Beyond Family Care: How Home- and Community-Based Services Complement Family Care to Reduce Unmet Care Needs and Enhance the Well-Being Among Older Adults With Disabilities

Home- and community-based services (HCBS) complement informal family care and support healthy aging. While HCBS benefits are well documented, how informal family care moderates the association between HCBS and the subjective well-being (SWB) of older adults with disabilities and mediation mechanisms remain underexplored. Using 2018 China Health and Retirement Longitudinal Survey data ( n = 1,812), we find that HCBS utilization is positively associated with SWB (measured by life satisfaction), with unmet care needs–reflecting person-environment incongruence–serving as a mediator. Informal family care moderates the HCBS–SWB association. The positive HCBS–SWB association is stronger among older adults with disabilities who were childless, lived alone, and had fewer family caregivers, primarily due to a greater mediation effect of unmet care needs. These findings highlight the importance of considering the structure and capacity of family care when promoting HCBS, ensuring HCBS more effectively complements family support and addresses older adults’ needs.