Time Banking for Active and Mutual Support Ageing: Mechanisms, Digital Transformation, and Policy Pathways for Sustainable Community-Based Chronic Care

Abstract

Context: Population ageing and multimorbidity have increased the demand for sustainable, community-based chronic care models. Conventional models remain heavily dependent on the professional workforce and family caregiving, while many older adults experience loneliness, functional vulnerability, and unmet supportive care needs. Time banking, a reciprocal exchange system in which service hours are converted into time credits, has emerged as a social innovation that may complement formal chronic care by mobilizing community assets and recognizing non-market care work. Evidence Acquisition: This structured narrative review synthesizes evidence on time banking for active and mutual support ageing, with an emphasis on mechanisms, digital transformation, and policy pathways for sustainable community-based chronic care. A targeted narrative search was conducted across PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, SpringerLink, Frontiers, Oxford Academic, and PLOS ONE, supplemented by uploaded full-text sources, reference-list screening, and recent web searches. The final search update was completed on 14 May 2026. Search terms included time banking, time bank, time credit, older adults, active ageing, long-term care, chronic care, community care, digital platform, and policy. The search identified 210 records and sources, of which 36 were retained for synthesis. Evidence was coded using a mixed deductive–inductive thematic approach. Results: Evidence suggests that time banking may indirectly support chronic care through reciprocity, recognition, empowerment, trust, belonging, and community resource mobilization. Direct evidence on time banking indicates increased volunteering and indirect quality-of-life benefits mediated by volunteering-related self-efficacy. Indirect evidence from volunteering, social support, and community participation suggests potential psychosocial relevance for chronic care; however, chronic disease-specific outcomes remain insufficiently tested. Conclusions: Time banking should not be conceptualized as a substitute for professional chronic care. Rather, it is best understood as a complementary, community-based supportive-care infrastructure that may address the social, functional, and relational dimensions of chronic illness in later life. Integrated time-banking models in primary care, nursing, and long-term care require prospective evaluation.