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Informal carers account for nearly 80% of the care providers at EU level. Whilst carers may find care meaningful, high intensity caring over time carries a “triple penalty”, with negative impacts on carers’ health, financial and social situation (Buckner & Yeandle 2015). The burden associated with informal caregiving represents a chronic stress experience (Zarit 2006), and prevalence of anxiety and depression among carers was shown earlier to be 20% higher than among non-carers (Colombo et al. 2011). The intense and unpredictable circumstances of care during the COVID-19 pandemic increased psychological distress, strain and overall health deterioration experienced by informal carers (IRCCS-INRCA/Eurocarers 2021).

Whilst 75% of LTC workers perceive they are doing useful work, the highest proportion of strained jobs is among LTC workers (42%) (Eurofound, 2023) which is due to a range of factors, such as complex tasks to be performed (moving and handling care recipients, personal hygiene, risk of exposure to infectious agents), low wages, irregular and/or longer working hours, shift work, heavy workload and a high exposure to adverse social behaviours (e.g. verbal abuse or threats, bullying or harassment, unwanted sexual attention) (Eurofound, 2023; OECD 2020).). This situation and especially the emotional demands of their working tasks, represents a high risk for LTC workers to develop mental health problems, (e.g. anxiety, depression, burnout) which has been exacerbated by the COVID-19 outbreak (Eurofound, 2023, Boamah et al. 2022). The subsequent reduction of the LTC workforce in Europe, especially in residential settings, has led to a deterioration in recruitment and retention of LTC workers and staff shortages in this crucial and growing sector (Florek 2021).

Against this backdrop, and given the lack of available research and solutions, it is important to carry out cross-national research to better understand the complex interaction of both occupation-specific and non-occupation-specific protective factors able to sustain the mental health and resilience of the LTC workforce, and design support accordingly.

Project goal and objectives: Towards more resilient LTC workers and informal carers

The overall goal of the WELL CARE project is to strengthen the supports available to LTC workers and informal carers for improving their resilience and mental wellbeing. Our project consortium will do this by contributing to the identification, improvement/adaptation and implementation on a wide scale of innovative solutions for addressing care partnerships. The project will investigate what are the good practices that directly improve LTC workers and informal carers’ mental health, as well as those which prevent or mitigate the occupational risks (e.g. heavy workload, stressful working conditions, risk of exposure to infectious agents, precariousness, ethical stress) and non-occupational risks (based on factors such as gender, age, migration background, socio-economic status, and the quality of the care partnership) affecting their mental health. WELL CARE will select, model and promote such innovative solutions (e.g. prototypes). Our fieldwork with good practices and solution prototypes will be focused on 5 EU countries, i.e. Germany, Italy, Netherlands, Slovenia, and Sweden. These countries were selected to capture contrasting features of (formal and informal) LTC systems in Europe and to guarantee the geographical coverage and relevance of our project.

Overall project methodology

The WELL CARE project aims at improving supports available for LTC workers and informal carers to increase their resilience and mental wellbeing. The project adopts a participatory research approach in order to tailor activities and outputs to actual needs and contexts of end-users.

The project is shaped as a research and innovation action (RIA), thus including mostly research and development (R&D) activity for creating new knowledge and evaluating the feasibility and impact of a set of new solution prototypes for LTC workers and informal carers. The latter will concern field research for implementing and validating such prototypes in the 5 targeted project countries (Germany, Italy, Netherlands, Slovenia, Sweden).

The project is a complex endeavour which will be implemented in 5 EU Member States, allowing the participating researchers to gain an in-depth understanding of needs, solutions, effects, mechanisms and contexts. The available and newly collected data will enable the consortium to examine how the long-standing effects and innovative solutions collected (good practices) and improved (prototypes) decrease mental health problems for LTC workers and informal carers, as well as prevent and mitigate occupational and non-occupational risk factors, and what the mechanisms are of successful implementation of proven good practices.

Key research questions are as follows:

  1. What are the most successful and promising innovative solutions supporting resilience and mental wellbeing of LTC workers and informal carers in Europe?
  2. How do they work and what are the essential characteristics (success drivers) of each one? How can they be decontextualised and modelled into more general and transferable prototypes?
  3. To what extent is it effective (for end-users) and feasible (for organisational providers) to adopt and implement the solution prototypes in different countries or local/regional contexts?
  4. Can prototypes also guarantee usability and satisfaction for the end-users?
  5. How good practices and prototypes address gaps and challenges posed by social changes and grand social challenges, including LTC work and informal care in a (post-) pandemic era, digitalisation of health and care services, changing social norms and values, globalised care labour markets, demographic ageing, and decreasing availability of both informal and formal care?
  6. How good practices and prototypes address issues related to gender, inclusion and intersectionality?
  7.  Can prototypes contribute to establishing or improving resilient communities?
  8.  What are the needs, barriers and challenges to be addressed in each country in order to establish a successful ecosystem supporting LTC workers’ and informal carers’ mental wellbeing and resilience?
  9. What are the gaps in policy, legislative, service and financial frameworks that should be addressed by policy makers and stakeholders in order to have a supportive national context?

Knowledge translation and advocacy work

WELL CARE advocacy work will first aim at raising awareness about the situation and needs of the formal and informal care workforce and the contribution of the WELL CARE project. It will frame the project in the European level policy making environment, characterised notably by the implementation of the European Care Strategy adopted in 2022, and the announced European initiative on Mental Health for 2023. It will seek to ensure that issues related to the mental health of the care workforce are addressed in the long term, beyond the current policy momentum, and considered in all relevant debates and policy initiatives concerning LTC provision.

Partners will widely disseminate the project’s outcomes towards identified target groups (namely informal carers’ and LTC workers’ representatives, policy makers and stakeholders, including among others LTC employers, health and social care service organisations, social partners) in order to maximise the buy-in, the use of the proposed tools and the transfer of identified good practices and solution prototypes. Beyond decision makers directly targeted by dissemination activities such as conferences and EU exchange platforms, partners will ensure that messages get out to a wider audience in the field and achieve real impact among the communities of (formal and informal) carers and stakeholders, by ensuring knowledge translation and developing attractive and accessible dissemination tools such as briefings and podcasts.

Building on WELL CARE research outcomes regarding good practices, enablers and barriers in innovation for LTC workers’ and carers’ resilience and wellbeing at national/regional level, the project ambition is to contribute to the shaping and implementation of concrete and effective national LTC plans. By discussing policy recommendations with key stakeholders, WELL CARE will contribute to maintaining the momentum created by the European Care Strategy and reflect on its implementation.


The WELL CARE is a 48-month project is funded by the Funded by the European Union, under the research and innovation programme Horizon Europe (Grant Agreement no. 101137468).

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