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This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors underlying the CCS and provides some short-term, medium-term, and long-term recommendations.

A literature review was conducted, including relevant government reports, consultation papers, Legislative Council papers and articles from academic journals from 1980 to the present.

The Four A’s approach shows that applicants to both centre-based services and home-based services endure lengthy waiting times because of the limited number of CCS. Furthermore, the awareness of day respite services is approximately 50 percent, which lags behind other CCS. Accessibility is contingent on a cross-district day respite service system and a lack of consistency between the quota and the proportion of older adults in the districts. Finally, the level of service provided by CCS is unsatisfactory due to inflexible service provision. Reviewing the brief history of long-term care services (LTC) reveals the deep-seated factors at the core of their heavy reliance on the subvention model, in contrast to the adoption of the ‘mixed economy of care’ by residential care services (RCS). An imbalance in budget allocation to RCS and CCS is also revealed.

Although the principle of ‘ageing in place’ was introduced in 1977, the institutionalisation rate (6.8 percent) of older adults remains unexpectedly high in Hong Kong, even surpassing its Asian counterparts, whereas the usage rate of CCS hovers around 0.8 percent. Thus, how to implement policy concerning LTC services for older adults must be re-evaluated.

The purpose of this study is to examine the effectiveness of the Thai nursing student competency enhancement program applied through project-based learning (PjBL) in caring for the elderly in the community.

This quasi-experimental one-group pre-post-test design was used to compare mean scores on gerontological nursing competency scales comprising four dimensions including holistic health promotion, empirical evidence, empowerment and quality care and ethical and moral competencies. A total of 95 participants were randomly selected from a list of registered attendees. A five-week PjBL approach for a community nursing practicum was designed and comprised of an introduction to the project, components of research methodology, group projects and group presentations. A gerontological nursing competencies questionnaire was used with participants, and data were analyzed using descriptive statistics. Two-way ANOVA and a paired t-test were used to compare pre-post mean scores of competencies.

A total of 95 students participated in the PjBL and the majority of participants were female (92.6%). The results revealed post–PjBL mean scores of gerontological nursing competencies were higher than the premean score (p value < 0.05) except the empirical evidence competencies which showed no statistical difference.

Since the results show the effectiveness of the student nursing competency enhancement program through PjBL when caring for the elderly in the community, it is important for health care instructors to apply PjBL, especially in community nursing. Improving empirical competency evidence among nursing students is still required and necessary.

The aim of this paper is to argue for the values of familial caring and relationships in addition to the provision of social media technology during the COVID-19 pandemic in Hong Kong.

The discussion of this paper has adopted an inter-disciplinary approach by integrating health care system and psychological analysis, based on cultural philosophical argument through the hermeneutic approach of classical texts and critical analysis.

The COVID-19 pandemic has exposed the dilemma between the public health measures for COVID-19 and sustaining elderly social psychological health through familial connection. From a Confucian perspective, the practice of filial piety (xiao, 孝), which demands taking care of parents, is essential for one’s moral formation, and for one’s becoming a virtuous (ren, 仁) person. The necessity of taking care of elderly parents by adult children is not something that can be explained in terms of consequentialism. Indeed, the rising trend of instrumental rationality seems to weaken rather than strengthen the sense of filial obligation. In the face of the COVID-19 pandemic which tends to separate connections between family members, the author argues that we should emphasize the values of familial caring and relationship because it enhances the elderly’s characteristic of resilience.

This paper shows that while social media technology has mitigated the negative effect of social distancing, such online relationships should never replace the bodily connections between the elderly and their family members from a Confucian perspective.

The purpose of the study is to assess the quality of life (QOL) of older adults and explore factors associated with it.

A cross-sectional study was conducted in a remote community in Nepal. A total of 671 older adults aged 60 years were enrolled in the study. QOL was measured by WHOQOL-OLD questionnaire. Data were analyzed using multiple logistic regression.

Most participants were female (53.0%), illiterate (70.6%), married (64.2%) and living with family (59.3%). Among participants, 82.4% had fair QOL, and the autonomy domain received the lowest score (average = 10.98). After adjusting the model, the elderly aged <70 years had 11.07 times better QOL (aOR = 11.070; 95% CI = 2.546–48.123), elderly with high sufficient income had 2.73 times better QOL (aOR = 2.738; 95% CI = 1.183–6.337) and elderly free from depression had 9.45 times better QOL (aOR = 9.452; 95% CI = 3.466–25.773) compared to their counterparts. The elderly receiving social support had 9.97 times better QOL than those who did not (aOR = 9.976; 95% CI = 3.152–31.574), and those able to afford healthcare services had 4.69 times better QOL than those who could not afford it (aOR = 4.694; 95% CI = 1.046–21.063).

The five predictors – age, income sufficiency, depression, social support and healthcare service affordability – were found to significantly affect QOL. This study suggests special care strategies for vulnerable older adults addressing the issues that affect geriatric depression. This article provides relevant information to the government to consider increment of income, encourage family and community for social support and make health services affordable for older adults.

