Session 5

Aging, Eldercare, and Digital Inclusion for Older Adults

P37  Social Isolation and Loneliness in Older Adults: A Review of Influencing Factors and Effective Interventions

*Xiaoxuan Yao¹, Ying Wang¹

¹School of Philosophy and Sociology, Lanzhou University, Lanzhou, China

Abstract

Background and Purpose: As global aging accelerates, older adults' social isolation and loneliness have become a pressing public health crisis. This review clarifies the distinction and asynchrony between objective isolation and subjective loneliness, identifies cumulative risk and protective factors across the socio-ecological life-course, and evaluates intervention efficacy and mechanisms. Core questions addressed: What constitutes late-life loneliness? What causes it? And how can it be mitigated? Specifically, we aim to differentiate isolation from loneliness, map their determinants within a life-course framework, and critically assess outcomes of interventions targeting social structure versus internal cognition.

Methods: A narrative synthesis examined literature from gerontology, psychology, public health, and social work, including longitudinal studies, randomized trials, and meta-analyses. Analysis employed a socio-ecological model (individual to societal levels) and a life-course perspective to capture cumulative disadvantage. Three intervention categories were evaluated: group-based psychosocial therapies, digital technology integration, and social-cognitive retraining. The goal was to synthesize evidence on risk factor predictive strength and comparative intervention effectiveness.

Results: Three key findings emerged. First, there is marked asynchrony: roughly 80% of older adults living alone report no significant loneliness, confirming isolation as an objective risk factor while loneliness remains a subjective perceptual state. Second, loneliness etiology is multifactorial and cumulative, driven by aggregated biological, psychological, and social decline. Poor mental health, diminished quality of life, and adverse childhood experiences are robust predictors, often outweighing current social network metrics. Third, intervention efficacy varies. Group-based therapies yield the strongest effects by fostering connection and shared meaning. Digital tools offer connectivity but pose a "technological paradox," risking exclusion without digital literacy support. Social-cognitive interventions address the psychological root by reshaping maladaptive perceptions.

Conclusions and Implications: Loneliness and isolation constitute a multidimensional challenge resisting simplistic solutions. Effective practice requires a tripartite strategy: promoting social engagement, imparting skills, and transforming maladaptive cognitions, balancing technological enablement with humanistic care. Future social work should move toward precision and integration, tailoring interventions based on deficits in objective networks, subjective appraisals, or behavioral competencies. Given the strong influence of early adversity, a life-course continuum of psychological support is essential. Alleviating late-life loneliness begins with safeguarding mental well-being across the entire lifespan.

P38  Patterns of Community Service Needs Among Family Caregivers of Older Adults in Hong Kong

*Xuhong Li¹, Vera Mun Yu Tang¹, Wenyi Lin¹, Vivian Weiqun Lou¹,²

¹Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong, China; ²Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China

Abstract

Background and Purpose: Providing care for older adults can be a stressful experience. Community-based services help reduce the burden on family caregivers and enhance the well-being of care recipients. However, few studies have investigated the heterogeneity of community service needs among family caregivers. This study aims to identify distinct groups of community service needs and to examine the association between these groups and associated factors.

Method: A total of 2,357 family caregivers from the Jockey Club Carer Space Project (JCCSP) were included in the final analysis. Latent class analysis (LCA) was conducted to identify homogeneous groups of community service needs. Multinomial logistic regression was used to investigate the related factors on different groups.

Results: Four latent classes were identified: Comprehensive Service Seekers (Class 1, 12.1%), Light Service Seekers (Class 2, 36.3%), Day Care and Community Resource Information Seekers (Class 3, 12.3%) and Community Resource Information and Social Activity Seekers (Class 4, 39.3%). The results of multiple logistic regression suggested that younger and higher socioeconomic status (SES) family caregivers were more inclined to be comprehensive support seekers.

Conclusion and Implication: This study provides valuable insights into community care within the caregiving context. The findings emphasize the significance of understanding multiple service needs among caregivers and underscore the importance for developing targeted interventions tailored different caregiver groups.

P39  Frontline healthcare providers’ perspectives on strengthening dementia care in rural China

Dexia Kong¹, *Lingshuang Jiang²

¹Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China; ²Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong, China

Abstract

Background and Purpose: Dementia has become a major public health challenge in China, accounting for nearly 30% of the global dementia population. Rural areas bear a particularly heavy burden due to limited healthcare resources, service infrastructure, and public awareness. In these settings, care is often delivered under constrained conditions, and less is known about how frontline healthcare personnel sustain dementia care in practice. This study examines the experiences of healthcare personnel in rural Sichuan, focusing on key challenges, adaptive strategies, and implications for service development.

