Factors related to complex care needs of older adults in community-based integrated care centers in Japan: A cross-sectional study

Aim This study aimed to identify the factors related to complex care needs of older adults in community-based integrated care centers. Methods We sent 936 self-reported questionnaires to community-based integrated care center directors in the Kinki region of Japan. These questionnaires included questions not only about the directors' demographic data, but also regarding the sociodemographic, psychosocial, and family-related dimensions of the older adults in the community centers. The directors divided their cases into two categories: "Complex cases" and "Straightforward cases." We compared the intergroup differences and examined the factors related to complex care needs in older adults. Results A total of 232 directors responded. Complex cases were significantly associated with younger age, poor health conditions, and having a family member who needs care, as compared to straightforward cases where these associations were not present. Logistic regression showed that in older adults, factors of refusing support or social services, social isolation, and trouble with neighbors were associated with their complexities. Additionally, family members with a high likelihood of refusing social services, older adults without a key family member, and difficulties in forming their consensus regarding care were associated with older adults' complexities. Conclusion Older adults with complex care needs could have the risk of self-neglect, and their families faced difficulties in supporting them as family members. Healthcare professions should carefully assess these factors and develop needs-oriented services for them without their family support as an upstream intervention.