychosocial Risk Framework
The Turkish Ministry of Labour and Social Security's 2024 Psychosocial Factors Information Guide lists the interaction between work and life outside work among the categories of psychosocial hazards (ÇSGB, 2024). Caring is one of the situations in which this interaction is felt most intensely. Unpredictable working hours, overtime expectations and lack of flexibility directly increase the risk for these employees.
Article 5(f) of Occupational Health and Safety Law No. 6331 requires the employer to develop a consistent prevention policy covering the effects of factors related to work organisation, working conditions and social relationships. Article 8 of the Occupational Health and Safety Risk Assessment Regulation also provides for psychosocial hazard sources to be identified and recorded. The presence of employees with a care load can be taken into account in the risk assessment when work schedules and shift patterns are considered.
For current regulations on rights such as accompanying a patient, excuse leave and unpaid leave, I recommend getting an opinion from your legal department or an employment law specialist. Giving employees clear, written information about their rights reduces uncertainty in what is already a busy period.
The ILO stresses that individual measures should complement organisational measures, not replace them (ILO, 2026). Recommending only stress management to a person with a sick relative while leaving the work arrangement as it is does not touch the source of the load.
What Can Organisations Do for Working Carers?
1. Create an environment where it can be talked about. Many employees see caring responsibilities as a "private matter" or fear looking weak at work. In a survey in Europe, 50% of employees think disclosing a mental health problem would harm their career (EU-OSHA, 2022). There may be a similar hesitation around caring. When managers and HR treat this as an ordinary life situation, it makes it easier for employees to ask for support early.
2. Put flexible working options in writing. Define options such as flexible start and finish times, partial remote work in suitable roles, shift swaps, hourly leave and temporarily reduced working hours. A transparent policy instead of an "understanding" that varies from person to person protects the perception of fairness.
3. Increase predictability. For someone with caring responsibilities, one of the hardest situations is last-minute overtime and shift changes. Publish plans in advance and ask for the employee's views when a change is needed.
4. Define a route for emergencies. In sudden situations such as a relative being taken to hospital, it should be clear in advance who the employee will notify, how their work will be handed over and which leave arrangement will be used.
5. Prepare managers. In the World Health Organization's guidelines on mental health at work, the recommendation with the strongest evidence is providing managers with mental health training (WHO, 2022). Noticing an employee who is struggling because of a care load, having a respectful conversation with them and planning possible adjustments together are the concrete outcomes of this training.
6. Offer confidential psychological support. A confidential counselling channel where people with a sick relative can share their emotional load is an important resource for preventing burnout. Remind people regularly that this support exists.
7. Provide information and signposting. A guide showing how to reach basic information on care services, home healthcare, patient rights and social support reduces the time employees lose.
8. Make peer support easier. A voluntary sharing group where employees with similar experiences can come together can ease the feeling of loneliness. It is important that such groups are started by a professional and that confidentiality rules are set out clearly.
Say a man working as quality control manager in a food factory takes on both the hospital processes and the care at home after his mother has a stroke. For several weeks he is often late and seems distracted in meetings. Instead of issuing a performance warning, his manager invites him to a short conversation, listens to the situation and makes a plan together: flexible start times for the next two months, afternoon leave on physiotherapy days and information about the organisation's confidential counselling service. The employee gets through this period without the fear of losing his job.
How to Get Started in Your Organisation
Needs analysis: With a survey that protects confidentiality, you can learn how many employees have caring responsibilities, how this affects their work arrangements and which supports are needed. Data on short-term absence, resignations and leave can also help this analysis.
Programme: Based on the results of the analysis, a flexible working policy, an emergency procedure, manager training, an information guide, psychoeducation sessions for people with a sick relative and confidential individual support are planned. In a meta-analysis examining workplace stress management programmes, cognitive-behavioural programmes were found to show consistently larger effects than other types (Richardson and Rothstein, 2008). You can see how programmes suited to your organisation can be structured on the corporate services page.
Measurement: Use of flexible arrangements, short-term absence, resignations, use of support services and employee surveys are monitored at regular intervals. The ILO also lists absence, resignations, use of support services and employee surveys among monitoring indicators (ILO, 2026).
Frequently Asked Questions
How can we identify working carers?
It is not right to force employees to disclose this. Instead, using language that treats caring as an ordinary life situation, announcing support options to everyone and getting a general picture through confidential surveys makes it easier for employees to come forward on their own.
Would giving flexibility to an employee with a sick relative be unfair to other employees?
When flexibility rests on a written, transparent policy open to everyone in a similar situation, the perception of fairness is protected. Reminding people that every employee may face a similar need at some point in their lives also increases understanding within the team.
What should I do about an employee whose performance has dropped because of a care load?
First try to understand the situation; if the source of the drop is the care load, plan temporary adjustments to the work arrangement together. Keeping expectations clear and reviewing the situation together at regular intervals balances the needs of both the employee and the team.
How can I support a carer who seems burnt out?
Listen without judging, talk about adjustments that could lighten the load and remind them of the option of confidential psychological support. If you notice marked hopelessness, severe changes in sleep and appetite or thoughts of self-harm, refer them to a mental health professional; in emergencies, 112 (emergency services) should be called. It helps to remind carers that protecting their own health matters for the person they care for too.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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