Method: This qualitative study is based on focus group discussions with 30 healthcare professionals working across village-, township-, and district-level institutions in rural Sichuan. Participants were purposively sampled to capture variation in professional roles, institutional contexts, and levels of clinical experience. Data were collected through semi-structured focus group discussions and analyzed using thematic analysis. An iterative coding process was employed, combining inductive theme development with constant comparison to identify shared patterns and contextual variations in participants’ accounts.

Results: Findings reveal a persistent gap between care demands and available resources in rural dementia care. Frontline professionals face chronic shortages in staffing, infrastructure, and specialized training. These challenges are compounded by communication difficulties with people living with dementia and by mismatched family expectations regarding disease progression. Despite these constraints, healthcare professionals sustain care through pragmatic, experience-based strategies. These include maintaining ongoing communication with families, recalibrating expectations over time, and flexibly adapting care practices to patients’ evolving conditions and behavioral symptoms. The findings also highlight the far-reaching impact of dementia on families, including ongoing emotional and physical exhaustion, disrupted employment, and increasing financial strain. Barriers to early diagnosis remain pronounced due to limited awareness, economic hardship, restricted access to services, and persistent stigma, which delay timely intervention.

Conclusion and Implication: This study highlights the central role of frontline healthcare professionals in delivering dementia care in rural China, where care must be continuously adapted to meet changing needs under resource-constrained conditions. Strengthening dementia care therefore requires targeted support for both healthcare providers and families. For frontline professionals, this involves enhanced training and adequate resources to support care delivery. For families, who carry substantial caregiving responsibilities, priorities include improving access to long-term care, expanding coverage for dementia-related treatment, developing accessible community-based services, and promoting earlier recognition of dementia alongside more timely engagement with care. Future research should examine how care needs evolve over the course of dementia and how both healthcare providers and families adapt to these changes, in order to better understand how care can be sustained over time.

P40  Situation Matching Degree of Evidence Application of Social Prescription Intervention in Elderly Loneliness: A Multidimensional Integration Framework

*Yuanli Wang¹, Ying Wang¹

¹School of Philosophy and Sociology, Lanzhou University, Lanzhou, China

 Abstract

Elderly loneliness has become a public health problem that affects the physical and mental health of the elderly all over the world. As a non-medical intervention model linking community resources to improve health and well-being, social prescription shows great potential in coping with the global elderly loneliness crisis. The study found that its effectiveness and sustainability are highly dependent on the deep matching with specific application situations. Based on systematic literature review and integrated analysis, this paper aims to explore the effectiveness of social prescription in intervening elderly loneliness, and deeply analyze the conditions and specific scenarios in which it plays its role. On this basis, a comprehensive analysis framework of evidence application situation matching degree is constructed from four dimensions: cultural situation, resource situation, institutional situation and other situational factors. It is found that the successful implementation of social prescription depends not only on the effectiveness of the intervention program itself, but also on its fit with local cultural values, the use of existing resource systems, the ability to embed policies and service systems, and the adaptability to the community support network and technical environment. This paper systematically summarizes the limitations of the research content, methods and theoretical perspectives in this field, and based on the existing evidence, discusses the necessity, feasibility and importance of carrying out relevant research in China in the future, aiming at providing theoretical guidance and practical path for promoting the accurate and systematic development of social prescriptions in localization practice.

P41  Digital Empathy Empowering Gerontological Social Work: Predicaments of Older Adults’ Digital Inclusion and AI-Driven Empathic Intervention Pathways

*Shuo Tang¹

¹School of Philosophy and Sociology, Lanzhou University, Lanzhou, China

Abstract

Background and Purpose: Rapid AI and digital transformation has widened the digital divide among older adults in the Asia-Pacific region, leading to social exclusion, digital anxiety, and post-fraud psychological distress. Traditional gerontological social work overemphasizes technical training while lacking human-centered emotional understanding, often resulting in pity-based rather than empathic support. This study aims to clarify older adults’ digital inclusion dilemmas, explore how digital empathy (cognitive and affective) empowers gerontological social work, and construct ethical, AI-enhanced intervention pathways that fit local cultural contexts.

