Lived Experiences and Everyday Life of Elderly Residents Living in Old Age Homes

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Old age homes, once perceived as culturally stigmatized institutions, are increasingly emerging as alternative residential arrangements for senior citizens. This qualitative study explores the lived experiences, emotional well-being, social integration, health concerns, and identity perceptions of elderly residents residing in institutional settings. The research was conducted under the framework of the National Service Scheme (NSS) community engagement initiative and involved in-depth interviews and open-ended survey responses from 40 elderly residents across two old age homes. Thematic analysis generated eight interconnected themes: (1) Family Disintegration and Changing Social Values, (2) Loneliness and Emotional Isolation, (3) Health Vulnerability and Medical Dependency, (4) Adjustment and Adaptive Coping, (5) Social Relationships within Institutional Settings, (6) Perceptions of Institutional Care and Services, (7) Expectations from Youth and Broader Society, and (8) Spirituality as a Meaning-Making Resource. Findings indicate that while institutional environments largely ensure physical security, routine medical care, and basic material support, emotional fulfillment and identity affirmation remain only partially addressed. Residents frequently negotiate feelings of abandonment, diminished authority, and perceived burden alongside gradual adaptation and spiritual resilience. The coexistence of structural care and emotional vulnerability reveals a critical gap between functional adjustment and psychosocial well-being. The study underscores the urgent need for holistic elderly care models that integrate emotional recognition, intergenerational engagement, community participation, and dignity-centered policy reforms. Strengthening relational belonging and identity preservation within institutional contexts is essential to ensuring not merely extended life, but aging with dignity. Aging Old Age Homes Elderly Care Qualitative Research Thematic Analysis Social Change Loneliness Institutional Living Intergenerational Gap NSS Study 1. Introduction Population aging is one of the most profound demographic transformations of the twenty-first century. Globally, improvements in public health, medical advancements, and socio-economic development have significantly increased life expectancy. According to the United Nations, the proportion of individuals aged 60 years and above is expected to double by 2050, reaching over 2 billion worldwide [ 1 ]. The World Health Organization further emphasizes that by 2030, one in six people globally will be aged 60 or older [ 2 ]. This demographic shift presents complex social, economic, and healthcare challenges, particularly in developing countries where institutional and policy frameworks are still evolving. India is experiencing rapid demographic aging. Census projections indicate that the elderly population has grown substantially over the past two decades, with estimates suggesting over 138 million older persons in 2021 [ 1 ]. Scholars argue that population aging in India is occurring at a much faster pace than the development of adequate social security systems [ 3 ]. Rajan and Kumar [ 4 ] observed that the traditional pattern of co-residence with children is declining, thereby increasing vulnerability among older adults. Historically, Indian society has been rooted in joint family systems where elderly individuals occupied respected positions within households. They served as custodians of tradition, decision-makers, and caregivers for grandchildren. However, sociological research indicates that modernization and industrialization have fundamentally altered family structures [ 5 ]. Bhat and Dhruvarajan [ 6 ] noted that intergenerational bonds have weakened due to migration, urban employment opportunities, and economic independence among younger members. Similarly, modern family theory suggests that nuclearization reduces daily interaction between generations, thereby weakening support systems [ 7 ]. The process of modernization has also contributed to what scholars describe as the “marginalization of aging” [ 8 ]. Cowgill’s modernization theory argues that industrialization diminishes the status of older persons in society [ 9 ]. Studies conducted in urban India have shown increasing instances of neglect and emotional abandonment [ 10 ]. The HelpAge India Report revealed that nearly 47% of elderly respondents experienced some form of neglect, including emotional, financial, or verbal abuse [ 11 ]. Institutionalization of the elderly, once considered socially unacceptable in Indian culture, is gradually becoming more common. Research on old age homes indicates that such institutions provide safety and medical care but may fail to address emotional and psychological needs [ 12 ]. Lamb’s ethnographic study highlighted feelings of abandonment and loss among residents in Indian old age homes [ 13 ]. Similarly, qualitative investigations reveal that relocation to institutional settings often results in identity crises and diminished self-worth [ 14 ]. Loneliness has emerged as one of the most critical concerns among institutionalized elderly individuals. The United Nations identifies social isolation as a growing global issue affecting older populations [ 1 ]. Psychological studies indicate a strong correlation between institutional living and depression [ 15 ]. Chaudhuri and Roy [ 16 ] found