‘It Should Be All Hands on Deck’: A Qualitative Exploration of Shared Experiences and Needs of Older Adults, Family Carers, and Health Professionals in Disability Management in China

BACKGROUND: Population ageing has increased the demand for disability care services in China. Disability in older adults is associated with adverse health outcomes and therefore requires a collaborative approach involving hospitals, communities and families. However, the collaborative experiences and needs of key stakeholders-older adults, family carers and health professionals-remain underexplored from a multifaceted approach, hindering the development of integrated care systems. OBJECTIVE: To explore the experiences, perceived challenges and collaborative needs of older adults, family carers and health professionals about disability management in China. METHODS: We conducted a descriptive qualitative study using semistructured, in-depth interviews. A total of 44 participants (17 older adults, 11 family carers and 16 health professionals) were recruited from hospitals and communities. Data were analysed using an inductive thematic framework approach guided by Bronfenbrenner's ecological systems theory. RESULTS: Key themes were identified across four ecological levels: (1) microsystem: insufficient awareness and excessive burden; (2) mesosystem: cross-agency care coordination and interprofessional integration; (3) exosystem: policies and allocation of social resources; and (4) macrosystem: the dual influence of filial piety culture. CONCLUSION: Disability management for older adults in China is a complex, multilevel challenge anchored not only in resource deficits but also in a shared disability literacy deficit and culturally reinforced care dependencies. Filial piety emerged as a dual force that sustains family care while masking care needs and straining carers. Realising integrated care requires a shift from fragmented, reactive services to an interdependent, function-oriented continuum, with specialist nurses acting as pivotal coordinators across hospital, community and home. Future interventions and policy should prioritise multilevel frameworks that embed routine functional assessment and targeted caregiver capacity-building to support sustainable healthy ageing.