Method: A mixed-methods design is adopted, targeting community-dwelling older adults and frontline gerontological social workers in Asia-Pacific urban communities. Purposive and snowball sampling are used. Data are collected via semi-structured interviews, field observations, and focus group discussions. Thematic analysis is applied to identify barriers and needs; a deductive framework is used to build a digital empathy model integrated with age-appropriate AI tools (e.g., therapeutic digital humans, simplified voice interfaces).

Results: Four core barriers are identified: high technical thresholds, intergenerational cognitive gaps, procedural coldness in digital services, and security anxiety. Digital empathy significantly enhances social workers’ ability to grasp older adults’ life narratives and emotional experiences. The AI-supported cognitive–affective–behavioral intervention framework improves older adults’ digital participation, reduces anxiety, and strengthens trust. Ethical AI use preserves dignity and avoids over-technicalization or reverse empathy.

Conclusion and Implication: Digital empathy embedded with AI advances people-centered, culturally responsive gerontological social work. It balances efficiency and ethics, technology and humanity. For practice: social workers should integrate digital empathy and AI tools into person-centered services. For education: curricula should strengthen digital empathy literacy and ethical AI application. For policy: support age-friendly digital design and equitable digital access in the Asia-Pacific. This study contributes to humanistic AI social work and inclusive development for API communities.

P42  Cultural Dimensions of Gambling: Perspectives from Older Chinese Immigrants in New York City

*Jieru Bai¹, Wooksoo Kim²

¹School of Social Work, California State University Los Angeles, Los Angeles, USA; ²School of Social Work, University at Buffalo, New York, USA

Abstract

Background and Purpose: The prevalence of problem gambling among older adults aged 55 and older ranges from 0.3% to 10.4% in the United States. Casinos are a preferred venue and casino marketing strategies often specifically target older adults, such as senior discounts, which encourage gambling among older adults. Problem gambling are more prevalent among racial and ethnic minorities, particularly among Chinese immigrants. The purpose of this study is to explore the beliefs and experiences with casino gambling among older Chinese immigrants through a cultural lens.

Methods: A total of 25 older Chinese immigrants (11 men and 14 women) were recruited through a senior center in New York City’s Chinatown. The inclusion criteria were Chinese immigrants who were 65 years or older, were able to interview in Mandarin or Cantonese, had any gambling experiences, and had no known cognitive disabilities. We used a semi-structured interview schedule. The interviews were transcribed verbatim and analyzed using a thematic analysis in English and Chinese.

Results: The mean age of the participants was 72. On average, participants had lived in the U.S. for 35 years. Regarding casino gambling, participants fell into three distinct groups. The first group consisted of four participants who had never visited a casino, reasons including religious belief and disliking the physical environment. The second group consisted of seven participants, who occasionally visited casinos for special occasions or simply to socialize with family and friends. But they barely gamble even when inside the casino. The third group comprised 14 participants who reported visiting casinos on a regular basis, with frequencies ranging from 1-2 times per week to 1-2 times per month. Four major themes emerged, including social connection (Qin Peng Hao You), self-control (Zi Wo Kong Zhi), breakdown of family (Qi Li Zi San), and dishonesty and misfortune (Chang Du Bi Shu). Many participants continued to gamble in casinos and enjoy it with family and friends. They viewed casino visits primarily as opportunities for outings, entertainment, and socializing, rather than for gambling itself. Self-control was considered as the dividing line between problem gambling and recreational gambling. Participants employed various strategies to exercise self-control while gambling in casinos, such as setting a predetermined budget beforehand and using only cash instead of credit cards. Despite the many negative consequences of gambling, the breakdown of a family appeared to be the primary concern. Many participants used the term “Qi Li Zi San” to convey that individuals addicted to gambling often fail to take care of their families, eventually leading family members to leave them. Participants used many Chinese proverbs to express negative views about gambling. Gambling is seen as deceptive and dishonest and gamblers are often perceived as untrustworthy.

Conclusions and Implications: The findings highlight the importance of culturally sensitive interventions that help them navigate these culturally acceptable activities safely while mitigating the risk of developing a gambling problem. Interventions should shift focus from individuals’ willpower to the broader environment and community that contribute to gambling behaviors, emphasizing family and community-based support and education.

