Aging Successfully Despite Limitations? Meanings and Perceptions of Aging Well Among Older Adults Living in Long-Term Care Institutions

TL;DR

Older adults in long-term care facilities define aging well in terms of health, attitude, social connections, security, and activities, often perceiving themselves as aging well despite limitations.

Contribution

This study provides a person-centered understanding of aging well from the perspective of long-term care residents, contrasting with traditional academic definitions.

Findings

Residents defined aging well through five themes: health, attitude, social ties, security, and activities.

Two-thirds of participants perceived themselves as aging well, aligning with their personal definitions.

Negative self-perceptions were linked to poor health, loss of autonomy, or loneliness.

Abstract

Background/Objectives: Dominant models of successful aging emphasize health, autonomy, and active engagement, often excluding older adults belonging to vulnerable groups, such as those living in long-term care facilities (LTCFs). This study aims to address this limitation by exploring how LTCF residents define “aging well” and by examining whether they perceive themselves as aging well according to their own criteria. Methods: A qualitative design was employed using semi-structured interviews with 30 residents aged 67–95 living in three long-term care facilities located in Barcelona, Spain. Interview transcripts were analyzed using inductive thematic analysis. Results: Five core themes emerged in the participants’ definitions of aging well: health, attitude, social ties, security, and activities. Health was the most frequently mentioned domain but was conceptualized in undemanding terms, focusing on basic autonomy and cognitive functioning. Psychological attitudes and meaningful social relationships were also key, alongside contextual factors, such as security and access to activities. Two-thirds of the participants perceived themselves as aging well, with justifications closely aligned with their personal definitions; negative self-perceptions were mainly associated with poor health, loss of autonomy, or loneliness. Conclusions: The findings suggest that, in contrast with academic definitions, LTCF residents define aging well in a broader, more context-sensitive manner, which allows them to view themselves positively despite their limitations. Person-centered care environments may play a crucial role in supporting aging well in institutional settings.