Behind closed doors: Navigating complex behaviours and staying safe at home

Sensitive Content Warning:

This post explores difficult situations that can arise in caring roles, including conflict and safety, and why those of us caring for a friend or family member may be more at risk. While it can be helpful to understand the risks, and know when and where to get help, this can also feel heavy to read about.

You may want to check in with yourself to see if you’re in a place where you feel able to keep reading. Or if you know you need support, you can skip straight to the ‘where to go for help’ section at the end of the page.

Caring for someone we love is often portrayed as an act of devotion. However, the reality behind closed doors can be incredibly complex, exhausting, and, at times, frightening. If you're reading this and feeling entirely overwhelmed, isolated, or trapped in a caring role, please know that you are not alone, and having negative or overwhelming thoughts is a natural response to a stressful situation.

There can be a gap between the standard advice offered to carers, and the reality of crisis intervention. We want to fill that gap by talking about the things that are often too difficult to say out loud. When we are stretched to our absolute limits physically, emotionally, and financially, our safety and the safety of those we care for can become compromised.

This page is a non-judgmental space designed to help us recognise warning signs, understand complex behavioural changes, and create a plan before reaching a crisis point.

Redefining what it means to cope

As carers we can feel like we are expected to  simply "cope" and carry on. But coping is not a static state; it fluctuates daily. Sometimes, coping looks like managing a complex medication schedule with ease. On other days, coping might just mean surviving until bedtime while battling feelings of intense resentment or despair.

When the demands of caring outstrip the support available, it is normal to feel like we are failing. But we aren't failing; the likelihood is that the caring situation is complex and different support is needed. Acknowledging that we are struggling, or that our relationship with the person we care for has become strained or even unsafe, is the first and bravest step toward finding a solution.

There is a common misconception that domestic abuse only involves regular physical harm intentionally inflicted by an able-bodied adult. Because of this, many of us do not recognise our own experiences as abuse, or we feel guilty for applying that label to someone who is unwell or vulnerable.

Within the Mobilise community, we see a different reality. Around 50% of the safeguarding concerns raised with us are connected to domestic abuse in its many forms. Domestic abuse is fundamentally about power and control, but in a caring relationship, the dynamics can be blurred by illness, dependency, and duty.

How abuse shows up in caring relationships

• Behavioural changes from medical conditions: Conditions like Dementia, Alzheimer’s, or Parkinson’s, as well as mental health crises and certain medications, can cause sudden or progressive changes in behaviour. A person who was once gentle may become aggressive, highly critical, or coercive. While the illness may be the cause, the impact on us as carers is still profound and harmful.

  
  

• Emotional and psychological abuse: This includes constant belittling, manipulation, or unreasonable demands that erode our self-esteem and independence.

  
  

• Financial abuse: This involves someone else controlling your spending or access to cash, assets and finances. This can leave you feeling isolated, lacking in confidence and trapped.

  
  

• Child-to-parent abuse: This is a deeply stigmatised issue where a child (whether a minor or an adult) uses physical violence, emotional abuse, or financial control against a parent. Organisations like PEGS (Parental Education Growth Support) exist specifically to address this hidden challenge.

  
  

• Unique barriers for older carers Domestic abuse in later life is severely under-reported. Older carers and victims face unique barriers, often failing to recognise behaviours like shouting or controlling movement as abuse. For many older individuals, abuse is frequently considered a private family affair steeped in shame. They may not know how to report it, or they might mistakenly believe abuse must be physical to qualify. It is important to break down these misconceptions; emotional abuse, coercive control, and restrictions on your movement are all forms of abuse that deserve recognition and support.

  
  

• Feeling trapped: The intense dependency inherent in our caring roles creates a unique barrier. We often feel completely unable to leave or make changes because we are the sole lifeline for the person harming us.

  
  

• The impact on others: It is also important to recognise that children witnessing domestic abuse or aggressive behaviour within a caring household is a serious child protection concern that requires external support. The NSPCC provides excellent resources on understanding these child protection concerns.

