Most older adults wish to age in place—living, and ultimately dying, in their own home. However, at some point, some older adults need to move to a residential care facility (RCF), such as a nursing home or an assisted living facility, due to the worsening of their physical and/or cognitive conditions, the loss of family relationships, or the inability of their family members to take care of them. Moving to an RCF is a critical moment in an older adult’s life, as it separates them from significant people and objects in their life, disrupts their habits, and breaks their connection with their local community. These changes can negatively affect the physical, psychological, social, and spiritual well-being of older adults if they fail to create a new home in the novel environment.1 For older adults, feeling a sense of being “at home” is a multifactorial phenomenon influenced by several psychological, social, and built-environmental aspects.2 Health care personnel who provide care in RCFs, and the directors and managers responsible for organization of care and resource allocation, have an important role in fostering the sense of “home” for older adults residing in RCFs, as highlighted by the qualitative systematic review published in this issue of JBI Evidence Synthesis.3 This review synthesized the evidence derived from 7 qualitative studies from Europe and North America that explored the experiences of health care personnel in promoting a sense of home for older adults in RCFs using a meta-aggregative approach, which is the method endorsed by JBI for qualitative synthesis. This approach enables the creation of generalizable statements in the form of recommendations to guide practitioners and policy-makers.4 We learned from this review that physical factors (eg, building structure, design), work organizational features, and care culture of the RCFs, as well as national, regional, and local regulations, can influence the creation of a sense of home in older adults residing in these settings.3 If we want to make older adults feel at home in a care facility, we must create a home-like environment and not a hospital-like environment. This involves offering large, private rooms with en-suite bathrooms for each resident and common areas that resemble domestic spaces, such as private or common kitchens, television lounges, sitting rooms, dining rooms, and accessible outdoor spaces. We should allow older residents to bring furniture or other personal artefacts to foster familiarity with the place and continuity of life. These environmental standards should be included in national and local regulations and guidelines, along with safety standards to guarantee that the creation of a sense of home is assured in all RCFs. Moreover, we should replace a hospital-like work model with a home-like work model, which includes flexible organization of daily activities that respects residents’ autonomy, freedom of choice, and personal habits. Participation in domestic and recreational activities should be promoted according to residents’ preferences to make them feel like active members of the facility community. The maintenance of meaningful, reciprocal relationships between residents and family members, staff, and other residents creates a sense of familiarity and belonging to a larger community. We should embrace a person-centered rather than a patient-centered care model in RCFs. Residents should not be thought of as sick patients requiring medical care and assistance, but as persons with wishes and the potentiality of further growth who want to live a meaningful life, regardless of physical or cognitive impairments. If we want to make older adult residents feel at home in RCFs, we must not only provide a shelter, but we must listen to the experiences of health care personnel and help create an ambience that promotes meaningful relationships, a sense of purpose, and a fulfilling community. This review3 presents the available evidence on the sentiments of health care personnel regarding older people aging in RCFs. Although the level of confidence in the findings was classified as low due to dependability and credibility issues, evidence from this review seemingly reflects many of our own views about getting older and living our best lives, and supports a realistic and empathic way forward.
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Nov 22, 2023
Jorinde L Broekhoven + 8
Open Access
