Abstract

Family caregivers are vital to palliative and end-of-life care, yet their experiences of strain remain underrecognized and insufficiently supported. This review synthesized evidence from 12 studies published between 2020 and 2025 to examine caregiver challenges. A narrative synthesis approach was employed due to heterogeneity across study designs and outcomes. Findings showed caregiver burden is multidimensional, spanning five domains. Psychological and emotional strain included stress, anxiety, depression, grief, guilt, and hopelessness. Physical, practical, and economic strain encompassed fatigue, disrupted routines, role overload, and financial hardship. Informational and training needs reflected inadequate knowledge, skill gaps, and fragmented services. Relational and social strain involved dyadic conflict, family disputes, social withdrawal, and stigma. Socio-cultural and contextual strain arose from cultural duty, religious obligation, and systemic inequities. Counseling interventions were central to addressing these burdens, including cognitive–behavioural and meaning-centred therapies, psychoeducation, family counselling, and culturally sensitive approaches. The review emphasizes that counselling must move beyond symptom relief, positioning counsellors as educators, advocates, and community connectors.