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

aimTo develop a grounded theory explaining the psychosocial processes older adults use when adapting to life in residential aged care.

designAn evolved grounded theory methodology was used.

methodsSemi-structured interviews were conducted with 20 residents and three staff members across four residential aged care homes in Victoria, Australia, supplemented with ethnographic observations. Theoretical sampling continued until theoretical saturation was achieved.

resultsThe theory of Adapting to a shrunken world comprises three categories: realising the need for care; facing a life in care; and living with loss. Adaptation is an active, ongoing process shaped by accumulating losses. Positive adaptation requires residents to recognise and accept care needs while ceding aspects of independence, autonomy and control. This theory extends transition-focused accounts of adaptation by showing that, while early phases of adjustment and acceptance are important, adaptation to life in residential aged care remains an active, ongoing, psychosocial process shaped by continual change and accumulating loss across residents' lives in care.

conclusionAdaptation continues throughout residents' lives in care. Acceptance of care needs is critical, as perceived losses of independence and control can lead to resistance or resentment that inhibits adjustment. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This theory provides a framework for person-centred policies and practices that support positive adaptation. Healthcare professionals can recognise early signs of maladaptation and implement interventions that foster acceptance while maintaining resident autonomy. IMPACT: This study addresses gaps in understanding long-term adaptation to residential care, informing nursing practice, aged care policy and care models internationally. REPORTING

methodData were analysed using grounded theory methods. The COREQ checklist was applied to guide transparent reporting of study design, data collection and analysis. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.