1 Introduction

With continuous advancements in medical and social living standards, human life expectancy has significantly increased. However, a declining birth rate driven by multiple factors has led to structural imbalances in the population, exacerbating the issue of population aging. This has become an increasingly pressing global concern. According to the seventh national census by the National Bureau of Statistics, China’s population aged 60 and above has reached 264 million, with nearly 191 million individuals aged 65 and above, accounting for 13.52% of the total population. This indicates that China has entered an aging society. Du Peng and Li Long predict that China’s elderly population will continue to grow throughout the first half of the 21st century, reaching 412 million by 2035 and 480 million by 2050 [1]. Corresponding to the rapid growth of the aging and advanced-aging populations is the increasing number of elderly individuals with disabilities. Providing effective and long-term care for this demographic has become an urgent issue.

Elderly individuals with disabilities refer to those who, due to aging, illness, or injury, suffer from functional impairments or disabilities and require assistance from others or complete dependence on others for daily activities [2]. In contemporary China, caregiving responsibilities for elderly individuals often fall on their children, adhering to the traditional notion of family care. However, in modern society, traditional multi-generational households are becoming less common. Economic pressures often necessitate that both spouses work, leaving them with limited time and energy to care for elderly family members. Moreover, many families lack the professional skills and knowledge needed to provide effective care, making it difficult to meet the special needs of elderly individuals with disabilities, such as specialized nursing, rehabilitation training, and psychological support. Consequently, traditional family care struggles to effectively address the care needs of this population.

Community care, on the other hand, offers several advantages over family care. It can provide more professional and diverse care services for elderly individuals with disabilities while alleviating the economic burden on their children. Despite its advantages, community care currently faces challenges such as underdeveloped service institutions and insufficient reserves of professional personnel. Therefore, this paper adopts a social work perspective, focusing on elderly individuals with disabilities, and explores the construction of a service model that integrates social work interventions. This model is based on family care and supplemented by case services and community care, aiming to provide a reference for offering long-term and effective care for elderly individuals with disabilities.

2 Current Research on Community Care for Elderly Individuals with Disabilities

2.1 Research on Care Needs of Elderly Individuals with Disabilities

According to the Long-term Care Disability Assessment Standards (Trial) issued by the National Healthcare Security Administration in 2021, the current assessment indicators for elderly individuals with disabilities in China primarily include three primary indicators (activities of daily living, cognitive ability, sensory and communication ability) and 17 secondary indicators. Specifically, the activities of daily living include 10 secondary indicators such as eating, dressing, and climbing stairs; cognitive ability encompasses four secondary indicators including orientation to time, people, space, and memory; sensory and communication ability involves three secondary indicators: vision, hearing, and communication ability. By summarizing the scores for these indicators, the disability level of elderly individuals is classified into six levels: Level 0 (basically normal), Level 1 (mild disability), Level 2 (moderate disability), Level 3 (severe disability I), Level 4 (severe disability II), and Level 5 (severe disability III). It is evident that these indicators and the classification of disability levels are closely related to the daily lives and health conditions of elderly individuals, directly reflecting certain aspects of their care needs.

Domestic scholars have conducted targeted research on the needs of elderly individuals with disabilities. Wang Hongru and Li Yue, based on data from CLHLS (2018) and CLASS (2018), assessed the disability status of elderly individuals in China and examined their care needs. They found that approximately 87% of elderly individuals with disabilities require long-term care, with the highest demand for medical care, followed by emotional support, and the lowest demand for daily care [3]. Cheng Qian et al., through empirical analysis of the current state of care needs and influencing factors for elderly individuals with disabilities, discovered that the overall degree of care needs in China is relatively high, and that individual socioeconomic characteristics, health conditions, and family characteristics significantly influence the level of care service needs [4]. Huang Liqun’s team found that urban elderly individuals with disabilities living at home have a high demand for professional home-based care, particularly for health promotion-related professional care [5]. Chen Na and other scholars found that the proportion of elderly individuals with disabilities requiring informal care is as high as 90.8%, with an average of 48.01 hours of informal care provided per week [6]. These studies collectively highlight the substantial and diverse care needs of elderly individuals with disabilities. The large base of unmet care demand presents a pressing issue: how to effectively provide care services to this population and meet their daily living needs. This remains a practical challenge that urgently requires solutions.

