Abstract
This study aims to explore the changes in well-being of the elderly population in the Guangdong-Hong Kong-Macao Greater Bay Area in terms of physical health, mental state, daily activity capability, and social interaction before and after receiving home care, as well as the main issues and challenges in the implementation of home care services. By collecting 800 valid responses through a self-designed questionnaire, dimensions including chronic disease management, daily activity capability, mental state, and social interaction were assessed. Data analysis was conducted using SPSS 26.0. The study found that the scores of the elderly in mental state and social interaction significantly improved after home care, while the scores for chronic disease management and daily activity capability slightly decreased. Additionally, the study explored the influence of different regions, genders, and economic levels on the effectiveness of home care. The results indicate that elderly individuals in the high-income group and economically developed cities showed more significant improvements in mental state and social interaction after home care, while those in the low-income group and economically disadvantaged areas showed less improvement in these aspects. Gender differences also manifested in the effectiveness of home care, with female elderly individuals showing more noticeable improvements in mental state and social interaction. These findings emphasize the necessity of developing personalized and diversified home care strategies to better meet the needs of elderly individuals from various backgrounds.
Similar content being viewed by others
Data availability
Data is provided within the manuscript. Data storage path “E-mail: glxmsremix@gdmu.edu.cn”.
References
Zihui, D. A new option for the elderly in Hong Kong–crossborder elderly care in Guangdong, Hong Kong and Macao Greater Bay Area. Int. J. Social Sci. Economic Res. 8(8), 2131–2139 (2023).
Li, Q. et al. Temporal and spatial characteristics of population aging and its economic effects in the Guangdong-Hong Kong-Macao Greater Bay Area. Geographical Res. 39(9), 2130–2147 (2020).
Zhong, Y. & Hu, X. The construction and institutional innovation of the Guangdong-Hong Kong-Macao Greater Bay Area: theoretical foundation and implementation mechanism. Economist. (12), 50–57 (2017).
Qing, Z. Age-friendly city construction and its practical application: A case study on the application of service demand research for the elderly in Guangzhou, China. Administrative Consulting. 12, 62–75 (2022).
Azevedo, N. M. & Espirito Santo, F. H. Teaching to take care: the nurse and caregiver familiar in home care elderly. Online Brazilian J. Nurs. 9(2), 1–12 (2010).
Wachs, L. S. et al. Prevalence of home care and associated factors in the Brazilian elderly population. Cad Saude Publica. 32(3), e00048515. https://doi.org/10.1590/0102-311X00048515 (2016).
Li, L. W. & Conwell, Y. Mental health status of home care elders in Michigan. Gerontologist 47(4), 528–534 (2007).
Kalwij, A., Pasini, G. & Wu, M. Home care for the elderly: the role of relatives, friends and neighbors. Rev. Econ. Househ. 12(2), 379–404 (2012).
Pellander, S. The ageing body as a bordering site: narrowing definitions of dependency for elderly family reunification in Finland. Nordic J. Migration Res. 8(3), 159–166 (2018).
Zhang, B. et al. A framework for remote interaction and management of home care elderly adults. IEEE Sens. J. 22(11), 11034–11044 (2022).
Wang, Y. L., Duan, Y. & Zhang, Y. A summary of researches on the quality of home-based care services in China. Public. Adm. Res. 10(1), 41–26 (2021).
Tang, S. M., Guo, C. J. & Ge, W. J. Respite service: work innovation to solve the problem of home care for the elderly. DEStech Transactions on Social Science, Education and Human Science. https://www.dpi-journals.com/index.php/dtssehs/article/view/27615 (2019).
Qiu, M. et al. Research on innovation path of internet plus home-based elderly care service model. In Proceedings of the International Conference on Urban Engineering and Management Science (ICUEMS). 476–480 (2020).
Huang, J. & Liang, S. On development and solutions of service for aged living with family in urban community of China. Adv. Educ. Humanit. Social Sci. Res. 2(1), 163–163 (2022).
Song, Q. & Sun, J. Is it feasible for China to establish a long-term care system for the elderly? Rev. Econ. Manage. 36(5), 65–75 (2020).
Yang, R. & Xie, H. The current status and comparison of care service provision lists under long-term care insurance systems at home and abroad. Chin. Nurs. Manage. 19(8), 1214–1218 (2019).
