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For older adults to thrive, caregivers need to navigate health care systems, social systems, government systems, and various communication channels for information. This study examines the resilience of systems supporting older adults in a large urban area, focusing on how community organizations coordinate, collaborate, and maintain relationships across different service sectors. Drawing on the concept of resilience at the system interface (Laskey et.al., 2023), this research aims to identify the gaps and strengths in service delivery for older adults and their caregivers. Caregivers are conceptualized as community staff who are lifelong learners, continually adapting to new challenges and training opportunities. Key research questions include: What kind of service systems collaboration facilitate perceptions of quality services for older adults? How do relationships between system coordinating bodies and partner organizations impact public perception? Finally, what are the determinants of caregiver self-efficacy and self-rated health?
Methods:
This study employed a mixed-methods approach to assess the needs of older adults in a major urban area. Surveys were administered to a representative mailed sample of older adults (55 and above) (n=832), including interviews with homebound seniors (n=30). Additional surveys were collected by service providers (n=64) and registered caregivers (n=44). Eight focus groups (n=33) with targeted older adult populations, including caregivers, were conducted to explore the relational dynamics between community organizations, service providers, and caregivers. Quantitative data were analyzed using descriptive statistics, correlations, Bayesian model averaging, and regression, while qualitative data from open-ended survey questions and focus groups were analyzed thematically to identify key patterns and areas for improvement in system interfaces.
Results:
Preliminary findings suggest that coordination and collaboration between service organizations often lack integration, which results in service gaps for older adults, particularly regarding emergency response, transportation, home repairs, and caregiver support. Partner organizations that collaborate on a public response with older adults report stronger relationships (0.98, p = 0.001). Caregivers who report taking Caregiver care management classes have on average 0.34 increase in self-rated health (p = 0.007) and a 0.26 point increase in self-rated emotional/mental health (p=0.002). Caregivers who live with children, parents, or other adults have higher average self-efficacy, but those living with adult children or have children away at college have lower self-efficacy. The research also highlighted the need for more formalized learning opportunities for caregivers to build resilience in the face of changing needs and expectations.
Conclusions and Implications:
The findings underscore the importance of strengthening coordination and collaboration across service systems to improve the resilience of communities supporting older adults. By viewing caregivers and partner organization as lifelong learners, policies and practices can be better designed to empower caregivers and enhance their ability to respond to the evolving needs of older adults. This study offers practical implications for policy development, emphasizing the role of continuous education and adaptive systems in promoting community resilience.