Resilience and Protective Factors Associated with Well-Being Among Older Informal Caregivers: A Convergent Segregated Mixed Studies Systematic Review.

BACKGROUND

Population aging has led to an increasing proportion of older adults (aged 65 and older) acting as informal caregivers. These caregivers face risks of burden, stress, and depression. While research frequently documents negative psychological outcomes, resilience represents a crucial protective process. This systematic review synthesizes and maps the empirical evidence regarding the association between the socio-ecological resilience process and the well-being of older informal caregivers.

METHODS

Following Joanna Briggs Institute (JBI) mixed-methods guidelines, a convergent segregated mixed studies systematic review was conducted. A systematic search of Medline (PubMed), CINAHL, PsycINFO, and Scopus identified primary articles (2014-2025) in English and Spanish. Methodological quality was appraised using JBI critical appraisal checklists and the Mixed Methods Appraisal Tool. PROSPERO registration number: CRD420251142190.

RESULTS

Thirty-one studies were included. Elevated caregiver resilience was associated with lower reported symptoms of depression and anxiety, higher self-rated health, and positive psychological adaptation. Framed within a social ecological model, personal resources such as spirituality, hope, and self care, alongside relational assets like dyadic relationship quality and mutual coping, demonstrated a positive association with resilience and a reduction in subjective burden. Within the community context, informal peer networks and Online Health Communities functioned as essential supportive resources. On a structural level, both household wealth and the regional availability of long-term care beds acted as moderators for spousal well-being, whereas exceeding 30 weekly caregiving hours acted as a temporal threshold for positive adaptation.

CONCLUSIONS

These findings suggest that resilience in older caregivers may be best conceptualized not as a static individual trait, but as a multi-level, dynamic socio-ecological process. Rather than relying on individual coping alone, public policies and clinical practice should prioritize systemic, relational, and structural environmental support, including formal respite services and long-term care infrastructure, to preserve the well-being of older spousal caregivers.