The study was led by Paicheng Liu of Guangdong Medical University, together with Zili Xu of Zhejiang University’s School of Public Health, Yunying Zhu and Sisi Li of Zhejiang University School of Medicine, and colleagues. Drawing on data from 608 adults aged 60 and above in Qiantang District, Zhejiang Province, the team set out to test a deceptively simple hypothesis: that older people with higher well-being are more likely to engage with community- and home-based care, or CHBC, a service model that China has championed as a middle path between traditional family caregiving and institutional care.

What makes the study distinctive is its dual conception of well-being, rooted in decades of psychological theory. Hedonic well-being refers to pleasure, positive emotion, and life satisfaction—the classical philosophical pursuit of happiness—while eudaimonic well-being captures purpose, meaning, psychological functioning, and social contribution, tracing back to Aristotle’s notion of the good life. The researchers measured both dimensions using the Mental Health Continuum-Short Form, a validated instrument developed by Corey Keyes that assesses emotional, social, and psychological well-being along a continuum from languishing to flourishing. Rather than treating well-being as a single undifferentiated feeling, the analysis disentangled these strands and asked which of them actually predict care use.

The methodological design was equally careful. Participants were recruited through stratified random sampling, ensuring the sample reflected the older population of the district. CHBC utilization was measured along two axes: the frequency of service use and the variety of service types consumed, capturing both intensity and breadth of engagement. To analyze the data, the team employed descriptive statistics, linear regression, and—critically—propensity score matching, a statistical technique that helps control for confounding variables by comparing service users and non-users with otherwise similar characteristics. This allowed the authors to estimate the association of well-being with care utilization more rigorously than a naive correlation would permit.

The headline finding was clear: higher overall well-being scores were significantly associated with greater CHBC utilization, with a p-value of .019. When the researchers broke well-being into its components, two dimensions stood out. Emotional well-being, the hedonic component encompassing positive feelings and satisfaction with life, showed an even stronger association with service use (p = .007). Social well-being—encompassing a sense of belonging, social acceptance, and integration into one’s community—was also positively associated with utilization (p = .017). In other words, elders who feel good emotionally and feel connected socially are more likely to take advantage of the care services available to them.

Perhaps the most nuanced finding concerns the moderating role of social context. The associations between well-being dimensions and the use of specific service types differed according to marital status and living arrangements. Among married individuals and those who resided with others, higher well-being was linked to greater service utilization. This pattern suggests that well-being does not operate in a vacuum: its effect on care-seeking appears to be channeled through the social networks that surround an older adult. A spouse or co-residing family member may act as an information conduit, an encourager, or a logistical enabler, amplifying the tendency of a flourishing elder to engage with community services. Conversely, elders who are unmarried or living alone may face barriers that dampen even positive well-being into actual service use.

The implications of this finding ripple outward to a society undergoing one of the fastest demographic transitions in history. Research cited by the authors indicates that China’s population is aging at a faster pace than Japan’s over the coming decades, straining both family-based care traditions and the institutional care system. Confucian norms of filial piety have long made family caregiving the default expectation, yet shrinking family sizes, urban migration, and the rise of empty-nest households have eroded that foundation. CHBC has emerged as the policy response—an approach that delivers medical, personal, and social support while allowing elders to remain in their own homes and communities. Despite its demonstrated benefits, including reduced disability and promotion of aging in place documented in international studies, uptake in China has remained stubbornly low.

By identifying well-being as a significant correlate of utilization, the study reframes the problem. Previous frameworks, such as Andersen’s behavioral model of health services use, emphasized predisposing factors, enabling resources, and need. The new findings add psychological flourishing to that calculus: an elder’s emotional and social state influences whether services are sought even when they exist and are affordable. The mechanistic logic is plausible. Positive emotions broaden an individual’s thought-action repertoires and build personal resources, as psychologist Barbara Fredrickson’s work suggests, while purpose and social integration foster the self-efficacy needed to navigate service systems. Elders languishing emotionally or socially may lack the motivation, energy, or informational pathways to seek help, even when help is available.

The policy prescription that follows is both simple and profound. Rather than focusing solely on expanding service supply or lowering costs, the authors argue that policymakers should target older adults with low well-being and limited social networks—precisely the groups least likely to use services and most vulnerable to care gaps. Practical interventions could include integrating well-being screening into community health assessments, pairing isolated elders with peer navigators, and designing outreach programs that leverage spouse and co-resident networks to normalize and facilitate service uptake. In doing so, China’s care system would treat emotional and social flourishing not as a luxury for later, but as a precondition for the success of the entire care model.

The research also carries a caution about equity. If flourishing elders use services while languishing ones do not, existing disparities in care access could widen: those most in need may be the least likely to receive help. The study’s finding that the well-being effect operates differently across marital status and living arrangements offers a map of where such disparities concentrate. As aging societies worldwide grapple with sustainable long-term care, the Chinese evidence adds a new dimension to the global conversation: the psychology of happiness and meaning may be as consequential for elder care as economics or infrastructure. In the contest between hedonism and eudemonism, the victor appears to be older adults themselves—provided societies recognize that well-being is not the reward of good care, but, in part, the road to it.

