“There is a resource available around the clock and every day of the year, that can help people to be cared for and die in the place that they want to be, and helps keep them out of hospital, that is low-cost or free to the NHS. That resource is people. We call them carers. We need to invest in supporting carers because without them the system will collapse.” Abridged quote: Simon Chapman. Director. NCPC (2013). It is estimated that in total there are 6.5 million people caring in the UK at any one time and this is set to increase by 60% in the next 30 years. Over a third of carers give 20 or more hours of care a week. Carers can be family; including children, close friends and those who are important to the patient and all have a vital role in the provision of care. They need to be closely involved in decision making, as they are key members of the team and are experts in the patients’ care. This is particularly important if a patient is admitted to hospital and the carer may lose their status. Additionally if the patient has special needs such as learning disabilities or has dementia then it is extremely important that the carer continues to be closely involved. Carers also have their own needs and often need practical and emotional support both during the person’s life and most importantly after bereavement. There are some specific issues which carers face when caring for someone approaching end of life. This can include coping with emotional, social and spiritual needs and having difficult conversations about the time that is left and the process of dying. Carers have to cope emotionally with the person’s physical changes, understanding the effects of medication which can alleviate or exacerbate symptoms. This can all be particularly important where younger carers are involved. If left unsupported and stretched beyond their developmental and maturity level, caring for a dying adult in childhood can lead to poor mental health with lifelong implications.. Caring for people that are dying can be a positive time, although emotional and sometimes painful. However, if the carer does not have access to the right support at the right time there is a danger that they will become exhausted unable to cope and to continue with their caring role. It is frequently the carer who has to coordinate care and healthcare professionals. A significant percentage of carers are older and may have pre-existing ill health and need support. Increasingly there are young carers who need particular consideration and appropriate support, . Carers need information and access to support both in their role as carer but also for themselves. They need to have information about the illness, what course it may take, what assistance they can expect, what benefits they may be entitled, work related issues, and where children are involved what support may be provided by the school and other organisations. Carers may face significant losses during the time they are caring and need support and space to discuss these feelings which may include the impending loss of a loved one, anxiety over financial and legal matters, work or education related issues, not being able to participate in social activities, meet colleagues, and friends. These can culminate in isolation, loneliness and depression, which is, heightened once the loved one has died. If the Government’s ambition for meeting people’s preferences at the end of life is to be achieved we need to provide carers with the knowledge, skills and support for this demanding role. To help build resilience they need access to a range of support services that are appropriate to the need, responsive and readily available.