2.2 Analysis of Care Models for Elderly Individuals with Disabilities

Based on differences in the location, method, and identity of the service providers offering care services to elderly individuals with disabilities, care models can be categorized into family care, institutional care, and community care.

The family care model refers to care services provided by family members, relatives, friends, or other non-professionals. In Chinese traditional culture, values such as “raising children to provide for old age” and “filial piety as the foremost virtue” align with the concept of family care, which is also a significant reason most elderly individuals with disabilities opt for this model. However, Li Lin and others suggest that the care needs of elderly individuals with disabilities are continuous. Under the prevalent “4-2-1” family structure in China, issues such as work obligations and child-rearing responsibilities prevent family members from providing the necessary continuous care for elderly individuals with disabilities [7]. Sun Jian’e and Wang Hui found that, under the dual pressures of career and caregiving, children often choose to provide financial support to compensate for their inability to care for disabled elderly family members directly. However, this support does not effectively resolve the insufficiency of family caregiving resources [8]. Shen Xilian and Luo Dan, through an analysis of the gap between care supply and demand, identified a lack of professionalism as a significant limitation of family care [9].

The institutional care model involves providing care services in specialized facilities, such as nursing homes, senior centers, and elderly rehabilitation centers. The advantage of this model lies in its ability to offer round-the-clock, professional care for elderly individuals with disabilities. However, such a model often lacks the familial warmth and individualized arrangements that elderly individuals value, leading many to resist this option. Consequently, most elderly care institutions face unmet demand, with some large private elderly care facilities reporting occupancy rates of less than 10% [10]. Furthermore, the relatively high cost of institutional care imposes a significant financial burden on families, making it unaffordable for many.

The community care model provides care services within the residential communities of elderly individuals with disabilities. Caregivers typically include community-based nursing agencies, social workers, volunteers, and other professionals in related fields. This model allows elderly individuals to receive care in familiar environments, maintaining a degree of independence and social interaction. Community care can also offer more flexible and personalized care services tailored to the needs of elderly individuals. Huang Zishuo and colleagues argue that community care not only mitigates the negative impacts of family and institutional care but also helps elderly individuals overcome psychological issues caused by physical deterioration, while reducing the caregiving burden on their children. They identify community care as the most effective model for meeting the care needs of elderly individuals with disabilities [11].

3 Case Analysis of Community Care for Elderly Individuals with Disabilities

3.1 Multi-Angle Cross-Professional Service Provision: The “CCHC” Model in Dongguan, Guangdong

The Z Social Work Service Center in Dongguan, Guangdong Province, operates based on the core principles of “one concept, two platforms, three projects, and four value-added services.” Through accumulated experience in cross-professional team collaboration, such as “Four-Sector Linkage” and “Social Worker+,” the center has gradually developed the Continuing Care Home-based Community Model (abbreviated as the “CCHC” Model). Since 2015, the center has been exploring individualized services for elderly individuals with disabilities and support for their families. By integrating the service needs of different elderly individuals with disabilities and their caregivers, the center employs a cross-professional team composed of social workers, rehabilitation therapists, medical staff, nursing aides, and volunteers. This team enhances caregivers’ skills in caring for elderly individuals with disabilities and improves the quality of life for the elderly. Social workers play multiple roles in this process. They are not only direct providers of professional services, offering individualized services to elderly individuals with disabilities, but also act as senior care consultants, providing tailored advice to elderly individuals and their caregivers[12]. Additionally, they advocate for creating an elderly-friendly community environment, promoting awareness and care for elderly individuals with disabilities among community residents. Furthermore, social workers serve as coordinators among various entities, facilitating the establishment of cross-professional teams and ensuring the smooth implementation of services.