high levels of loneliness among elderly residents in care institutions, particularly among widowed individuals. Research in geriatric psychology also demonstrates that lack of meaningful social interaction increases the risk of cognitive decline and mental health disorders [ 17 ]. Health vulnerabilities further complicate the aging experience. Studies show that chronic conditions such as diabetes, hypertension, and arthritis are prevalent among older adults in India [ 18 ]. The World Health Organization emphasizes that healthy aging requires more than medical intervention; it necessitates social participation, dignity, and inclusion [ 2 ]. Research in public health highlights the importance of community-based care models over purely institutional frameworks [ 19 ]. Socio-economic factors also influence elderly well-being. Economic insecurity remains a significant issue, particularly for those without pension coverage [ 20 ]. Feminization of aging is another emerging trend, with older women often facing compounded vulnerabilities due to widowhood and financial dependency [ 21 ]. Studies indicate that elderly women in institutional settings report higher levels of emotional distress compared to men [ 22 ]. Theoretical perspectives provide further understanding of aging experiences. Disengagement theory suggests that aging involves gradual withdrawal from social roles [ 23 ], whereas activity theory argues that continued engagement promotes well-being [ 24 ]. Continuity theory emphasizes maintaining consistent patterns of behavior and relationships throughout life [ 25 ]. These theoretical frameworks highlight the importance of social interaction and meaningful participation in enhancing quality of life among older adults. Despite extensive demographic and quantitative research, there remains limited qualitative exploration of the lived experiences of elderly individuals residing in semi-urban old age homes. Many studies focus on statistical trends, health indicators, or policy frameworks, but fewer studies capture the subjective emotions, narratives, coping mechanisms, and perceptions of institutional care from the residents’ perspectives. Understanding these lived realities is crucial for designing policies that prioritize dignity, psychological well-being, and intergenerational solidarity. Therefore, this study seeks to fill this research gap by conducting an in-depth qualitative investigation of elderly residents living in old age homes. By centering their voices through narrative inquiry and thematic analysis, the study aims to provide a holistic understanding of aging in institutional settings and contribute to the development of more humane and inclusive elderly care systems. 1.1 Objectives of the Study The present study was undertaken with the primary objective of exploring the lived experiences of elderly residents residing in old age homes. Aging is not merely a biological process but also a deeply social and emotional experience shaped by family relationships, socio-economic conditions, and institutional environments. Therefore, this study seeks to understand how elderly individuals perceive and interpret their everyday lives within institutional settings. A second objective of the research is to identify the emotional, social, and psychological challenges faced by elderly residents. Issues such as loneliness, neglect, loss of identity, declining health, and reduced social interaction are often associated with institutional living. By examining these aspects in depth, the study aims to highlight the multifaceted vulnerabilities experienced by older adults. The study further aims to analyze residents’ perceptions of institutional care, including their level of satisfaction with facilities, staff behavior, healthcare support, safety, and social environment within the old age homes. Understanding these perceptions helps in evaluating whether such institutions serve merely as shelter homes or function as supportive living communities. Another important objective is to explore the expectations elderly individuals hold toward their families, younger generations, society, and government institutions. Their perspectives provide valuable insights into intergenerational relationships and societal attitudes toward aging. Finally, the study seeks to offer policy-oriented suggestions and practical recommendations for improving elderly well-being, with a focus on dignity, inclusion, emotional security, and community participation. 2. Methodology 2.1Research Design The study adopted a qualitative research design, as the primary aim was to explore subjective experiences, emotions, and personal narratives of elderly residents. Qualitative research is particularly appropriate for understanding complex social phenomena where human perceptions, meanings, and interpretations play a central role. Instead of focusing on numerical measurement alone, this approach emphasizes depth, context, and richness of data. Thematic analysis was used as the primary analytical framework, allowing the researcher to systematically identify patterns, recurring ideas, and underlying themes emerging from participants’ narratives. 