Abstract
INTRODUCTION: Dependent older persons with limitations in activities of daily living (ADL) often experience reduced functioning and require ongoing support from family caregivers and community-based care systems. PURPOSE: This study aimed to explore the experiences, challenges, and care needs of family caregivers providing care for dependent older persons in urban communities. METHODS: A qualitative descriptive design was employed. Twenty-five family caregivers residing in Bangkok, Thailand, were purposively recruited. Participants were family members who had provided primary care for a dependent older person for at least six months and were able to communicate in Thai. Data were collected through in-depth, semi-structured interviews guided by Donabedian's model of healthcare quality. Each interview lasted approximately one hour, and the interview guide was validated by three experts (content validity index = 0.97). Data were analyzed using conventional content analysis. RESULTS: Family caregivers reported six significant challenges: limited caregiving knowledge and skills, time constraints, caregiving isolation, declining personal health, financial burden, and difficulties managing the older person's emotional and behavioral problems. Eight key needs emerged: access to reliable health information, online health services, transportation assistance, home healthcare, financial and psychosocial support, home environment modification, and recognition from healthcare authorities. Guided by Donabedian's framework, findings were categorized into inputs (caregiver and system attributes), processes (caregiving activities), and outcomes (quality and continuity of care supported by digital technologies). CONCLUSION: Family caregivers of dependent older persons in urban settings face complex, interrelated challenges that affect their well-being. Strengthening integrated community and health support systems, together with evidence-based caregiver empowerment programs, is essential for promoting sustainable, high-quality long-term care.