PTOTSLPRNQualitativeJournal of advanced nursing2026

Adapting to a Shrunken World: A Grounded Theory of Resident Adaptation to Life in Residential Aged Care.

Jarrah FitzGerald, Yvonne D Wells, Jane Mills

PMID 41808315

WHAT IT FOUND

Residents who accepted their need for care viewed the move as a trade-off for safety, allowing them to focus on remaining abilities.

Those who resisted saw every assistance as a loss of self, leading to resentment and withdrawal.

Key findings

01Adaptation is an ongoing process driven by accumulating losses, not a transition phase that ends once a resident settles in.

02Residents who turned towards life in care willingly shared control and tasks with staff, viewing this as teamwork that preserved their sense of self.

03Residents who turned away interpreted care practices as threats to their identity, focusing on losses rather than opportunities for engagement.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs

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What it does not show

The sample excluded residents with noticeable cognitive impairment, limiting applicability to those with dementia or significant cognitive decline. Most residents were born in Australia, with only one from a culturally and linguistically diverse background, so the theory may not capture experiences of diverse populations. Residents who were 'turning away' were fewer in the sample, possibly because those with negative experiences opted out of the study. Staff perspectives were limited to three senior roles (lifestyle coordinators and one director), so the findings may not reflect the views of bedside nursing or care staff.

Declared interests

The authors declare no conflicts of interest. The work was supported by an Australian Government Research Training Scholarship and a Postgraduate Research Scholarship.

The easy way to misread this

Do not interpret the 'turning towards' orientation as a sign that the resident is happy or that the facility is providing high-quality care. It is a coping mechanism for an ongoing loss of autonomy. Conversely, do not view 'turning away' as simple non-compliance; it is a protective response to a perceived threat to the resident's identity.

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