2.2 Study Area The research was conducted in two selected old age homes situated in a semi-urban region of India, chosen to reflect diverse geographic and socio-cultural contexts. One institution was managed by a non-governmental organization (NGO) catering to residents from multiple states, while the other was privately operated and drew elderly individuals from different regions of the country. This selection strategy ensured representation from northern, southern, eastern, and western parts of India, capturing variations in language, culture, and family backgrounds. Both institutions provided residential care, nutritious meals, and basic medical facilities for elderly residents. By including institutions with diverse management styles and resident profiles, the study enabled a comparative understanding of institutional experiences across regions and socio-cultural contexts. 2.3 Sample The total sample comprised 40 elderly residents aged between 60 and 85 years. Among them, 22 were female and 18 were male participants. A purposive sampling technique was employed, as the study required participants who were willing to share their experiences and were capable of engaging in detailed conversations. This method ensured that individuals with diverse backgrounds, varying lengths of stay, and different family circumstances were included. The sample represented widowed individuals, those without children, and residents who had been admitted due to family conflicts or financial difficulties. 2.4 Data Collection Tools Multiple qualitative tools were used to ensure comprehensive data collection. Semi-structured interviews formed the primary method, allowing participants to freely express their thoughts while maintaining a guiding structure of key questions. Open-ended questionnaires were used to gather reflective responses related to emotional well-being, family relationships, and institutional satisfaction. Informal conversations were conducted to build rapport and capture spontaneous insights that might not emerge in formal interviews. Additionally, field notes were maintained to record observations regarding living conditions, interpersonal interactions, and non-verbal expressions, thereby enriching contextual understanding. 2.5 Data Analysis All interviews and discussions were transcribed verbatim to maintain accuracy. The data were analyzed using Thematic Analysis as proposed by Braun and Clarke (2006). The analytical process involved several systematic stages. First, familiarization with the data was achieved through repeated reading of transcripts. Second, initial codes were generated to identify significant statements and recurring ideas. Third, related codes were grouped to form broader themes representing patterns across participants. Fourth, themes were reviewed, refined, and interpreted in relation to the study objectives and existing literature. This step ensured coherence and conceptual clarity. 2.6 Ethical Considerations Ethical principles were strictly maintained throughout the research process. Informed consent was obtained from all participants prior to data collection. Participants were assured that their identities would remain confidential and that pseudonyms would be used in reporting narratives. They were also informed that participation was voluntary and that they could withdraw at any time without any consequences. Special care was taken to conduct interviews sensitively, considering the emotional vulnerability of elderly participants. 3. Results and Thematic Findings The qualitative analysis of in-depth interviews, open-ended responses, and observational field notes led to the identification of eight major themes reflecting the lived realities of elderly residents in institutional settings. The findings reveal complex interconnections between family dynamics, emotional well-being, health concerns, institutional adjustment, and social expectations. These themes emerged through systematic coding and thematic categorization of participants’ narratives. Before presenting the thematic findings in detail, it is essential to understand the demographic profile of the participants, as age, gender, and marital status significantly influence experiences of aging, institutionalization, and emotional vulnerability. Demographic characteristics provide contextual grounding for interpreting the qualitative data and help in identifying patterns across different social categories. 3.1 Demographic Profile of Participants The study included 40 elderly residents aged between 60 and 85 years residing in two selected old age homes. The demographic composition reflects diversity in age groups, gender distribution, and marital status. The consolidated demographic details are presented in Table 1 . Table 1 Demographic Profile of Participants (N = 40) Variable Category Frequency Percentage Age Group 60–65 years 8 20% 66–70 years 10 25% 71–75 years 9 22.5% 76–80 years 7 17.5% 81–85 years 6 15% Gender Male 18 45% Female 22 55% Marital Status Widowed 20 50% Married (Spouse not present) 6 15% Divorced/Separated 5 12.5% Unmarried 9 22.5% Total Participants 40 100% As indicated in Table 1 , the largest proportion of participants (25%) belonged to the 66–70 years age group, followed closely by 22.5% in the 71–75 years category. This suggests that many individuals entered institutional care during the early stages of old age rather than in advanced or dependent old age. The relatively higher percentage in the younger elderly categories may reflect early family breakdown, financial instability, or lack of caregiving support. In terms of gender distribution, females constituted 55% of the sample, slightly higher than males (45%). This pattern reflects the broader demographic phenomenon known as the feminization of aging, wherein women generally have higher life expectancy and are more likely to outlive their spouses. Additionally, older