International Journal of Clinical Case Reports, 2025, Vol.15, No.2, 68-78 http://medscipublisher.com/index.php/ijccr 74 However, in many regions, some caregivers lack the necessary professional skills due to inadequate training systems, potentially affecting care quality and diminishing trust in care among elderly individuals. Studies have shown that community caregivers need to continuously enhance their skills to meet the complex and changing health needs of elderly individuals. Therefore, strengthening caregiver training, including psychological support, emergency response, and health education, is crucial for improving the quality of community-based home care. Research by Metzelthin et al. (2015) indicated that systematic training and support for caregivers not only improve care quality but also reduce stress and burnout, enhancing overall care effectiveness and sustainability. 5.3 Social and cultural factors affecting elderly care Social and cultural factors significantly influence the effectiveness of community-based home care, as different cultural backgrounds and social support systems can affect the acceptance and adaptability of elderly individuals to care services. In some cultures that emphasize family caregiving, elderly individuals may prefer to rely on family support rather than accept external care services, reducing the acceptance and effectiveness of home care. Liu et al. (2016) found that in regions where family responsibility is culturally emphasized, elderly individuals may resist home care services, viewing it as a sign of “family failure.” This belief can hinder the implementation of home care and impact its effectiveness. Additionally, socioeconomic conditions and community resources significantly affect care outcomes. Communities with abundant resources can provide high-quality, comprehensive care services to meet various needs, while resource-limited communities may struggle to meet the basic needs of elderly individuals, affecting care outcomes. For example, in urban areas, resources for home care services are relatively abundant, including professional caregivers, medical facilities, and emergency support systems, whereas rural or remote areas may face limitations in care quality and effectiveness due to resource shortages (Noguchi et al., 2022). Cultural and social factors also influence the design and implementation of care services. For instance, elderly individuals’ needs and expectations for care services vary across different social and cultural contexts; thus, considering local cultural characteristics and elderly individuals’ habits is essential when designing care services. Xiao and Wu (2015) noted that community-based home care services should be tailored to local cultural practices to enhance elderly individuals’ acceptance of and satisfaction with the services. Studies have shown that integrating cultural context into community care can effectively enhance elderly individuals' satisfaction with care services and improve care outcomes. Therefore, to optimize the overall effectiveness of community-based home care, it is essential to fully consider the impact of social and cultural factors and flexibly adjust care service design and implementation to better meet the needs of elderly individuals. 6 Case Study: Community-Based Home Care for Elderly Individuals Living Alone 6.1 Study location and methodology This study was conducted in a specific community, focusing on changes in mental health among elderly individuals living alone who received community-based home care. A combination of quantitative and qualitative methods was used to comprehensively assess the effects of care interventions. Basic information on participants, including age, health status, and mental health levels, was collected to establish baseline data. The tools used included the General Health Questionnaire (GHQ-12) and the Geriatric Depression Scale (GDS), both widely used for assessing mental health in elderly individuals (Agrawal and Khan, 2021). Data collection took place over six months, during which caregivers provided regular in-home care and recorded changes in mental health for each participant. To obtain in-depth qualitative data, structured interviews and observation records were designed. Through interviews, caregivers were able to understand elderly individuals' experiences and feedback on the care they received, providing unique insights for the study. Observations also provided critical references for analyzing specific aspects of community care operations. For example, caregivers’ observations helped identify the reactions and psychological changes of elderly individuals in response to particular care interventions (Grundberg et al., 2016). Through these methods, this study comprehensively analyzed the effectiveness of community-based home care in improving the mental health of elderly individuals living alone (Pu and Cai, 2024).
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