The Lived Experiences of Older Adults in Nursing Homes: A Phenomenological Study

One of the sensitive periods of life is aging, associated with a wide range of physiological and psychological changes. In recent years, the care of older adults has undergone changes, and a number of older people live in nursing homes, which have unique challenges and characteristics. Therefore, the purpose of the current study was to examine the experience of older adults in nursing homes. This was a qualitative study with a phenomenological method. The statistical population of the present study included all older adults living in nursing homes in Tehran, Iran. Using the purposive sampling method, we continued recruiting until reaching the saturation stage. Finally, 11 people were recruited as the sample group. Data were collected using semi-structured interviews and analyzed with Colaizzi’s 7-step method. The findings of the research were categorized in three categories: (1) identifying the challenges and problems of older adults in nursing homes, with three main themes and 13 sub-themes, (2) identifying effective factors and solutions to improve the quality of life of older adults, with three main themes and 10 sub-themes, and (3) hope and prospects for the future, with one main theme and two sub-themes. According to the obtained results, it can be concluded that older adults living in nursing homes have special conditions and characteristics, making it necessary to take measures to increase the quality of life of older adults living in nursing homes according to the suggestions of the present research.
EXTENDED ABSTRACT
Introduction
 With the increasing trend in global health and education, the lifespan and number of older adults have significantly increased compared to previous decades. Given the importance of quality of life for older adults, researchers in recent years have been seeking to improve the quality of life and mental health of this population. One of the challenges that older adults and their families constantly face is how to best care for older adults. Modern lifestyles and their limitations have led to extensive changes in the structure of elder care, resulting in the care of older adults being increasingly entrusted to institutions and nursing homes, unlike in the past. Research indicates that older people living at home enjoy a higher quality of life and social support compared to those living in nursing homes. Therefore, exploring the lived experiences of older adults residing in nursing homes and understanding their feelings, challenges, problems, and perspectives is of sufficient importance and necessity. Hence, the aim of the present study was to explore the lived experiences of older adults in nursing homes in three main areas: identifying the challenges and problems of older adults, identifying factors that improve the quality of life of older adults in nursing homes, and providing solutions and recommendations based on the lived experiences of older adults in nursing homes.
Method
This was a qualitative study with a phenomenological approach. The statistical population included all older adults residing in nursing homes in Tehran, Iran. Using the purposive sampling method, we continued recruiting until reaching the saturation stage. Finally, 11 people were recruited as the sample group. The inclusion criteria were: (1) being 60 years old or older, (2) ability to communicate and be interviewed, (3) having sufficient health, (4) providing informed consent, and (5) willingness to participate in the study. The exclusion criteria were: (1) a history of chronic physical illness, (2) cognitive impairment, and (3) Alzheimer’s disease. To explore the lived experiences of older adults in nursing homes, semi-structured interviews were used for data collection. Each interview lasted between 45 and 60 minutes and was conducted by the researcher who had prior experience. Initially, older individuals living in nursing homes were identified based on the inclusion and exclusion criteria and were purposively included in the study. Subsequently, data were collected through in-depth interviews. The data obtained from the interviews were analyzed using Colaizzi’s 7-step method.
Results
The data obtained from the interviews were categorized into three main themes using Colaizzi’s seven-step method: (1) identifying the challenges and problems of older adults in nursing homes, (2) identifying effective factors and strategies to improve the quality of life of older adults in nursing homes, and (3) hope and outlook for the future. Ultimately, the first theme had three main themes (and 13 sub-themes) of emotional and psychological challenges (feelings of rejection, loneliness, anxiety, being compared with others, hopelessness, sadness, fear of the future, feelings of futility), individual challenges (attachment to personal environment and limitations in recreational activities), and social challenges (receiving pity from others, lack of social participation, reduced family interactions). The second theme had three main themes (and 10 sub-themes) of physical environment (clean and private restrooms, increased green spaces, creation of suitable sports environments, creation of safe and healthy environments, expansion of library spaces), emotional and social support (increased family visits, increased cultural programs), and health and nutritional support (group visits and outings, healthy meals, collective cleanliness). The third theme had one main theme of hope and outlook with two sub-themes of positive and hopeful, and negative and hopeless. 
Conclusion
The present study aimed to identify the lived experiences of older adults in nursing homes. The lived experiences of older adults were examined and analyzed in three main themes: identifying the challenges and problems of older adults in nursing homes, identifying effective factors and strategies to improve the quality of life of older adults in nursing homes, and hope and outlook for the future. The results were categorized into main and sub-themes, and ultimately, suggestions were made to enhance the quality of life, increase hope, improve mental health, and reduce challenges and problems of older adults in nursing homes. Based on the results of the study, it can be stated that residing in nursing homes presents specific advantages and disadvantages for older adults, who face particular challenges that need to be addressed. Overall, it is essential to attend to the emotional and psychological well-being of older adults, design physical environments to meet necessary standards, increase cultural, social, recreational, and touristic programs, and ensure a healthy and specialized diet in nursing homes.
Ethical Consideration
Ethical Code
The authorization to conduct this research was issued by the Welfare Organization.
Financial Support
This study had no financial support
Authors’ Contributions
Z.B: Conceptualization, Methodology, Software, Validation, Formal Analysis; S.R: Data Curation, Resources, Writing- Original Draft, Writing-Review & Editing. 
Conflict of Interest
The author had no conflicts of interest. 
Acknowledgments
Respectful appreciation is extended to the esteemed older participants for their cooperation and assistance in taking part in the current study. 
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