women often face greater socio-economic dependency, limited pension access, and vulnerability following widowhood. Marital status data further strengthens this interpretation. Half of the participants (50%) were widowed, indicating that spousal loss is a major contributing factor to institutionalization. Widowhood often results in emotional distress, social isolation, and financial insecurity, particularly for women who may have relied on their husbands for economic stability. Moreover, 15% of participants were married but living separately from their spouses, suggesting circumstances such as illness, abandonment, or geographic separation. A smaller percentage were divorced or separated (12.5%), while 22.5% remained unmarried, indicating varied life trajectories influencing institutional living. The demographic characteristics outlined in Table 1 provide crucial context for understanding the subsequent experiences of elderly residents within institutional settings. Factors such as age, gender, and marital status are closely associated with reasons for institutionalization, emotional well-being, and patterns of adjustment. For instance, younger elderly residents may face early family breakdown or financial challenges, while widowed individuals—particularly women—may experience heightened vulnerability and social isolation. These background factors help explain the diversity in experiences reflected in Table 2 , which presents patterns of institutional entry, emotional loneliness, and adaptation among the participants. By examining these demographic influences alongside lived experiences, the study contextualizes how structural, relational, and personal variables interact to shape life in old age homes. Table 2 Institutionalization, Emotional Well-being and Adjustment Patterns (N = 40) Themes Category Frequency Percentage Reasons for Institutionalization Family Conflict 12 30% Theme1 Neglect 9 22.5% Financial Issues 8 20% No Children 6 15% Self-decision 5 12.5% Experience of Loneliness Often 16 40% Theme2 Sometimes 14 35% Rarely 6 15% Never 4 10% Level of Adjustment Well-adjusted 18 45% Theme3 Moderately adjusted 14 35% Poorly adjusted 8 20% Table 2 integrates three major themes that emerged from participants’ narratives: Theme 1: Family Disintegration and Institutional Entry , Theme 2: Loneliness and Emotional Isolation , and Theme 3: Adjustment and Adaptation to Institutional Life . Together, these themes illustrate that institutionalization is not a single event but an ongoing psychosocial process shaped by relational rupture, emotional vulnerability, and adaptive reconstruction. Theme 1: Family Disintegration and Institutional Entry The most dominant factor underlying institutionalization was family conflict. A significant proportion of participants reported strained relationships within the household, often involving intergenerational disagreements, property-related disputes, or feelings of exclusion from decision-making processes. The prominence of relational conflict over financial hardship indicates that emotional and interpersonal breakdown, rather than economic deprivation alone, plays a central role in the transition to institutional living. Neglect emerged as the second most significant factor. Importantly, participants rarely described physical abuse; instead, they emphasized emotional distancing. Being ignored in conversations, excluded from family events, or left alone for extended periods were frequently cited experiences. Such forms of emotional marginalization appeared deeply distressing and often precipitated the decision to relocate. Financial instability was another contributing factor, particularly among residents without pension security or independent income. However, even in economically vulnerable cases, emotional dimensions remained intertwined with financial strain. The presence of residents without children reflects structural vulnerability in later life, highlighting the absence of immediate familial caregivers. Interestingly, some participants described institutional entry as a self-initiated decision. Yet even voluntary relocation was often framed as an act of self-sacrifice—an attempt to avoid becoming a burden to children. This internalization of responsibility reveals deeply embedded cultural expectations regarding aging, dependency, and parental selflessness. Thus, Theme 1 demonstrates that institutionalization is rarely accidental or purely economic. It emerges at the intersection of relational strain, emotional invisibility, structural vulnerability, and internalized duty. Theme 2: Loneliness and Emotional Isolation Loneliness emerged as one of the most persistent emotional experiences among residents. A large proportion of participants reported feeling lonely either frequently or intermittently, despite living in a shared environment. This finding underscores a crucial distinction between physical proximity and emotional connectedness. Participants described communal living spaces as socially active yet emotionally insufficient. Conversations often remained surface-level, centered on routine activities rather than personal histories or deep emotional exchange. Many residents expressed longing not for company in general, but specifically for meaningful family interaction. Loneliness was frequently linked to reduced contact with children and grandchildren. Even when visits occurred, participants described them as brief or formal. This limited interaction intensified feelings of emotional displacement. Importantly, loneliness