Fang, Y. Diverse social security for home care: international experience and implications. Med. Philos. 44(7), 42–46 (2023).
Su, W. & Tian, X. Research on the cooperative development of the elderly care service industry in the Guangdong-Hong Kong-Macao Greater Bay Area. Hong Kong Macao StudiesOpen Herald. 15, 56–73+96 (2021).
Tian, X. Cross-border elderly care services: Collaborative cooperation in the Guangdong-Hong Kong-Macao Greater Bay Area. Open Herald.(5), 109–112 (2017).
Chand, M. & Tung, R. L. The aging of the world’s population and its effects on global business. Acad. Manage. Perspect. 28(4), 409–429.
Zhao, Y. The impact of population ageing on the economy. Int. J. Social Sci. Public. Adm. 2(2), 108–121 (2024). 2014.
Shafiq, S., Albrecht, K. & LeRoux, K. Extending the interdependence theory to local public service provision: evidence from Iowa. Nonprofit Policy Forum. 14(3), 255–278 (2023).
Gilmour, J., Machin, T., Brownlow, C. & Jeffries, C. Facebook-based social support and health: A systematic review. Psychol. Popular Media. 9(3), 328–346 (2020).
Fonseka, S. et al. Effectiveness of low dose ethinylestradiol/cyproterone acetate, ethinylestradiol/desogestrel and metformin on hirsutism, hormonal and metabolic parameters of patients with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled study. Archives Psychiatry Mental Health. 3(1), 25–31 (2019).
Scuri, S. et al. Use of an online platform to evaluate the impact of social distancing measures on psycho-physical well-being in the covid–19 era. Int. J. Environ. Res. Public Health. 19(11), 6805. https://doi.org/10.3390/ijerph19116805 (2022).
Riihimäki, K. et al. Health-related quality of life of primary care patients with depressive disorders. Eur. Psychiatry. 37, 28–34 (2016).
Peltzer, K. & Pengpid, S. Determinants of quality of life among patients attending monk healers and primary healthcare centers in Thailand. Popul. Med. 3, 1–9 (2021).
The World Health Organization. Quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc. Sci. Med. 41(10), 1403–1409 (1995).
Risal, A. et al. Quality of life and its predictors among aging people in urban and rural Nepal. Qual. Life Res. 29(12), 3201–3212 (2020).
Norman, G. Likert scales, levels of measurement and the laws of statistics. Adv. Health Sci. Education: Theory Pract. 15(5), 625–632 (2010).
Morris, J. N. et al. Mds cognitive performance scale. Journals Gerontol. Ser. A: Biol. Sci. Med. Sci. 49(4), M174–M182 (1994).
Katz, S. et al. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA 185, 914–919 (1963).
Yesavage, J. A. et al. Development and validation of a geriatric depression screening scale: A preliminary report. J. Psychiatr. Res. 17(1), 37–49 (1982).
Ware, J. E. & Sherbourne, C. D. The MOS 36-item short-form health survey (SF–36): I. Conceptual framework and item selection. Med. Care. 30(6), 473–483 (1992).
Folstein, M. F., Folstein, S. E. & McHugh, P. R. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12(3), 189–198 (1975).
Yager, R. R., Kacprzyk, J. & Beliakov, G. (eds). Recent Developments in the Ordered Weighted Averaging Operators: Theory and Practice. (Springer, 2011).
Jiang, H. & Liu, Z. Community home elderly care services, multidimensional health, and social participation of chronically ill elderly—empirical analysis based on propensity score matching and multiple mediation analysis. Front. Public. Health. 11, 1121909. https://doi.org/10.3389/fpubh.2023.1121909 (2023).
Wang, L. & Yu, L. The supply of long-term care services in China: marketization policies, practices, and reflections. Zhongzhou Acad. J. 07, 88–95 (2021).
de Barreto, S. Recommendations on physical activity and exercise for older adults living in long-term care facilities: A taskforce report. J. Am. Med. Dir. Assoc. 17(5), 381–392 (2016).
Wiles, J. L. et al. The meaning of aging in place to older people. Gerontologist 52(3), 357–366 (2012).
