Involvement, individual resilience and mental wellbeing of informal caregivers in elderly care: a correlational cross-sectional study from six European countries

Background: By 2060 the demand for caregiving is expected to exceed the number of informal carers available to care for the elderly in Europe. Informal caregivers already make a significant contribution across health sectors, both by alleviating the pressure on formal care services and by providing valuable information about patients. A projected shortfall in informal carers may challenge the caregiving capacity of elderly care services and the provision of high-quality care for elderly. Moreover, informal caregivers report poor communication and uncertainty around the division of care responsibilities with professional careers. Such external influences of these services can contribute to poor health outcomes and reduced motivation in the informal caregiving role. Evidence on how care services involvement of informal caregivers in care tasks and decisions impact their mental wellbeing is currently lacking. This quantitative study examines the factors influence mental wellbeing for informal caregivers in elderly care across six European countries: in Norway, Finland, the Netherlands, Italy, Romania and Spain. Methods: In this correlational cross-sectional study, N = 1487 informal caregivers were recruited across the six countries through purposeful selection. All participants provided unpaid care to elderly individuals aged 65 or older. The study featured self-reported measures and sociodemographic variables and self-assessed health. We measured involvement separately as involvement desire and opportunity, as well as mental wellbeing and resilience. These constructs were measured using the Family Involvement in Care Questionnaire, the Short Warwick Mental Well-being Scale and the Connor-Davidson Resilience Scale respectively. Results: Individual resilience was positively associated with mental wellbeing in informal caregivers in all six countries. Other country-specific associations with mental wellbeing were identified for self-assessed health, age, gender, education, caregiving time and experience. Neither involvement opportunity or desire was associated with mental wellbeing, with the exception of Romania where there was a positive association for involvement opportunity. Conclusions: Subjective influences on mental wellbeing among informal caregivers of the elderly varies greatly across European contexts. However, the individual capacity to deal with adversity is central to informal caregivers’ mental wellbeing across countries. These findings highlight the complex interplay between subjective and contextual predictors in shaping informal caregivers’ mental wellbeing.