appeared not only as sadness but also as a diminished sense of relevance. Several narratives conveyed feelings of being “left behind” in rapidly changing social environments. Festivals and family celebrations were particularly triggering moments, amplifying awareness of separation. Theme 2 thus reveals that institutional living does not automatically resolve emotional isolation. While the institution provides structure and safety, the absence of intimate familial bonds continues to shape residents’ psychological landscapes. Theme 3: Adjustment and Adaptation to Institutional Life Despite emotional challenges, many residents described themselves as moderately or well-adjusted over time. Adjustment, however, was not immediate. Several participants recounted initial feelings of shock, grief, embarrassment, or perceived social failure upon entering the institution. Over time, routine formation, peer interaction, participation in activities, and spiritual engagement facilitated gradual adaptation. The structured environment appeared to offer predictability, which contributed to emotional stabilization. Yet, a critical nuance emerges from the coexistence of reported adjustment and persistent loneliness. Adaptation did not necessarily imply emotional fulfillment. Residents often learned to function effectively within institutional norms while continuing to experience internal sadness or longing. Poor adjustment among a smaller segment of residents appeared linked to recent relocation, severe health problems, or unresolved family conflicts. This suggests that adaptation capacity varies based on psychological resilience, duration of stay, and support systems. Theme 3 therefore highlights adaptation as a dynamic and negotiated process. Institutional living becomes normalized over time, but normalization does not equate to restoration of belonging. When examined collectively, the three themes in Table 2 reveal a sequential yet overlapping process: Relational rupture initiates institutional entry. Emotional isolation persists within the institutional setting. Adaptive strategies gradually reconstruct functional stability. However, this reconstruction remains partial. Institutionalization addresses safety and structural stability but cannot fully compensate for fractured intergenerational bonds. The findings indicate that emotional marginalization—more than overt abuse or poverty—is a central pathway to institutional care. Furthermore, while residents demonstrate resilience and adaptive capacity, underlying loneliness continues to shape their lived experiences. Thus, Table 2 highlights a structural gap between functional adaptation and emotional fulfillment. Institutional living represents a negotiated compromise between security and belonging. While Table 2 highlights the reasons for institutionalization, the prevalence of loneliness, and patterns of adjustment among residents, it is also essential to consider how these experiences interact with other dimensions of daily life in old age homes. Physical health, social integration, satisfaction with institutional services, spiritual engagement, and self-perception play a critical role in shaping overall well-being. Table 3 presents these interconnected domains, illustrating how chronic health conditions, quality of social relationships, emotional coping mechanisms, and perceived dignity influence the lived experience of institutionalized elderly. By examining these aspects in conjunction with adaptation patterns, the study provides a comprehensive understanding of how structural, relational, and psychosocial factors collectively impact aging with dignity. Table 3 : Health Status, Social Integration, Satisfaction, Spiritual Engagement and Self-Perception (N = 40) Table 3 presents a multidimensional profile of institutional life by integrating five critical domains: chronic health status, social interaction patterns, perceived institutional satisfaction, spiritual engagement, and self-perception. When examined collectively, these dimensions illuminate the complex interplay between physical security and psychological identity within institutional settings. The findings demonstrate that while institutional care effectively addresses survival and safety needs, existential and relational needs remain partially unresolved. Themes Category Frequency Percentage Chronic Health Conditions * Hypertension 18 45% Theme 4 Diabetes 15 37.5% Arthritis 10 25% Heart-related issues 6 15% No major illness 8 20% Nature of Social Interaction Close friendships 12 30% Theme 5 Casual interaction 18 45% Minimal interaction 7 17.5% Socially withdrawn 3 7.5% Satisfaction with Institutional Services Highly satisfied 10 25% Theme 6 Satisfied 17 42.5% Neutral 8 20% Dissatisfied 5 12.5% Spiritual Engagement Daily 22 55% Theme 7 Occasional 10 25% Rarely 5 12.5% Not engaged 3 7.5% Self-Perception Feel valued 14 35% Theme 8 Mixed feelings 13 32.5% Feel burden 9 22.5% Feel irrelevant 4 10% Table 3 captures five interconnected themes that emerged from participants’ narratives: Theme 4: Health Vulnerability and Dependency , Theme 5: Social Relationships within the Institution , Theme 6: Perception of Institutional Care and Services , Theme 7: Spirituality and Coping Mechanisms , and Theme 8: Self-Perception, Dignity, and Sense of Worth . Together, these themes reveal the complex negotiation between physical security and psychological identity within institutional settings. While institutional care ensures structural stability, deeper existential and