Sarah’s story: navigating Dementia and aggression

(This is a fictional scenario based on a similar situation reported by a carer in our community)

Sarah* cares for her husband, Mark*, who was diagnosed with early-onset dementia. Over the past year, Mark’s confusion has turned into paranoia and verbal aggression. He frequently accuses Sarah of stealing from him and occasionally blocks her from leaving the house. Sarah felt profound guilt for feeling afraid of her husband, believing she just needed to be more patient. It wasn't until she spoke to an Admiral Nurse that she realised Mark’s behaviour, while driven by his illness, was severely impacting her safety and mental health. With medical adjustments and a personalised safety plan, Sarah was able to regain a sense of security without abandoning Mark’s care needs.

*Not their real names

When a carer reaches breaking point

It is important also to talk about the deeply taboo reality that carers can sometimes become the perpetrators of harm. This is rarely born out of malice; it is almost always the result of  burnout, stress, and a lack of support. If we are completely overwhelmed by physical, emotional, and financial demands without any adequate respite, we can experience what is known as "Carer Burden." When pushed far enough, we can snap.

Research conducted by Dr. Siobhan O’Dwyer highlights the severe mental health toll of unpaid caring. Her findings show that roughly 30% of carers have thought about suicide and some had attempted to take their own life, but only half of those who had thought about suicide had ever told anyone or sought help. Crucially, research suggests that you do not have to be clinically depressed to reach a crisis point.  Studies have identified thoughts of suicide and homicide in caregivers without the presence of mental illness. The sheer dissatisfaction, the feeling of being trapped, and the lack of support in the caring role are unique risk factors in themselves. 

Lottie Storey, a qualified therapist with a Masters in Counselling and Psychotherapy has written for Mobilise about the overlooked risk of suicide in unpaid carers. You can read more about this here.

In extreme cases, severe burden of care or a desperate desire to "end the suffering" of a loved one can lead to tragic outcomes. Dr. O’Dwyer’s research on homicide within caring relationships stresses that these are rarely unpredictable events. They are usually the result of missed warning signs, lack of professional curiosity, and a failure to provide the carer with a safe, non-judgmental space to say, "I cannot do this anymore."

If we have fleeting thoughts of walking away, self-harm, or losing control with the person we care for, this is a sign of system failure and exhaustion. It is not a moral failing. It is a signal that we need urgent, non-judgmental support.

David’s story: burnout and the edge of crisis (This is a fictional scenario based on a similar situation reported by a carer in our community)

David* had been caring for his bed bound mother for five years with zero respite. Working part-time and managing all her personal care, David stopped seeing friends and sleeping properly. One evening, after his mother refused to take her medication for the third time, David experienced a terrifying surge of rage and found himself screaming at her. He immediately felt sick with shame. He realised he was dangerously close to a breaking point. Calling a carer’s helpline was the hardest thing he ever did, but it was the first step in getting an emergency care assessment and vital respite support. 

*Not his real name

Warning signs that we are in, or close, to crisis

It is notoriously difficult to recognise our own burnout when we are in the thick of it. Many of us push through exhaustion for so long that crisis becomes our baseline. Here are the warning signs that we may be approaching a breaking point:

Physical signs:

• Chronic, inescapable exhaustion, even after resting.

• Significant changes in sleep patterns or appetite.

• Neglecting our own basic hygiene, medical needs, or skipping our own medications.
  

Emotional signs:

• Deep resentment towards the person we care for, followed by intense guilt.

• Feeling completely numb or disconnected from our surroundings.

• Sudden bouts of intense rage, irritability, or crying over small things.

• A pervasive sense of deep hopelessness or feeling completely trapped.
  

Social signs:

• Sudden withdrawal from friends, family, or support networks.

• Refusing help or canceling appointments with support services.

• Conflict with healthcare professionals over care needs.
  

Find out more about ‘Carer Burnout’ by clicking here, where there are suggested actions we can take that may help, as well as ideas for how we might recover.