P43  "Research on the Practical Dilemmas and Demand Adaptation of Urban Community Gerontological Social Work"

*Hao Xu¹

¹School of Philosophy and Social Sciences, Lanzhou University, Lanzhou, China

 Abstract

Background and Purpose: China has entered a deep aging society, with the size of urban empty-nest and solitary elderly groups continuously expanding, and deep-seated elderly care needs such as spiritual consolation and social participation becoming increasingly prominent. At present, community-based gerontological social work services are generally plagued by homogenization and formalization, making it difficult to accurately match the real needs of the elderly. This study aims to explore the practical dilemmas of community gerontological social work, clarify the core causes of supply-demand mismatch, and provide localized evidence for optimizing grassroots elderly social work services.

Methods: This study adopted a qualitative research design. Through purposive sampling, 22 respondents from 4 communities in a provincial capital city were selected, including 12 empty-nest or solitary elderly people aged 60 and above, 8 frontline gerontological social workers, and 2 community elderly care administrators. Data were collected through one-on-one semi-structured in-depth interviews, with the whole process audio-recorded and transcribed verbatim. The three-level coding method of grounded theory was used to analyze the data, and coding management was completed with Nvivo 12. The entire research process strictly complied with research ethics norms including informed consent and anonymization.

Results: The study extracted three core categories: aphasia in demand expression, suspended service supply, and constraints on professional practice. The core needs of the elderly are concentrated on emotional companionship, value realization, and rights protection, while existing services mostly focus on basic recreation and life care, presenting a significant structural mismatch. Social workers’ professional services are constrained by three core factors: squeeze from administrative tasks, insufficient funding guarantee, and the lack of a localized service model.

Conclusions and Implications: This study confirms that the core pain point of community gerontological social work services is the structural supply-demand mismatch, which is rooted in the absence of a professional demand assessment mechanism and insufficient professional autonomy of social workers. The findings provide practical reference for frontline social workers to carry out targeted elderly services, offer empirical basis for grassroots authorities to improve elderly care support policies, and enrich the qualitative research achievements of localized gerontological social work in China.

P44  The Effectiveness of Interventions in Reducing Stigma towards Individuals with Dementia: A Meta-analysis

Yiqi Wangliu¹, *Yu Xia², Yingyuan Liang³, Hanze Liu⁴, Chenxi Liao⁵, Xuhong Li6

¹Dept. of Social Work, Yunnan University, Kunming, China; ²Dept. of Social Work, The Chinese University of Hong Kong, Hong Kong, China; ³Dept. of Social Work, The Chinese University of Hong Kong, Hong Kong, China; ⁴Dept. of Social Work, Yunnan University,  Kunming, China; ⁵Dept. of Social Work, Yunnan University, Kunming, China; 6Sau Po Centre on Aging, The University of Hong Kong, Hong Kong, China

Abstract

Background and Purpose: Dementia is a leading global cause of disability and dependence among older adults. Stigma surrounding dementia is widely recognized as an important barrier to professional help‑seeking and treatment. This study aims to synthesize evidence from randomized controlled trials (RCTs) evaluating interventions designed to reduce public stigma toward people living with dementia.

Method: Following Cochrane and PRISMA guidelines, a systematic search was conducted across PubMed, PsycINFO, Scopus, CINAHL Plus, and Embase for studies published between 2000 and 2025. Additional manual searches were carried out using Google Scholar and reference lists of relevant publications. A random‑effects meta‑analysis was performed, and risk of bias was assessed using the RoB 2 tool.

Results: Of the studies reviewed, four studies provided sufficient data that could be incorporated into a quantitative analysis. All interventions targeted dementia-related attitudes, with one integrating knowledge enhancement and another incorporating behavioral outcome measures. Overall, interventions aimed at changing attitudes did not yield a statistically significant effect (Hedges’ g = 0.47, 95% confidence interval [−0.283, 0.225]), while evidence remains notably sparse from formal or informal caregiver and community service provider perspectives, and significant regional disparities persist. High heterogeneity was observed in attitude outcomes (I² = 94.02%), and Egger’s regression test revealed a non-significant intercept (17.45, p = 0.209), indicating no strong evidence of publication bias.

Conclusion and Implication: Given the substantial burden on caregivers and long‑term care systems, more efforts are needed to enhance the effectiveness of stigma‑reduction strategies and to develop interventions that significantly address both public and internalized stigma associated with dementia. Future research should place greater emphasis on improving knowledge, shifting stigmatizing behaviors, and incorporating the perspectives of caregivers and community frontline service providers.