relational needs remain unevenly fulfilled. Theme 4: Health Vulnerability and Dependency A dominant reality shaping institutional life was the widespread presence of chronic illness. Hypertension, diabetes, arthritis, and heart-related conditions were commonly reported, reflecting the broader epidemiological profile of aging populations. However, participants did not describe illness solely as a medical condition. Rather, it emerged as a lived experience influencing autonomy, daily routine, and emotional stability. Chronic illness structured residents’ everyday lives through medication schedules, dietary restrictions, and mobility limitations. Several participants expressed concern about progressive deterioration and the possibility of becoming fully dependent. Even though institutional healthcare provided regular monitoring and immediate assistance, illness remained a constant reminder of fragility and mortality. Health vulnerability therefore operated at both physical and symbolic levels. It reinforced dependence on caregivers and shaped self-perception. For some residents, declining physical capacity was closely associated with reduced self-confidence and diminished authority. Thus, health status influenced not only bodily well-being but also dignity and identity. Theme 5: Social Relationships within the Institution Institutional living created a shared social environment, yet the quality of relationships varied significantly. While many residents reported regular interaction with peers, most characterized these relationships as casual rather than deeply intimate. Participants often described companionship rooted in shared routines and collective living conditions. Conversations occurred during meals, recreational activities, or religious gatherings. However, emotional disclosure and profound attachment were less common. This distinction highlights a critical difference between social presence and emotional closeness. A minority of residents remained minimally interactive or socially withdrawn. Withdrawal appeared linked to grief, chronic pain, introverted personality traits, or unresolved family conflict. For some, maintaining emotional distance served as a protective coping strategy. Thus, institutional social networks functioned as substitute communities but did not fully replicate the depth of familial bonds. Interaction reduced complete isolation, yet emotional belonging remained partial. Theme 6: Perception of Institutional Care and Services Participants generally expressed satisfaction with institutional services, particularly in relation to food, cleanliness, medical supervision, and safety. For several residents, institutional life offered greater stability compared to previous living arrangements characterized by neglect or conflict. However, satisfaction was predominantly associated with material and structural aspects of care. Residents appreciated predictable routines and accessible healthcare, which reduced anxiety about survival needs. Nevertheless, emotional fulfillment did not automatically accompany logistical adequacy. The presence of neutral or dissatisfied responses suggests variability in expectations and experiences. Some participants desired greater recreational engagement, increased privacy, or more personalized interaction. This indicates that institutional effectiveness cannot be evaluated solely on infrastructural grounds. The theme thus reflects a dual reality: institutions succeed in meeting basic and safety needs, yet higher-order emotional needs require additional attention. Theme 7: Spirituality and Coping Mechanisms Spiritual engagement emerged as one of the most powerful coping mechanisms within the institutional context. A majority of participants reported daily or regular involvement in prayer, meditation, or religious practices. Spirituality provided emotional reassurance and a sense of continuity amidst change. Participants frequently described faith as a source of peace, acceptance, and inner strength. Rather than interpreting institutionalization purely as abandonment, some reframed it within a spiritual narrative of destiny or divine will. Spiritual coping appeared to moderate distress related to loneliness, illness, and separation. In situations where external circumstances were difficult to alter, faith enabled internal adaptation. This reflects a shift from control over environment to control over interpretation. Thus, spirituality functioned not merely as religious observance but as a psychological stabilizer and meaning-making framework. Theme 8: Self-Perception, Dignity, and Sense of Worth Self-perception emerged as one of the most sensitive and complex themes. While a portion of residents reported feeling valued and respected within the institution, a considerable number expressed ambivalence or internalized feelings of being a burden. The “burden narrative” appeared repeatedly across interviews. Many residents emphasized that they did not wish to inconvenience their children. Even those who voluntarily entered institutional care framed their decision as an act of responsibility toward their family rather than as personal choice. Feelings of worth were closely linked to respectful treatment by staff, participation in activities, and opportunities to express opinions. Simple acts—such as being consulted in decisions or addressed politely—significantly strengthened dignity. Conversely, rigid schedules, restricted autonomy, and health-related dependency sometimes contributed to diminished identity. Residents