Sarah Åkerman

"A proposed paradigm shift: recognising informal care research as an interdisciplinary field in its own right" published on 27 Aug 2026 by Policy Press.

Introduction: Peer support programmes are important complementary support forms in integrated care. This study investigates formal peer support experiences among family caregivers in Finland by scrutinising multidimensional input and output mechanisms of emotional, informational, and appraisal support. Methods: Seventeen family caregivers were interviewed through focus group and individual interviews. The qualitative data was analysed using a socioecological model for formal peer support. Results: The family caregivers described their caregiving situation as a source of pain enabling receiving emotional support from peer support participants with similar experiences – although norms of privacy and taboo hindered participation. Organisational aspects of programme delivery such as setting expectations, rules of confidentiality, environmental setting, group dynamics and leadership influenced experiences of informational and appraisal support. Overburden created barriers to receiving emotional and informational peer support. The participants wanted to influence society and contribute to other family caregivers through formal peer support – highlighting its socioecological nature. Conclusions: Each attribute of peer support [emotional, informational, and appraisal support] formed its own, yet interlinked, ecosystem. Experiences of peer support are beyond programme delivery, and future studies could employ a socioecological framework when further delving into attributes of formal peer support among family caregivers in specific target groups and/or settings.

This comparative study employs the Andersen Behavioural Model to investigate the role of predisposing, enabling and need factors for formal support use among older informal carers in Finland and Sweden. Multiple logistic regression analysis was performed using the Gerontological Regional Database (GERDA) survey data from 2021/2022, and 1167 informal carers were included. Living in Finland, lack of financial strain, non‐governmental organisation membership, providing care in one's household, providing care daily, caring for someone with cognitive decline, and helping with personal hygiene increased the likelihood of using formal support, while using the internet independently decreased it. The results partly reflect supported familialism, where, especially in Finland, the care recipients' objective care needs were the strongest predictors of informal carers' formal support use. Simultaneously, informal carers' subjective needs were not associated with formal support use. This is especially alarming in Finland given the explicit policy aim of supporting and integrating informal carers into formal care for older adults. Income‐related care fees might tentatively explain why formal support was related to financial strain but not personal income and educational level. More research is warranted on the role of income, especially at the household level. Enabling resources, assessed here as NGO membership and independent internet use, also influenced formal support use. These findings motivate the use of the multicomponent Andersen Behavioral Model theoretical framework when investigating inequalities in Nordic care. All in all, the results suggest that, despite differences between the countries, current familialistic policy shifts in both Finland and Sweden fail to ensure universal social rights for informal carers.

Aims: This longitudinal study investigated the prevalence of and risk factors for loneliness among older new informal caregivers, long-term informal caregivers, former informal caregivers and non-caregivers in selected regions of Finland and Sweden over 5 years. Methods: A longitudinal sample of 5083 respondents from the Gerontological Regional Database (GERDA) survey data in 2016 and 2021 was used. Bivariate correlation tests and multivariate logistic regression analyses were performed. Results: Loneliness prevalence rates varied between 6% and 8% in 2016 and increased in all groups, although not significantly among new informal caregivers. In 2021, the prevalence of loneliness varied between 8% and 14%. Among the baseline variables, reporting loneliness, single/unmarried/bereaved civil status, infrequent contact with friends and neighbours, poor self-rated health, depressive symptoms, living in Finland and financial strain increased the likelihood of reporting loneliness in 2021. Among the change variables, being a long-term caregiver, a negative change in civil status, a reduced number of confidants, a negative change in self-rated health and depressive symptoms increased the likelihood of reporting loneliness. Conclusions: Loneliness increased among all four groups of comparison. Being a long-term caregiver was a significant risk factor for reporting loneliness over time (odds ratio 2.00, 95% confidence interval 1.20–3.35), when controlling for several other social and health-related variables. To develop effective support, future research could address risk factors for loneliness among distinct groups of informal caregivers based on whether the care recipients have neurological or functional health limitations and examine the availability of support measures.

