Integrated Community-Based Care for Dependent Older People Community Participation in Preparation for Recurrent Outbreaks of COVID-19

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Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted family caregivers of older dependents, leading to fatigue, anxiety, depression, and financial burdens, which in turn diminish their quality of life. This study investigated the integration of community participatory systems in older care to address potential COVID-19 recurrence and develop policy proposals for the integrated care of dependent older people. Methods: An explanatory sequential design was used, with stratified random sampling across six provinces, resulting in a sample of 440 family caregiver dyads and 154 full-time community stakeholders (October 2021--May 2022). Five validated tools were employed, with a content validity of 0.91 and a Cronbach’s alpha of 0.69. The data analysis included descriptive statistics and thematic analysis. Results: Among the 440 primary caregiver households, 42.73% of the older people had moderate dependence, 30.00% had severe dependence, and 27.27% had complete dependence, with common health issues, including chronic illness and comorbidities. Most older adults lived with their children/grandchildren, had insufficient income, and were informed about COVID-19 prevention measures. Family caregivers, predominantly female (average age 54), had multiple underlying conditions and provided an average of 37 hours of care per week, primarily communicating via phones or apps. The 154 stakeholders included public health volunteers and professional nurses, with an average age of 55 years, and were predominantly female (74.55%). They adhered strictly to COVID-19 precautions during their caregiving duties. This study highlights the impact of trust and COVID-19 perceptions on older care, emphasizing the need for specific forms of care, community support, and resources. Perceptions of “trust”, “stay home”, “self-care”, and “distance” significantly influenced care for dependents. The findings will inform health and social workers’ planning, operation, and training, addressing the specific care needs of dependent older adults. Conclusion: This study recommends policy interventions such as budget allocations for essential equipment, better compensation for community work, and the fostering of expertise in elder care. Emphasis is placed on fostering collaborative community agreements.

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