Moving from signposting to safety planning

Knowing that support exists is not the same as being able to access it safely. Just sharing a list of phone numbers is a helpful starting point. We want to encourage unpaid carers to explore support early and create a plan before an emergency arises.

Taking preventative action: Often, worrying behaviours from the person we care for have a medical solution. Before assuming a behavioural change is permanent, chat with the GP or a healthcare professional. A sudden spike in aggression or confusion could be linked to a Urinary Tract Infection (UTI) or a medication interaction.

Creating a safety plan: A safety plan is a personalised, practical plan to help us stay safe when a situation escalates. You can create this with the help of a professional, although we have outlined some key steps below in case you are not ready to take that step. Having a plan for replacement care can also help you feel more able to step away; you can explore this through our Emergency plannings for carers resource. 

Key elements of a safety plan often include:

• Identifying "safe rooms" in the house where we can retreat if behaviour becomes threatening (rooms with a lock and a phone, avoiding kitchens or bathrooms where hazards exist).

• Establishing a code word or signal with trusted neighbours, friends, or family members so they know to call for help without us having to explain the situation.

• Keeping a fully charged phone handy at all times.

• Having a small bag packed with essential documents, medications, and keys in a hidden but accessible place in case we need to leave quickly.

  
  

More information about creating a safety plan is available here but you may wish to seek advice from a more local organisation or one that better reflects your circumstances (see list below).

Building a circle of care and setting boundaries: 

Protecting ourselves is not just about emergency action; it is about building sustainable support. It is vital to maintain friendships and other relationships outside the caring situation to prevent total isolation. By creating your own circle of care, you open up opportunities for vital breaks, respite, or replacement care. Have these conversations early in the caring situation with the person you care for and your wider circle. This includes openly sharing concerns about behaviour changes with your healthcare team and setting firm boundaries to protect your own wellbeing.

Demystifying the system: what happens when we ask for help?

A major barrier to seeking help is the fear of what will happen next. Many carers fear that admitting they are struggling means their loved one will be immediately taken away into a care home, or that they'll be judged or even prosecuted. It is important that you do not wait until you have reached a crisis point to ask for help. It is easier to seek support early, when there is more time to explore options, put practical help in place, and protect your own wellbeing as well as the person you care for.

Beyond the fear of the person being institutionalised, many carers are trapped in unsafe environments because they fear reporting will lead to poverty. Others grapple with deep family loyalty, particularly in cases of child or grandchild abusers, and fear for the perpetrator's safety if external agencies get involved. These fears are valid, but staying silent out of loyalty could put us and the person we care for at greater risk. The goal of intervention is to provide support to stabilise the situation, not to punish. One phone call or email is not going to trigger an unstoppable chain of events.

In reality, reaching out will probably mean one or more services will coordinate to find out how to best support both the carer and the cared-for, where appropriate. You might hear the term MARAC (Multi-Agency Risk Assessment Conference) being mentioned. This is simply a meeting where professionals (like social services, health representatives, and police) share information to create a coordinated safety plan for individuals at high risk of domestic abuse. The goal of these interventions is almost always to provide support, reduce risk, and stabilise the situation, not to punish carers for struggling.

Reading this might have brought up difficult emotions, and we want to reassure you that everything you are feeling is valid. We don’t have to fix everything today. Perhaps take just one small step, whether that is reflecting on your current boundaries, having a conversation with someone you trust, or calling one of the helplines listed below. If you know someone else who might benefit from reading this, please encourage them by sharing this piece. We all deserve to feel safe, seen, and supported.

Specialised resources and next steps

If you are in immediate danger or feel at risk, call 999 right away; if the situation is urgent but not life-threatening, you can contact the police on 101 or for mental health support NHS 111, option 2. You can also contact your GP or duty social work team at your local council if you feel you might be nearing crisis.