who perceived themselves as socially irrelevant often associated this feeling with loss of previous roles within the family and community. Thus, dignity within institutional settings depends not only on physical care but also on symbolic recognition and participatory inclusion. When the five themes are examined collectively, Table 3 reveals a layered and paradoxical reality of institutional living. Physical care and medical supervision are largely stabilized. Social interaction exists and provides moderate companionship. Spiritual practices foster resilience and emotional acceptance. Yet identity-related vulnerabilities persist beneath structural security. Chronic illness reinforces dependency, social interaction mitigates but does not eliminate loneliness, institutional satisfaction ensures safety without guaranteeing belonging, and spirituality provides coping without fully restoring relational intimacy. Institutional life therefore represents a negotiated balance between protection and selfhood. While survival and safety needs are effectively addressed, belongingness, esteem, and meaningful contribution remain areas of ongoing struggle. The findings indicate that holistic elderly care must extend beyond infrastructure toward emotional validation, autonomy support, identity preservation, and opportunities for meaningful engagement. Without such efforts, institutional systems risk achieving structural efficiency while leaving existential needs only partially fulfilled. 4. Discussion The present study examined the lived experiences of elderly residents in institutional settings, identifying eight major themes that reflect structural, emotional, health-related, and psychosocial dimensions of aging. These findings are situated within the context of global demographic shifts, Indian socio-cultural transformation, and established gerontological theories, highlighting the multifaceted nature of institutionalized aging. Population aging is a defining demographic trend of the 21st century. The United Nations (2022) reports that the global population aged 60 and above is growing faster than any other age group. Similarly, the World Health Organization (2021) emphasizes that aging encompasses not only biological changes but also structural, social, and cultural processes that require integrated policy interventions. Bloom et al. (2015) note that demographic aging reshapes family systems, dependency ratios, and welfare arrangements. Against this backdrop, the experiences of institutionalized elderly must be interpreted as part of broader societal and demographic transformations. 4.1 Family Disintegration and Structural Transformation Family conflict and emotional neglect emerged as the most prominent reasons for institutionalization. This aligns with Lamb (2009), who emphasized that emotional abandonment increasingly drives elderly displacement in India, and with HelpAge India (2018), which documented rising emotional neglect in urban households. The observed shift from joint to nuclear families corroborates Goode’s (1963) thesis on global family transformation, highlighting how industrialization and urbanization weaken extended kinship structures. Rajan and Kumar (2013) similarly noted declining co-residence trends among Indian elderly, particularly in urban areas. Cowgill’s Modernization Theory (1974) provides further explanatory insight: modernization diminishes the authority, economic productivity, and symbolic status of older persons. Participants’ narratives reflected this declining relevance, as older adults experienced reduced decision-making influence and moral authority within their families. Bhat and Dhruvarajan (2001) describe this as a “care gap,” where traditional family-based support erodes more rapidly than institutional alternatives develop. Many residents framed institutionalization as a “last resort,” reflecting tensions between cultural expectations of filial duty and modern socio-economic realities. 4.2 Emotional Neglect and Loneliness Loneliness and emotional isolation were pervasive, even among residents with regular peer interaction. This resonates with Cacioppo’s (2002) conceptualization of loneliness as perceived social isolation and Hawkley & Cacioppo’s (2010) findings linking chronic loneliness to depression, cognitive decline, and cardiovascular risk. The NSSO Elderly Health Survey (2017) similarly reports high levels of emotional distress among institutionalized or isolated elderly individuals, and Gupta (2012) identifies emotional neglect—not physical abuse—as the most prevalent form of elder mistreatment in urban India. Goffman’s (1961) analysis of institutional life provides further interpretive depth. Structured routines, regulated mobility, and limited autonomy create subtle forms of depersonalization. Participants’ experiences of invisibility, marginalization, and loss of voice reflect this dynamic. Emotional neglect, therefore, emerges as a critical determinant of psychological vulnerability within institutional settings. 4.3 Health Vulnerability and the Biomedicalization of Aging Chronic health conditions, particularly hypertension and diabetes, were highly prevalent, consistent with global aging reports (UN, 2022; WHO, 2021). While institutions successfully addressed medical needs, residents reported that psychosocial integration and emotional support were insufficient. Estes (1979) critiques the “biomedicalization” of aging, arguing that an overemphasis on medical management neglects dignity and social meaning. This study supports this critique: institutional care ensured medication adherence and routine health monitoring but did not necessarily alleviate fear of dependency or existential anxiety. Economic insecurity compounded these vulnerabilities. Participants without stable pensions expressed heightened dependency and psychological fragility, echoing Palacios (2002) on the inadequacy of financial protection among Indian elderly. 