P45  Satisfaction with Senior Canteen Services and Its Influencing Factors: A Case Study of District K, Pingliang City, Gansu Province

*Hanyu Shi¹,

¹Institute of Social Development, Southwestern University of Finance and Economics, Sichuan, China

Abstract

Background and Purpose: As population aging intensifies globally, strengthening community-based elderly care has emerged as a key policy priority in China. In recent years, senior canteens, as a cornerstone of community elderly care, fulfill overlapping functions in nutritional support, health management, and social participation, with their service quality directly shaping older adults' quality of life. Nevertheless, existing scholarship has concentrated largely on operational models in metropolitan and economically advanced areas, leaving satisfaction determinants among elderly users in smaller cities considerably underexplored.

Method: This study investigates senior canteens in District K, Pingliang City, Gansu Province, situated within the theoretical framework of Age-Friendly Community Theory and the 4C marketing model. A mixed-methods design integrating structured questionnaire surveys and semi-structured in-depth interviews was adopted. A total of 121 valid questionnaires were obtained from five canteen sites, measuring satisfaction across four dimensions: dining environment, food quality, meal pricing, and service delivery. A binary logistic regression model was subsequently employed to identify statistically significant predictors of overall satisfaction.

Results: Three key findings are reported. First, overall satisfaction was relatively high, with meal pricing satisfaction exceeding 88% and service satisfaction reaching 84.3%. Second, individual and household characteristics—including gender, age, and living arrangement—demonstrated no significant association with overall satisfaction. Conversely, food freshness, menu variety, menu renewal frequency, and word-of-mouth recommendation intention emerged as significant positive predictors, with menu renewal frequency yielding the strongest marginal effect, followed by recommendation intention. Third, fieldwork identified persistent structural constraints, including fiscal dependence on government subsidies, inadequate spatial coverage, and poor locational accessibility.

Conclusion and Implication: Accordingly, this study proposes interventions along two dimensions: improving service quality through demand-responsive menu management and stringent ingredient procurement standards; and optimizing facility distribution by prioritizing placement within residents' core activity zones, complemented by digital outreach strategies to diversify the user base and foster a sustainable meal assistance ecosystem. These findings provide empirical grounding for the refinement of elderly meal assistance systems in less-developed regions and carry practical implications for age-friendly community care policy in China.

P46  Mechanism sustaining sedentary behavior among the oldest-old in nursing homes：a social cognitive theory-informed qualitative study

Yutong Wei¹, *Xue Weng²

¹School of Sociology, Beijing Normal University, Beijing, China; ²Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China

Abstract

Background and Purpose: Sedentary behavior, independently of physical activity levels, is a major public health concern strongly associated with various adverse health outcomes, especially among the oldest-old population (≥80 years). This study aims to examine the formation and maintenance mechanisms of sedentary behavior among the oldest-old in nursing homes guided by social cognitive theory, and to provide theoretical evidence for context-sensitive intervention strategies.

Methods: We conducted semi-structured interviews with 15 residents aged 80 years and above in a nursing home in Zhuhai, Guangdong Province. Participants were purposively sampled to capture variation in functional status and daily routines. The interview guide addressed individual physical and psychological characteristics, prior behavioral habits, and institutional environment experiences. In-depth interviews were conducted, audio-recorded, and transcribed verbatim. Directed content analysis was employed, guided by the framework of social cognitive theory, including individual, behavioral, and environmental factors, and themes were identified and refined accordingly.

Results: A model of the formation and maintenance of sedentary behavior among the oldest-old was developed. Influencing factors were identified at three levels: (1) at the individual level, functional decline, persistent discomfort, and reinforced perceptions of aging as irreversible that diminished motivation and self-efficacy to engage in activity; (2) at the behavioral level, long-standing low-activity habits, reinforced by prior risk experiences such as falls or pain, contributed to the normalization of sedentary behavior, with low-intensity activities often substituting for more active movement; and (3) at the environmental level, limited family encouragement, institutional spatial constraints, and restricted social interaction contexts further reinforced sedentary patterns. Sedentary behavior was not merely an isolated individual choice but was formed and sustained through continuous interplay among changes in physical condition, pre-existing behavioral patterns, and institutional living contexts.