If you are experiencing thoughts of suicide or self-harm, please reach out to the Samaritans immediately by calling: 116 123 (Free from any phone, 24/7)

You don't have to navigate any of this alone. Below is a list of organisations equipped to handle the unique complexities of safeguarding and abuse within caring relationships. Taking the first step is daunting, but we deserve to feel safe and supported in our lives and our caring roles.

(Many domestic abuse support websites include a quick-exit or “hide this page” feature, allowing you to rapidly minimise the screen and remove traces from your browsing history if you need to stay safe while seeking help. We have flagged which sites have this mechanism.)

• You can call the 24-hour National Domestic Abuse Helpline at Refuge on 0808 2000 247. Refuge is the largest domestic abuse organisation in the UK. It also offers live chat online if it is difficult to talk freely on the telephone. Has a green ‘Exit Site’ button in the bottom right corner of the website.

• For support for child to parent abuse contact PEGS (Parental Education Growth Support). Parents can self-refer for support which includes online drop-ins and peer support groups.

• If you identify as LGBT+ a national helpline for LGBT+ victims and survivors of abuse and violence is provided by galop 0800 999 5428 or email help@galop.org.uk. Has a red ‘Exit Site’ button in the bottom left corner of the website.

• Support for men affected by domestic abuse is available from Respect 0808 8010327. Webchat support is also available on the Respect website.

• Support for the deaf or hard of hearing is available from SignHealth.

• Support for victims with pets the RSPCA can help you find details of domestic violence pet fostering services that can help you care for your pet.

• Local support services can also be found on your local council or local police website.

• Guidance is also available in easy read, and translated versions on the Government website.

• If you're worried that you are behaving abusively in your relationship, call the free Respect Phoneline on 0808 802 4040.

• Information on how multi-agency responses like MARAC work to keep people safe can be found at Standing Together. Has an ‘Exit Site’ button at the top of the website.

• The NSPCC provides expert information on understanding the child protection concerns that exist if a child is witnessing domestic abuse.

• Wales Live Fear Free is an organisation providing help and advice about violence against women, domestic abuse and sexual violence in Wales. Has a red ‘Exit Site’ button in the bottom left corner of the website.

• Hourglass (elder abuse): Helpline 0808 808 8141, text support  07860 052906 or email wearehourglass.org. Has a red ‘Exit Site’ button in the bottom right corner of the website.

• Age UK focuses on elder abuse. Their website has resources regarding their No Age Limit campaign and protection from abuse.

• SafeLives offers training, research, and resources on defining domestic abuse. Has a yellow ‘Exit Site’ button in the bottom right corner of the website.

Frequently Asked Questions

What happens if I tell my GP I'm struggling to control my temper?  A GP's primary role is to ensure their patient's health and safety. Disclosing that we are struggling to control our temper shows that we are being responsible and seeking help. The GP should listen without judgement, assess our mental health, and make a referral to appropriate support services, such as counselling, respite care, or adult social care for a carer's assessment.

Is it my fault if their medication makes the person I care for aggressive?  We are not responsible for the chemical or neurological changes in the person we care for. However, we do have the right to be safe from the resulting behaviour. It is vital to report these side effects to the medical team of the person you care for immediately.

If I leave for my own safety, will I be charged with neglect?  Our physical safety is the immediate priority. If we are in immediate danger and must leave the home, we should dial 999. Once safe, we must then inform emergency services or adult social services that the vulnerable person has been left alone so they can step in. Doing so fulfils our duty of care while protecting our own life.

How can I find out more about this issue?  

• The Unpaid Carers and Domestic Abuse Project run by ADASS (Association of Directors of Adult Social Services) provides multi-agency insights into improving support for carers experiencing domestic abuse. You can read about the project here. 

• For more information about the work of Dr Siobhan O’Dwyer click here. 

• The Domestic Abuse Commissioner provides multi-agency insights into domestic abuse, including impacts on older demographics. Has a red ‘Exit Site’ button on the right of the website.
  

We’d like to know how relevant this content is to your experience as a carer? This helps us shape future content ideas which can support our caring community. Please take a few minutes to share below.