3.2 Multi-Level Linkage to Improve Service Efficiency: The “Four-Level Service System” in Taicang, Jiangsu

In March 2021, the Municipal Social Work Service Guidance Center was established in Taicang, Jiangsu Province. From its inception, the center effectively integrated various resources and service forces, including social work service stations and community social work offices at all levels. The center explored and established a four-level service system: “grid-based needs identification → platform-based task assignment → guidance center processing → social work agency service.” It implemented a service process of “incident acceptance → level assessment → problem estimation → plan execution → follow-up counseling.” Relying on station-based social workers and employing individual and group work methods, the center provides social work services to 16 specific target groups across all communities in the city, with elderly individuals with disabilities being a key focus. Grid staff, as frontline information collectors, directly identify elderly individuals with disabilities requiring care. After systematically assessing their needs, the resource integration platform links cross-institutional resources under the guidance of the center. Social work stations, particularly community social work stations and offices, integrate existing community resources[13]. In turn, they deliver high-standard and efficient care services to elderly individuals with disabilities in the community. The “Four-Level Service System” also facilitates the accumulation of work and service experience, enhances capabilities across all aspects, and promotes the healthy development of the service system.

4 Challenges in Integrating “Social Work” and “Community Care” for Elderly Individuals with Disabilities

4.1 Imbalance Between Supply and Demand of Community Care Resources

With the accelerating trend of population aging, the demand for community care services for elderly individuals with disabilities has significantly increased, placing higher demands on community care resources. Under current circumstances, the growth rate of community care resources struggles to keep pace with the rising demand, resulting in an imbalance between supply and demand. Furthermore, disparities in the allocation of community care resources between eastern and western regions, as well as between urban and rural areas, exacerbate this imbalance. The operation of community care also requires substantial financial support, covering expenses such as facility construction, personnel training, and equipment procurement. However, certain regions or communities face financial constraints and cannot provide adequate funding to sustain community care models. Social workers, operating within this context of resource imbalance, often face challenges in delivering sufficient services to elderly individuals with disabilities. Additionally, a shortage of human resources persists. While community social work stations have been established in many areas across China, the number of stationed social workers remains limited, making it difficult to meet the care needs of all elderly individuals with disabilities within a given jurisdiction. Social workers often endure high workloads, leaving them unable to adequately address the individualized needs of elderly individuals with disabilities.

4.2 Imperfect Mechanisms for Multi-Departmental Coordination and Cooperation

In community care models, the coordination and collaboration among multiple departments and institutions are critical. Although the municipal-level Social Work Service Guidance Center in Taicang, Jiangsu Province, provides an exemplary model for multi-level coordination, most communities still face practical challenges in establishing such multi-departmental service systems. To provide comprehensive services for elderly individuals with disabilities, social workers must collaborate with community healthcare institutions, community-based organizations, and family members. However, conflicts of interest in resource allocation and responsibilities among different departments and institutions often arise. Each department operates based on its own priorities and objectives, and varying levels of understanding and recognition of social work create ambiguities in defining the roles and responsibilities of social workers. This lack of consensus hinders effective cooperation in the field of community care. In practice, issues such as information asymmetry and isolated information systems among departments further impede effective communication and collaboration. While social workers are expected to act as “bridges” between the community and various departments, the lack of well-developed mechanisms and platforms limits their ability to fulfill this role and integrate effectively into the system.

