Unmet Needs and Loneliness Among Older Adults: Parks vs. Long-Term Care Tier C Centers in Taiwan

Abstract Background Taiwan is estimated to become a super aged society; thus, the older adults’ health and welfare has been important nowadays. Meanwhile, loneliness is a crucial mental health problem among older adults. Tier C center is a key policy in Taiwan to delay the progression of disability. Park is a popular site for community-dwelling older adults. The study aims to discuss the relationship among sites, unmet needs and loneliness and identify whether effect modification of unmet needs exist between sites and loneliness. Methods This study combined secondary data analysis and survey methodology. The questionnaire consisted of respondents’ demographic information, regular communication partners, UCLA 3-item loneliness scale Chinese version, and a 1-5 Likert scale of 14 items of unmet needs. The final sample consisted of 377 participants. Multivariate analysis was performed to determine whether the effect modification existed. Results 40% participants were from the park, 60% from tier C center. 30% were male. Mean age was 79.4 in parks and 74.6 in tier C centers, number of diseases was 1.76 (±1.44), loneliness score was 4.96 (±2.6). The values for the two sites were generally consistent with the combined analysis. Loneliness among older adults in the park is lower than those in the tier C center (p = 0.0027/0.0088). Older adults in parks with unmet needs for transportation or communication apps would have higher loneliness levels than those in tier C centers with similar level of unmet needs (with an additional increase of approximately 1.65*** and 1.42** points, respectively). Conclusions The study found unmet needs moderate the relationship between site and loneliness. While older adults in parks report lower loneliness than those in Tier C centers, unmet needs may have a greater impact on them-possibly due to the caregiving support available in Tier C centers. Key messages • Older adults reported lower loneliness in parks than in Tier C centers. • Older adults in parks with unmet needs for transportation or communication apps would have higher loneliness levels than those in tier C centers.