To delay social and healthcare utilisation among the ageing population, there is an increasing focus on the role of health‐promoting lifestyle adopted at an individual and/or community level. Longevity is generally viewed as the ultimate outcome of health, although a high life expectancy does not necessarily go together with health and/or a health‐promoting lifestyle. The potential coherence between longevity, health and lifestyle may vary in different cultural, political, social and economic contexts. This Nordic regional study situated in regions differing in longevity aims to (i) explore differences in adherence to the comprehensive, health‐promoting Blue Zone lifestyle principles in four regions in Western Finland (bilingual Ostrobothnia, Swedish‐speaking Åland and Finnish‐speaking South Ostrobothnia) and (ii) investigate regional differences in health. Thus, the present study aims to examine if adherence to Blue Zone lifestyle principles and good health is highest in the most longevous region. Survey data from the Gerontological Regional Database in 2021–2022 were used. Marginal means were calculated using ANOVA. The results showed that Åland, Finland’s most longevous region, showed the best health and higher environmental agreeableness, while deviated from several Blue Zone lifestyle principles. Swedish‐speaking Ostrobothnia showed good health and adherence to the Blue Zone lifestyle. South Ostrobothnia showed the poorest health but as much adherence to the Blue Zone lifestyle as Swedish‐speaking Ostrobothnia. Finnish‐speaking Ostrobothnia deviated the most from the Blue Zone lifestyle. The findings imply that Nordic longevous regions do not necessarily adhere to the Blue Zone lifestyle. Future research incorporating individual, community and societal factors could further elucidate whether and how longevity, lifestyle and health are interconnected in different ethnolinguistic contexts to further advance the understanding of healthy ageing and improve the implementation of effective health‐promoting initiatives.

Inspired by the caregiver stress process model emphasising the role of resources for caregiving outcomes, the aim of this study was to investigate the prevalence of subjective caregiver burden (SCB) and its associations with individual social, economic, and political resources among older spousal caregivers in a Nordic regional setting. Cross-sectional survey data collected in 2016 in the Bothnia region of Finland and Sweden were used, where 674 spousal caregivers were identified and included in the analyses. The descriptive results showed that about half of the respondents experienced SCB. SCB was more common among Finnish-speaking caregivers. Results from the multivariate logistic regression analysis showed that none of the assessed political resources were significantly associated with SCB when controlling for other variables. Experiencing financial strain was associated with SCB, while personal income was not. Frequent contact with family members was statistically significantly associated with SCB. Future research could use longitudinal data to determine causal relationships, and when data allow, test the full caregiver stress process model to investigate the role of mediating factors in different comparative settings. Accumulated evidence on risk factors for negative outcomes of informal caregiving can contribute to effective screening tools for identifying and supporting vulnerable caregivers, which is becoming increasingly important with the ageing population.

Informal caregivers face risks of social isolation. Given the high prevalence of informal caregivers in Europe, a considerable proportion of the population are also former caregivers. The Finnish Expert Caregiver intervention sought to train former caregivers to become volunteers aiming to support current caregivers through mainly peer support. The aims of this mixed method non-controlled exploratory intervention study were to assess the feasibility of the Finnish Expert Caregiver intervention by co-designing and implementing the intervention, and by assessing demand and practicality with special attention to the impact of COVID-19. The findings imply that the intervention was feasible as it resulted in a co-designed training course consisting of 30 h with 25 participants enrolling and 19 of them trying volunteering activities. The participants reported high scores on well-being at all timepoints of study, however, without statistically significant differences. The analysis of the focus group interviews revealed that the Expert Caregivers experienced the intervention as meaningful and offered them a sense of belonging with the other participants. Apart from using their caregiving past as an asset, the participants also took advantage of other personal skills and resources. Risks of adverse effects were related to the participants’ expectations on their own contribution, demanding peer support recipients, poorly functioning peer support groups, and insufficient distance to one’s caregiving past. The participants stressed the need for continuing support from intervention facilitators. Future studies with larger samples should investigate whether the effects differ between subgroups of participants and explore the perspective of the peer support recipients.