4.3 Lack of Skills and Experience Among Social Workers

To provide timely and effective care services for elderly individuals with disabilities in the community, social workers must possess systematic and relevant professional skills and experience. Although casework, group work, and community work are fundamental methods in social work, integrating these approaches with community care for elderly individuals with disabilities remains a significant challenge. While universities across various regions are increasingly enhancing their training of social work professionals, the emphasis is largely on theoretical knowledge. The integration of theory with practical experience is neither systematic nor comprehensive, resulting in a lack of practical experience among social work graduates. Moreover, social workers already stationed at community service centers have limited opportunities for continued education and training. This lack of ongoing professional development leaves them without the necessary expertise to adequately serve special groups, particularly elderly individuals with disabilities, resulting in lower-quality care services.

4.4 Low Social Recognition of Elderly Individuals with Disabilities

Elderly individuals with disabilities often face challenges such as poor physical health, limited economic resources, and restricted social networks. These issues not only affect their quality of life and ability to achieve personal fulfillment but also diminish societal attention and regard for them. Their needs and desires are frequently ignored or dismissed, and they are often labeled with negative stereotypes and stigmatized with terms like “burden” or “useless.” Such phenomena exacerbate their marginalization within society. Furthermore, elderly individuals with disabilities lack opportunities to participate in normal social activities, leaving them unable to express their wishes and needs. This not only impacts their self-identity but also reduces their sense of social belonging. Consequently, when social workers and related personnel intervene to provide community care for elderly individuals with disabilities, they also face challenges stemming from societal attitudes. The public perception of elderly individuals with disabilities within the community becomes a critical factor in the integration of social work into their care.

5 Community Care Strategies for Elderly Individuals with Disabilities

5.1 Enhancing the Professionalization and Depth of Social Workers

University programs in social work and related disciplines serve as vital channels for cultivating a skilled social work workforce. These programs must establish professional boundaries during the training process to enhance the specialization of students and ensure a reliable pipeline of future professionals. Alongside imparting theoretical knowledge, programs should emphasize the accumulation of practical experience, particularly in addressing the needs of diverse groups and problems. This integration of theory and practice is a key approach to deepening professional expertise. For social workers already employed in agencies, participation in external training courses, seminars, or academic conferences is essential. Engaging with peers and other social work professionals helps them stay informed about the latest advancements and practical innovations in the field. These interactions not only elevate their professional skills but also foster the sharing of experiences and resources, driving the overall development of the social work profession. Furthermore, social workers must undertake practice-based research, systematically observing and analyzing issues and experiences encountered in their work. This approach allows for a deeper understanding of the principles and patterns underlying social work. The author believes that only through the continuous enhancement of professional competencies and the rich accumulation of practical experiences can social workers provide better services to their clients, particularly to special groups like elderly individuals with disabilities.

5.2 Promoting the Integration of Community Elder Care Resources

The inherent scarcity of resources in social work necessitates the integration of existing community elder care resources when addressing the needs of elderly individuals with disabilities. Social workers and supporting staff should assess and plan for community elder care needs. By conducting surveys and research, they can identify the care needs of elderly individuals with disabilities and evaluate the current resource landscape, thereby determining priorities and directions for resource integration. Social workers play a “bridging” role by coordinating community elder care resources. They can connect various providers, organizers, and relevant institutions to establish a resource network, aiming to deliver more comprehensive and diverse elder care services. Building platforms for resource sharing and collaboration is foundational to the provision of such services. While conflicts of interest among community departments and institutions are inevitable, they are not insurmountable. Social workers can build trust with various entities, understand their interests, and mediate relationships to align objectives. For example, they can invite representatives from different institutions to participate in the establishment of resource-sharing and collaboration platforms, collectively discussing and deciding on operational mechanisms. Additionally, social workers can use successful case studies from other community elder care platforms to guide public opinion and reduce conflicts of interest, thereby fostering cooperation among institutions. By working with the government to propose policy recommendations—such as tax reductions, financial subsidies, and other supportive measures—social workers can encourage the integration of community elder care resources. These efforts can expand service channels for elderly individuals with disabilities, ultimately improving the quality and efficiency of care services.