The purpose of this paper is to study and compare knowledge and skills in basic care for the dependent elderly of health volunteers before and after the increase in ability program participation.

Quasi experimental research includes one group pretest-posttest design. The research was conducted from January to March 2018. The samples were 30 health volunteers in Nakorn Pathom Province selected by purposive sampling. They were all female, aged 20–50 years, with minimal education level of early secondary school and were current or former health volunteers. The increase ability program consisted of lecture and skill practice by demonstration and individual replay demonstration. The program duration was 30 h with 19 h of skill practice and 2 days of site visit to the dependent elderly’ homes. The tool for collecting data was a questionnaire for the evaluation of knowledge and skills in basic care for the dependent elderly. The data were analyzed by means, standard deviation and paired t-test.

After the increase in ability program participation, the health volunteers had very good level of knowledge in basic care for the dependent elderly with statistical significance (p<0.01) and had most correct skills in basic care for the dependent elderly with a score of 9 from 11 items.

Knowledge and skills in basic care for the dependent elderly of the health volunteers increased to a very good level after program participation. Thailand should provide periodic and continuous training program to increase health volunteers’ knowledge and skills in basic elderly care to provide care for the elderly with most benefits.

The purpose of this paper is to assess the relationship between elderly people's health literacy skills and those people's decision to make use of digital health service platforms. Despite the substantial influence of digitisation on the delivery of healthcare services, understanding how health intervention strategies might help empower elderly people's health literacy skills is critical.

This paper analyses the existing trends in research on the convergence of health literacy, health intervention programmes and digital health service platforms by reviewing 34 studies published between 2000 and 2020.

The findings of the review indicate three primary themes (health literacy skills, health management competency and attitude/confidence), which provide a summary of the current literature, and in all three the results show that health intervention programmes help to enhance health literacy skills of elderly people. Based on the review results and by organising the fragmented status quo of health intervention research, the authors develop a comprehensive research model and identify future research directions for research in this domain.

The findings will be useful to health professionals in two ways: (1) the findings provide practical information about the growing need to implement health literacy intervention programmes to satisfy elderly people's appetite for accessing health services due to cognitive and physiological impairments, and (2) the finding help them to understand that with digital health platforms, elderly people have quicker access to health services, improving the quality of care provided to them.

This paper presents a comprehensive research model for analysing the impact of health literacy skills on older people's ability and intention to access digital health information sources, considering various health intervention approaches.

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.

The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.

The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.

The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.

The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.

The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.

While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

This paper theoretically and empirically analyzes the effects of the elderly’s physical health status on their need for care and the choice of care models in China.

Empirically, the estimation results of a large-sample randomized intervention trial with chronic obstructive pulmonary disease (COPD) patients through the difference-in-difference method indicated the following: (1) After the COPD intervention trial, the physical health status of the elderly in the treatment group improved significantly, the need for care was substantially reduced and the health improvement led to a 35.5% reduction in the probability of using elderly care. (2) The reduction in the need for care regarding the treatment group occurred mainly in social care. The probability of using social care decreased by 67.8% due to the elderly’s health improvement, while that of home care remained unchanged generally. (3) Further heterogeneity tests suggested that families with fewer potential internal resources for caregiving had a more pronounced decline in the need for social care.

Theoretically, these empirical results support the existence of the “pecking order” theory in the family’s choice of elderly care model, that is, families tend to employ all internal resources for caregiving before resorting to social care, resulting in a higher sensitivity of social care to health.

The main policy implication of this paper is that ex ante preventive health intervention policies can significantly alleviate the burden of care, especially social care, on families. And preventive health intervention policies are particularly effective in reducing the burden of the families with relatively few resources for informal internal care.

The technological revolution in the service sector is radically changing the ways in which and with whom consumers co-create value. This conceptual paper considers social robots in elderly care services and outlines ways in which their human-like affect and cognition influence users’ social perceptions and anticipations of robots’ value co-creation or co-destruction potential. A future research agenda offers relevant, conceptually robust directions for stimulating the advancement of knowledge and understanding in this nascent field.

Drawing from service, robotics and social cognition research, this paper develops a conceptual understanding of the value co-creation/destruction potential of social robots in services.

Three theoretical propositions construct an iterative framework of users’ evaluations of social robots in services. First, social robots offer users value propositions leveraging affective and cognitive resources. Second, users’ personal values become salient through interactions with social robots’ affective and cognitive resources. Third, users evaluate social robots’ value co-creation/destruction potential according to social cognition dimensions.

Social robots in services are an emerging topic in service research and hold promising implications for organizations and users. This relevant, conceptually robust framework advances scholarly understanding of their opportunities and pitfalls for realizing value. This study also identifies guidelines for service managers for designing and introducing social robots into complex service environments.