International Journal of Clinical Case Reports, 2025, Vol.15, No.6, 283-292 http://medscipublisher.com/index.php/ijccr 285 subsidies, improving the level of community services, and establishing a comprehensive nursing system that can meet different needs (Zhang et al., 2022). 3 Sources and Impacts of Caregiver Stress 3.1 Sources of stress: care burden, emotional tension, insufficient resources, etc The stress of caregivers mainly comes from the primary stressors directly related to the needs of the elderly being cared for, as well as the secondary stressors caused by their own circumstances. These needs often require caregivers to provide high-intensity round-the-clock care. Especially when daily care exceeds 9 hours, it will significantly increase the stress (Yue et al., 2022). Secondary stressors include caregivers' own psychological problems, economic stress, and lack of training and assistance (Liu et al., 2024; Li et al., 2025). The difficulty in obtaining resources such as temporary care will further intensify the pressure, especially for rural or low-income caregivers. Emotional tension is very common in the care process, and caregivers often feel lonely and depressed (Hellis and Mukaetova-Ladinska, 2022; Li et al., 2025). The subjective burden of caregivers has a significant impact on problems such as anxiety and depression (Del-Pino-Casado et al., 2021). Theories such as the Stress process model hold that the interaction between stressors and caregivers' coping abilities determines the degree of burden (Hu et al., 2023; Liu et al., 2024). Therefore, caregiver stress is not only related to the need for care, but also influenced by psychological state and social environment. 3.2 Mechanisms by which stress affects the physical and mental health of caregivers Caregiver stress can affect physical and mental health in many ways. Long-term high-intensity care is prone to cause sleep disorders, headaches and other problems. Psychological distress such as anxiety and depression is also very common among caregivers. The stress process model indicates that the interaction of different stressors can lead to stress accumulation. If it cannot be relieved in time, it will deteriorate the health condition (Yue et al., 2022; Hu et al., 2023; Li et al., 2025). Long-term stress can cause the body to age faster and increase the risk of chronic diseases and cardiovascular and cerebrovascular related diseases (Watson et al., 2025). Caregivers often prioritize the needs of the elderly but neglect their own health, resulting in delays in seeing a doctor. Social support and self-regulation ability are regarded as important protective factors for helping people relieve stress (Tough et al., 2022; Liu et al., 2024). If such support is lacking, the quality of life of caregivers will be even worse and the probability of getting sick will also increase 3.3 The impact of stress on nursing quality and family care system Caregiver stress can significantly affect the quality of care and the stability of the family care system. A heavy burden can easily lead to a decline in the quality of care (Hellis and Mukaetova-Ladinska, 2022). In severe cases, long-term stress can make home care difficult to sustain and force the elderly to be sent to institutions (Li et al., 2025). Stress within a family can be passed on to each other, forming a vicious cycle (Abulaiti et al., 2022). From a systemic perspective, caregiver stress threatens the sustainability of the home care model, and families under long-term stress have difficulty adapting to the changing needs of the elderly (Cui et al., 2024). The accumulation of stress will increase the expenditure of families and the medical system. Therefore, addressing the stress of caregivers is crucial, and relevant intervention measures can maintain the quality of care (Yue et al., 2022). 4. Construction of A Home-based Elderly Care Support Mechanism 4.1 Institutional support Institutional support is an important backing for elderly people with disabilities to receive long-term home care. Long-term care insurance (LTCI), economic subsidies and temporary care are key policy measures. In countries such as Japan and China, LTCI projects provide services based on user needs, including options such as institutional care, home care and community care (Figure 1) (Yamada and Arai, 2020; Qian et al., 2025). However,
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