A new conceptual model of experiences of aging in place in the United States: Results of a systematic review and meta-ethnography of qualitative studies.
Amy Rosenwohl-Mack, Karen Schumacher, Min-Lin Fang and 1 others
PMID 31884333WHAT IT FOUND
Aging in place is an active negotiation, not passive residence.
Older adults balance threats to identity, connection, and home against their agency. Without resources, staying put can mean isolation, loss of dignity, and unsafe conditions rather than preferred independence.
Key findings
01Aging in place requires active work to cope with changing needs, involving mindset shifts, home modifications, and altered social strategies.
02When agency is outweighed by threats, older adults experience isolation, uncertainty, and dislocation, particularly if housing is unsafe or unsuitable.
03Identity threats arise from losing valued roles and routines, such as driving or home upkeep, which can trigger feelings of dependence and vulnerability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review included only English-language, peer-reviewed studies, potentially excluding non-English speakers and grey literature. Many included studies lacked reporting on researcher positionality and reflexivity, which affects the confidence in the synthesis. The included studies had limited geographic and racial/ethnic diversity, despite the growing diversity of the US older adult population. Meta-ethnography is an interpretive process, so another research team might have generated different conceptual models.
The easy way to misread this
Do not interpret this model as evidence that staying at home is always preferable or safer. The review found that for many, aging in place was a constraint driven by lack of resources, leading to isolation and unsafe conditions, rather than a successful achievement of independence.