Developing a screening-guided volunteer-supported in-home respite services model: a modified online Delphi study

Global population ageing is intensifying the demand for sustainable, person-centered care models that enable older adults to age in place. In-home respite services, particularly those supported by volunteers, offer critical support for family caregivers, especially those caring for homebound older adults. Successful implementation requires stakeholder-informed co-design. This study aimed to establish expert consensus on a screening-guided, volunteer-supported in-home respite service model.

We conducted a modified online Delphi study to co-design the service model. A panel of 17 experts, including international researchers and Hong Kong-based NGO practitioners, participated in two Delphi rounds. Participants rated the model across four domains (appropriateness, completeness, clarity, and applicability) using 9-point Likert scale, with consensus defined as ≥ 75% of ratings ≥ 7. Qualitative feedback was analyzed using thematical analysis.

The final model incorporates a structured 4-level risk triage and needs assessment process to guide volunteer matching and services provision within a collaborative framework. Moderate overall consensus was achieved after two Delphi rounds, with strong endorsement for the model's clarity and appropriateness. However, significant divergence emerged among stakeholder subgroups, reflecting tensions between methodological rigor and practical feasibility. The model was perceived as feasible and acceptable for supporting family caregivers. The co-design process underscored the importance of stakeholder engagement in tailoring services to local community needs.

This study presents a co-designed, risk-triaged, volunteer-supported in-home respite service model that aligns with ageing in place policies and addresses growing caregiver support needs in ageing societies. By integrating international research perspectives and local practice-based expertise, and by transparently documenting consensus and divergence, this work offers actionable insights for developing, adapting, and scaling respite care services internationally. Future research should evaluate the model's generalizability, long-term outcomes, and sustainability across diverse populations and settings.