The wors "carer" (UK, NZ, Australian usage) and "caregiver" (US, Canadian usage) are normally used to refer to unpaid relatives or friends who support people with disabilities. The words may be prefixed with "Family" "Spousal" or "Child" to distinguish between different care situations. Terms such as "Voluntary caregiver" and "Informal carer" are also used occasionally, but these terms have been criticized by carers as misnomers because they are perceived as belittling the huge impact that caring may have on an individual's life, the lack of realistic alternatives, and the degree of perceived duty of care felt by many relatives.