Abstract
Background: Informal caregivers play a central role in supporting older adults with functional limitations, yet caregiving may impose substantial physical, psychological, social, and occupational demands. Objectives: This study aimed to explore caregiving experiences, sources of burden, and unmet healthcare and social support needs among informal caregivers of older adults with high caregiver burden. Methods: This qualitative study represented the second phase of a sequential explanatory mixed-methods study. Ten caregivers were purposively selected from the preceding quantitative phase based on a high caregiver burden, Caregiver Strain Index Plus (CSI+) score ≥ 7. In-depth semi-structured interviews were conducted in Kazakh or Russian across four cities of Kazakhstan and analyzed using inductive reflexive thematic analysis. Results: Six themes were identified: (1) physical and psychological impact of caregiving; (2) work–care balance and social isolation; (3) gender roles in the care of older adults; (4) insufficient support from healthcare and social services; (5) unmet caregiver needs; and (6) limited awareness of available support and services. Participants described increasing physical and emotional strain, disruption of employment and social life, and gendered expectations surrounding family caregiving. They also reported limited professional guidance and recognition, unmet needs for respite and practical assistance, and limited awareness of available health and social services, with informal networks and online sources often used to obtain information. Conclusions: Strengthening caregiver support within primary healthcare and improving access to information, practical assistance, and respite services may help address the needs identified among caregivers with high caregiver burden.