A scoping review of outcomes and implementation challenges of mental health care interventions among conflict-affected populations in Africa.

Aging is often accompanied by a rise in the prevalence of dementia, chronic conditions, and disability []. Given the poor physical and mental capacity of affected older adults, combined with limited options of professional care and institutionalization, informal caregivers play an increasingly crucial role in managing older adults’ health needs in the community. It is well-established that caregiving over extended periods of time imposes considerable care burden in a significant proportion of informal caregivers of older adults For example, 23% of informal caregivers of geriatric cancer patients in Singapore experienced mild to severe care burden [], while it was found to be 59% among dementia caregivers []. Caregiver burden is defined as a multidimensional phenomenon arising from the response to perceived stress and negative appraisal of the caregiving role, significant physical, financial, and psychosocial problems, and increased morbidity and mortality [, ]. While objective burden - attributed to hands-on caregiving activities [], can result from the physical strain and time spent while assisting older adults with activities of daily living (ADLs), subjective care burden – relating to caregivers’ attitudes and emotions [], is influenced by characteristics of the care recipient such as behavioural and psychological symptoms of dementia (BPSD), care needs or cognitive decline, and factors related to the caregivers, such as age, gender, ethnicity, marital status, social support or financial capacity [, ]. Together these strains can affect caregivers’ mental health and causing psychiatric morbidity []. Psychiatric morbidity manifests through symptoms of depression or anxiety, such as hopelessness, restlessness, and somatic symptoms that affect the caregivers’ ability to cope which can vary by the social and clinical characteristics of the caregivers and can be influenced by the level of care required [–]. Literature indicates a more rapid deterioration in the psychological state of informal caregivers following the COVID-19 pandemic compared with non-caregivers, owing to the increased risk of illness in older adults that require additional measures from the caregivers in an environment of limited access to services, resource reallocation, and movement restrictions [].