Social needs in home care for older adults: A qualitative exploration of recognition, expectations and opportunities

Social engagement is vital for older adults living at home, yet cognitive decline and reduced mobility often limit support. As "aging in place" expands home care's remit, it remains unclear to what extent healthcare services address social needs alongside medical and functional needs.

To explore how older adults, their families, home care staff, and care administrators perceive and address older adults' social needs.

Two qualitative studies from Central and Eastern Norway were combined and analysed using thematic analysis. Participants included eight older adults, 13 relatives, 15 home care nurses, and 17 care administrators.

The participants had differing views on social needs. Older adults valued companionship with home care staff, highlighting trust, kindness, and meaningful conversation. These "small acts of kindness" were central to their experience of care. Relatives largely shared this perspective. Home care nurses were uncertain whether meeting social needs fell within their responsibilities yet regarded social interaction as important for understanding the older person's resources and challenges in terms of care. In contrast, care administrators saw social needs as a shared responsibility-primarily for families, neighbours, and volunteers-and emphasised structured activities in community centres.

Social needs should be viewed as part of relational care, embedded in daily interactions-not as separate, resource-heavy tasks. When care time constraints become too rigid, essential social interactions often go unrecognised and undervalued in service allocations. The small acts of kindness prove to be far from insignificant, emerging instead as necessities in both social support and tailored care provision.