Wong, S. Y. S. et al. Impact of covid–19 on loneliness, mental health, and health service utilisation: A prospective cohort study of older adults with multimorbidity in primary care. Br. J. Gen. Pract. 70, 817–824 (2020).
Diener, E. & Seligman, M. E. Beyond money: toward an economy of well-being. Psychol. Sci. Public. Interest. 5(1), 1–31 (2004).
Hui, S., Aspalter, C. & Lai, D. Social welfare in Macau — between east and west:: A comparative, analytical welfare regime perspective. SSRN Electron. J. https://doi.org/10.2139/ssrn.2027764 (2012).
Lorito, C. D. et al. Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation. BMC Geriatr. 24(1), 615 (2024).
Chen, Y., Yuan, Y. & Zhou, Y. Exploring the association between neighborhood blue space and self-rated health among elderly adults: evidence from Guangzhou, China. Int. J. Environ. Res. Public Health. 19(23), 16342. https://doi.org/10.3390/ijerph192316342 (2022).
Szinovacz, M. E. & Davey, A. Caregiving Contexts: Cultural, Familial, and Societal Implications. (Springer Publishing Company, 2007).
Seeman, T. E. & Crimmins, E. Social environment effects on health and aging: integrating epidemiologic and demographic approaches and perspectives. Ann. N. Y. Acad. Sci. 954, 88–117 (2001).
Rodin, J. Aging and health: effects of the sense of control. Science 233(4770), 1271–1276 (1986).
Avital, D. Gender differences in leisure patterns at age 50 and above: micro and macro aspects. Aging Soc. 37(1), 139–166 (2015).
Zhang, Z. Gender differentials in cognitive impairment and decline of the oldest old in China. J. Gerontology: Psychol. Sci. Social Sci. 61(2), S107–S115 (2006).
Verbrugge, L. M. Gender and health: an update on hypotheses and evidence. J. Health Soc. Behav. 26(3), 156–182 (1985).
Wen, P., Zhang, J. & Zhou, S. Social group differences in influencing factors for Chinese urban residents’ subjective well-being: from the perspective of social stratification. Int. J. Environ. Res. Public Health. 19(15), 9409. https://doi.org/10.3390/ijerph19159409 (2022).
Orbe, J. et al. Priests aging well: the role of gerotranscendence and its relationships with perceived health status, and life satisfaction among Catholic priests. J. Aging Stud. 72, 101301 (2025).
Repetti, M. & Fellay-Favre, E. Ageism and the digital divide in Switzerland during COVID–19: lessons for the post-pandemic world. J. Aging Stud. 69, 101227 (2024).
World Health Organization Ageing and Life Course Unit. Who global report on falls prevention in older age. https://www.who.int/publications/i/item/9789241563536 (2008).
Zhang, Q., Li, M. & Wu, Y. Smart home for elderly care: development and challenges in China. BMC Geriatr. 20(1), 318. https://doi.org/10.1186/s12877-020-01737-y (2020).
Torchia, M., Calabrò, A. & Morner, M. Public–private partnerships in the health care sector: A systematic review of the literature. Public. Manage. Rev. 17(2), 236–261 (2015).
Yu, W., Lin, D. & Chen, X. The current research status of integrated medical and nursing long-term care. Chin. Nurs. Manage. 13(04), 91–93 (2013).
Sun, Q. & Lu, N. Community social capital and self-rated health among older adults in urban China: the moderating roles of instrumental activities of daily living and smoking. Ageing Soc. 45(5), 969–986 (2025).
Acknowledgements
We would like to express Special thanks to the reviewers. Their comments and suggestions have helped improve the content of the present paper.
Funding
The authors received no funding for this work.
Author information
Authors and Affiliations
Contributions
All authors listed have made a substantial, direct, and intellectual contribution to the work, and approved it for publication. The ideas and data appearing in the manuscript have not been disseminated before (e.g., at a conference or meeting, posted on a listserv, shared on a website).
Corresponding authors
Ethics declarations
Ethics approvals
This study was conducted with the approval of the Ethics Committee of Guangdong Medical University. All participants signed an informed consent form. All experiments were conducted in accordance with the guidelines and regulations of the Declaration of Helsinki.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Zhong, Y., Huang, J., Luo, A. et al. Factors influencing the well-being of elderly population in home care mode and optimization research. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35719-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-35719-8