Conclusion and Implication: Sedentary behavior among the oldest-old demonstrates strong contextual dependency and process characteristics. Interventions should extend beyond exercise prescriptions or health education and instead focus on restructuring institutional daily routines, enhancing social interaction support, reducing the cost of behavior change, breaking the vicious cycle of sedentary behavior, and embedding physical activity into everyday life contexts to foster healthier aging.

P47  Do Community Elder Care Services Improve Mental Health? Evidence From a Six‑Year Three‑Wave Mediation Model

*Hongyu Wang¹, Yi Tian¹, Lin Lin²

¹Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macau, China; ²Faculty of Business, Macao Polytechnic University, Macau, China

Abstract

Background and Purpose: As China faces rapid population aging and ongoing expansion of community-based eldercare, community eldercare services have become an important channel for supporting older adults’ mental health. However, the behavioral and cognitive mechanisms underlying this relationship remain insufficiently understood. This study examines how community eldercare services influence mental health and develops a model in which social participation and attitudes toward aging operate as sequential mediators, with social networks acting as a contextual moderator.

Methods: Using multiple waves of a national longitudinal survey of older adults in China, the study adopts a time-ordered analytical design to assess the links between community eldercare services, social participation, attitudes toward aging, and mental health. Key demographic characteristics are controlled, and mediation and moderation analyses are applied to identify the primary pathways.

Results: Community eldercare services are significantly associated with better subsequent mental health. Social participation and attitudes toward aging each mediate this association and also form a sequential pathway linking service use to mental health outcomes. In addition, social networks moderate the relationship between community eldercare services and mental health, with stronger networks amplifying this association.

Conclusions and Implication: Community eldercare services can improve mental health by fostering social participation and shaping attitudes toward aging, and their effectiveness is conditioned by the strength of older adults’ social networks. The findings highlight the need to refine community service provision, strengthen participatory and supportive resources, and address the needs of individuals with weaker social networks to promote healthy and active aging.

P48  Digital Companionship in Later Life: Practice Implications from a Self-Determination Theory Perspective

*Yaling Shang¹, Jiyixi Hua¹, Jie Song¹, Xinghua Ren¹, Yunan Wu¹, Changyin Lin¹, Wenqi Huang¹, Zheng Xu¹

¹School of Philosophy and Sociology, Lanzhou University, Lanzhou, China

 Abstract

Background and Purpose: Digital companionship (e.g., conversational agents and interactive devices) is increasingly entering the everyday lives of some older adults and has begun to appear in community care and family support settings. Prior studies have reported insights on emotional support, loneliness-related experiences, and use-related difficulties. However, the evidence is often fragmented, less frequently synthesized within a shared theoretical lens, and seldom translated into practice-relevant considerations for professional decision-making. Guided by Self-Determination Theory (SDT), this paper aims to integrate research on older adults’ experiences with digital companionship through the lens of three basic psychological needs—relatedness, competence, and autonomy—and to derive implications for social work practice across contexts.

Methods: An integrative literature review was conducted to synthesize qualitative, quantitative, mixed-methods, and review studies on older adults’ use of digital companionship. SDT’s basic psychological needs were used as an analytic framework. Findings were thematically mapped and compared to identify how need-supportive and need-thwarting experiences may emerge under differing support conditions and interpersonal contexts.

Results: Across the synthesized literature, digital companionship does not appear to uniformly enhance or undermine older adults’ psychological experiences; rather, its implications are contingent on support conditions and existing social relationships. When opportunities for offline interaction are limited, sustained responsiveness and high accessibility may strengthen feelings of being heard and accompanied. However, if digital interaction gradually substitutes for offline relationships, relatedness experiences may shift, potentially altering existing social ties and introducing risks of dependency. Competence-related experiences are similarly conditional: with appropriate assistance and encouragement, learning and use may foster self-efficacy; where repeated setbacks occur alongside limited support, anxiety and avoidance are more likely. By comparison, autonomy is more closely tied to whether engagement is informed, voluntary, and controllable—such as being able to proceed at one’s own pace and to retain meaningful control over one’s participation.

Conclusions and Implications: For social work practice, introducing and assessing digital companionship should be situated within older adults’ motivations and support networks, with attention to possible changes in offline social relationships. Phased and tailored support may help reduce competence frustration, while ongoing professional communication can safeguard older adults’ agency and dignity. SDT offers a concise interpretive lens that may help practitioners make cautious, context-sensitive judgments in complex and rapidly evolving settings.