Experiences and Needs of Caregivers of Community-Dwelling Frail Older Adults: A Mixed Methods Systematic Review

AimThis study aimed to synthesise current evidence about the experiences and needs of informal caregivers of community-dwelling frail older adults to inform targeted interventions for improving their caregiving situations.DesignThis was a mixed methods systematic review using the convergent integrated analysis framework.MethodsWe conducted systematic searches across 11 databases, including CINAHL, CNKI, EMBASE, OpenGrey, ProQuest, PsycINFO, PubMed, SinoMed, VIP, WanFang and Web of Science, as well as reference lists, for studies published between January 1, 2000 and March 12, 2025. Quality appraisal was performed using the Mixed Methods Appraisal Tool. Findings were synthesised using a narrative approach.ResultsOf the 5297 citations, 2905 were screened for titles and abstracts, 176 were further screened for full-texts and eight studies were included (n = 6 quantitative, n = 2 qualitative; 1949 caregivers). The themes of caregiving experiences related to (1) influential factors contributing to negative, (2) or positive caregiver outcomes; (3) coping strategies or resources that caregivers employed to address caregiving situations; the outcomes that could be (4) negatively, (5) or positively impacted by caregiving; and (6) difficulties they encountered related to caring for frail older adults. Caregivers expressed needs for psychological support, detailed information on available resources, and family-centred and integrated public services with self-advocacy and coordinators.ConclusionsThis review highlights broad areas that require more attention for enhancing the well-being of these caregivers. More research is warranted on caregivers' experiences, needs, and interventions, especially their support needs. A theoretical framework, comparative analyses between child caregivers and spousal caregivers, as well as emphasising both mastery and competence, is recommended for future research and practice.Relevance to Clinical PracticeOur findings hold the potential to guide the development of needs-oriented and evidence-based interventions tailored to the unique challenges faced by caregivers, thereby supporting them in their caregiving roles.Reporting MethodThis review followed the PRISMA 2020 guidelines.Patient or Public ContributionNo patient or public contribution due to design.