5.3 Emphasizing the Integration of Multiple Working Methods

In terms of work methods and areas, social work encompasses individual casework, group work, and community work, alongside specialized fields such as gerontological social work, family social work, and community social work. Each method and area has its distinct focus, but their comprehensive integration may be one effective approach to providing care services for elderly individuals with disabilities. First, social workers can utilize casework methods to conduct individualized interviews and consultations with elderly individuals with disabilities within the community. By assessing their physical health, specific needs, and issues through these interactions, social workers can develop personalized care plans, provide psychological support, and help them address emotional challenges such as loneliness, depression, and anxiety. This approach also aids in overcoming difficulties and challenges in daily life. Second, family care remains the primary mode of care for elderly individuals with disabilities. However, limitations in family members’ caregiving time and methods often exist, and the long-term caregiving process can lead to emotional or psychological strain on family members. In such cases, the intervention of social workers is crucial. By providing caregiving guidance and training, social workers can equip family members with essential caregiving skills and knowledge, enhancing care quality and outcomes. Additionally, social workers can offer family support to help members manage emotional and relational issues, coordinate caregiving responsibilities, and address conflicts or challenges within the family. Finally, supplementing family care with community-based care is not only an optimal caregiving strategy but also a fundamental right of elderly individuals with disabilities, who deserve to receive care within their everyday community settings. Social workers must integrate and manage community care resources, particularly medical services, which are a critical component of care services and an essential condition for promoting the integration of medical and elder care services. By employing diverse working methods, a caregiving model can be established that prioritizes family care while supplementing it with individual casework and community care. This integrated approach ensures more efficient and effective care for elderly individuals with disabilities.

5.4 Creating a Community-Friendly Care Environment for Elderly Individuals with Disabilities

A supportive community environment for elderly individuals with disabilities can not only enhance their quality of life but also improve their overall sense of happiness. Social workers can first utilize group work methods to organize collaborative activities involving elderly individuals with disabilities and other community residents. Examples include community rehabilitation training classes, mutual aid groups for elderly individuals with disabilities, and community volunteer services. These activities help foster emotional connections among community members and create a warm and friendly community atmosphere for elderly individuals with disabilities. Second, social workers can advocate and organize community residents to participate in community governance and planning. This includes implementing age-friendly modifications to certain community facilities to improve the physical environment’s friendliness and suitability for elderly individuals. Such efforts promote the establishment of a supportive community care environment, increase community residents’ awareness and support for elderly individuals with disabilities, and enhance the community’s overall inclusiveness. Lastly, social workers can conduct community education and awareness campaigns centered on community care for elderly individuals with disabilities. Activities such as health seminars and family rehabilitation training sessions can raise community residents’ caregiving awareness and skills while also increasing their attention to and support for elderly individuals with disabilities. Additionally, through advocacy efforts, social workers can call on community residents to recognize the rights and needs of elderly individuals with disabilities, fostering a heightened sense of social responsibility and collective action. Together, these efforts contribute to creating a community-friendly care environment, transforming the community into a warm and welcoming home where elderly individuals with disabilities can enjoy their later years in comfort.

6 Conclusion

At present, the number of elderly individuals with disabilities in China is steadily increasing, accompanied by a growing demand for care services. As a helping profession, social work can fully demonstrate its professional value in the field of care services for elderly individuals with disabilities. By analyzing and summarizing the strengths and weaknesses of various care models, social workers can apply professional methods and approaches to integrate and coordinate existing community resources. This involves making full use of community advantages and resources while encouraging broader participation from community residents to create a more inclusive, age-friendly community environment. Gradually, a community care model for elderly individuals with disabilities can be established, one that is based on family care, supplemented and supported by individualized case services and community care. This model aims to provide higher-quality and more efficient care services, addressing the daily living needs of elderly individuals with disabilities in their later years. It ensures that every elderly individual with disabilities can feel respected and cared for within the community, thereby meeting the developmental goals of ensuring care, support, joy, and comfort for the elderly. As stated, “Let all elderly people enjoy a happy and fulfilling later life” [14].