Input from formal services can make a significant difference in the lives of informal carers. Regular assistance for the user can alleviate strain, particularly if this involves help with tasks which the carer previously performed but found difficult or time-consuming. Formal service intervention can allow the carer more time for friends and family, or for employment. Other research has suggested that the breaks from caring which services provide can also improve the carer’s own physical and mental health (Wenger, 1990; Twigg and Atkin, 1994; Ashworth et al., 1996). However, service intervention does not always yield positive outcomes for carers. Inflexible or inappropriate services can increase stress, particularly if the carer continues to balance work and caregiving responsibilities (Neal et al., 1997). Service intervention can also aggravate conflict between the user and carer, particularly if the user has been reluctant to accept services and feels assistance should be provided by family members (Noelker et al., 1998). Thus, the measurement of outcomes for carers involves an assessment of both the positive and negative impact of services on a variety of relevant indicators.