Subject of Research: The role of hedonic and eudaimonic well-being in community- and home-based care utilization among older adults in China

Article Title: Hedonism and eudemonism: the role of well-being in community- and home-based care utilization among older adults in China

Article References: Liu, P., Xu, Z., Zhu, Y., & Li, S. (2026). Hedonism and eudemonism: the role of well-being in community- and home-based care utilization among older adults in China. Current Psychology, 45(17), Article 1483. https://doi.org/10.1007/s12144-026-10037-4

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10037-4

Keywords: well-being, hedonism, eudaimonism, community-based care, home-based care, older adults, China, aging, social networks, care utilization, emotional well-being, Current Psychology

The research, led by Tiro Theodore Monamo together with Mpho Keetile and Gobopamang Letamo of the Department of Statistics, Demography and Population Studies at the University of Botswana, used in-depth, semi-structured interviews with 18 older adults aged 65 and above who live with various forms of disability. Participants were recruited through health service networks in the Serowe/Palapye District, a setting that combines urban infrastructure with deeply rural and underserved communities. The team analysed the transcripts thematically with ATLAS.ti software, anchoring the analysis in Smith’s Interpretative Phenomenological Analysis, a method designed to capture the depth of individual lived experience while still identifying patterns shared across narratives.

Two broader theoretical lenses shaped the interpretation. The social model of disability reframes disability not simply as a bodily limitation but as the product of barriers erected by society, from inaccessible buildings to discriminatory attitudes. A life-course perspective, meanwhile, allowed the researchers to trace how personal, social and structural factors accumulate and interact over decades, shaping how a person arrives at old age and how they experience disability within it. Together, these frameworks pushed the study beyond a catalogue of impairments toward an account of how disability is made, endured and negotiated across a lifetime.

What emerged from the interviews is a picture of compounding disadvantage. Participants described declining health and memory loss, but they placed equal or greater weight on social exclusion, inadequate access to healthcare and economic marginalisation. For many, the loss of income-earning capacity in old age collided with the costs of transport, medication and daily necessities, while distance to clinics and the quality of services added further friction. Social isolation compounded these pressures: reduced mobility and shifting family structures left some older adults cut off from the community networks that had once sustained them. The findings suggest that disability in later life cannot be understood as a purely medical phenomenon; it is woven into systems of care, economy and belonging.

Yet the study refuses a narrative of pure deprivation. Alongside the hardships, participants reported genuinely positive dimensions of ageing, including emotional growth, spiritual acceptance and pride in the contributions they had made across their lives. Many framed their later years through faith and a sense of completion rather than solely through loss. This duality, the authors argue, is essential for anyone hoping to design policy for this population: interventions that treat older adults with disabilities only as recipients of need miss the agency, purpose and meaning that participants themselves identified as central to their lives.

That agency took concrete, culturally grounded forms. Coping strategies reported by participants included engaging in light physical activity, making traditional dietary adjustments, and turning to prayer as a source of strength and structure. Equally important were efforts to remain socially and culturally relevant, finding alternative roles and ways of contributing when physical limitations closed off previous ones. Participants drew on indigenous knowledge to self-manage health conditions, and many articulated a deep sense of purpose that persisted despite disability. These are not trivial details; they represent resources, familial, cultural and personal, that any serious policy framework would need to strengthen rather than bypass.

The study’s conclusions point squarely at structural reform. The authors argue that addressing the needs of older adults with disabilities in Botswana requires policy changes that strengthen community-based care, improve physical and service accessibility, and integrate both ageing and disability into national development plans. At present, they note, existing policies often overlook the complex realities faced by this population, particularly in rural and underserved communities where the intersection of age and disability is most acute. The researchers call for rights-based, contextually grounded approaches to healthy ageing, an orientation that treats older adults with disabilities as rights-holders with agency rather than as passive beneficiaries of charity.

The significance of the work extends beyond Botswana’s borders. Sub-Saharan Africa is ageing faster than many public health systems are prepared for, and research on the intersection of ageing and disability in the region remains thin. By documenting lived experience with methodological rigour, the study contributes to a growing body of literature that can inform regional policy, from the design of community care programmes to the inclusion of disability considerations in healthy-ageing strategies. It also demonstrates the value of phenomenological methods in demographic and population health research, where large surveys often flatten the textures of experience that determine whether policies actually work on the ground.

The research was conducted with extensive ethical safeguards. It received clearance from the University of Botswana Institutional Review Board and regulatory approval from the Ministry of Local Government and Traditional Affairs, with additional approval from the Serowe District Health Management Team and Palapye Primary Hospital management. Written informed consent was obtained from all participants, who were informed of their right to withdraw at any stage, and all quotations were anonymised to protect identities. The study received no external funding, and the authors declare no competing interests. The article is published open access under a Creative Commons licence, making the full findings available to researchers, policymakers and communities across the region.

For Botswana, the message of the study is ultimately one of both warning and opportunity. The warning is that systemic, cultural and economic barriers, not just functional decline, shape disability in later life, and that ignoring them will deepen inequality as the population ages. The opportunity lies in the resilience the researchers documented: older adults are already managing their health, sustaining their communities and finding meaning despite constrained circumstances. Policy that builds on those existing strengths, while dismantling the barriers that exhaust them, could transform what it means to grow old with a disability in Botswana, and offer a model for the wider region.

Subject of Research: Lived experiences of ageing and disability among older adults in Botswana

Article Title: Lived experiences of ageing and disability among older adults in Botswana

Article References: Monamo, T. T., Keetile, M., & Letamo, G. (2026). Lived experiences of ageing and disability among older adults in Botswana. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00478-4

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00478-4

Keywords: ageing, disability, Botswana, older adults, lived experiences, qualitative research, interpretative phenomenological analysis, social model of disability, life-course perspective, sub-Saharan Africa, healthy ageing, community-based care