4.4 Adaptation and Theories of Successful Aging Adjustment to institutional life varied widely. Atchley’s Continuity Theory (1989) helps explain why residents who maintained familiar habits—religious practices, reading routines, or social roles—demonstrated smoother psychological adaptation. In contrast, Cumming & Henry’s Disengagement Theory (1961) posits that aging involves natural withdrawal from social roles. Findings here suggest that institutional withdrawal was often involuntary, stemming from structural or relational limitations rather than developmental necessity. Havighurst’s Activity Theory (1963) aligns closely with observed outcomes. Residents participating in group discussions, recreational activities, and spiritual routines reported higher life satisfaction, confirming the importance of engagement and meaningful activity in promoting well-being. Chaudhuri & Roy (2020) similarly report that adaptation improves with peer integration and supportive institutional culture. 4.5 Institutional Relationships and Identity Reconstruction Social networks within institutions functioned as surrogate family systems, providing support but lacking the depth of biological bonds. Achenbaum (1995) observes that institutionalization transforms identity from family-based roles to “resident” status, requiring residents to renegotiate self-perception. Symbolic respect—from peers and staff through consultation, polite address, and inclusion in activities—significantly reinforced dignity. This aligns with WHO’s community-based care framework (2015), emphasizing person-centered approaches over custodial care. 4.6 Gendered Dimensions of Aging Female residents slightly outnumbered males, reflecting the feminization of aging. Agarwal (2010) highlights gendered economic disparities among older adults, while Das (2015) links widowhood to social marginalization and depressive symptoms. In the present study, half of the participants were widowed, underscoring compounded emotional and economic vulnerabilities for women. Widowhood not only limits companionship but often reduces decision-making autonomy and access to resources. 4.7 Spiritual Coping and Cultural Context Spirituality emerged as a central coping mechanism, consistent with Lamb (2009) and culturally contextualized aging experiences in India. Residents often reframed institutionalization and familial separation as part of divine will or karmic destiny, reducing emotional resentment. Spiritual engagement also aligns with Atchley’s Continuity Theory (1989), enabling residents to maintain identity and routine through long-standing religious practices. In contrast to many Western secular models, spiritual coping is integral to daily psychological resilience among Indian elderly. 4.8 Structural Policy Gaps and Implications India’s rapid demographic transition is occurring without proportionate expansion of formal eldercare infrastructure (UN, 2022; Bloom et al., 2015). While old age homes provide shelter and medical supervision, participants consistently framed institutional living as a “last resort.” Estes (1979) notes that aging policy often prioritizes survival over quality of life. In this study, limited psychosocial services highlight a policy gap: infrastructure alone cannot ensure dignity, emotional well-being, or meaningful engagement. WHO (2015) emphasizes community-based models as culturally appropriate alternatives, which resonate with participants’ desire for intergenerational contact and social inclusion. The findings underscore that holistic eldercare must integrate physical safety with psychosocial support, relational belonging, identity affirmation, and dignity-centered interventions. Aging with dignity thus requires a balance between structural provision and emotional, social, and spiritual recognition. 5. Conclusion The present study examined the lived experiences of elderly residents in institutional settings and revealed that while old age homes provide essential physical security, structured routine, and medical supervision, they are unable to fully replace the emotional depth and attachment associated with family life. Institutional care ensures shelter, food, and safety; however, the findings clearly demonstrate that emotional belonging, dignity, meaningful communication, and intergenerational connection remain central to elderly well-being. A major conclusion emerging from this study is that institutionalization in the Indian context continues to be perceived as a last resort rather than a preferred living arrangement. Unlike Western societies where assisted living facilities are often normalized as part of retirement planning, elderly individuals in this study associated old age homes with family breakdown, emotional neglect, or unavoidable circumstances such as widowhood and financial insecurity. This highlights the continued cultural significance of filial responsibility and joint family traditions in India, even amid rapid modernization and urbanization. The study further concludes that emotional well-being is more strongly influenced by quality of relationships than by infrastructural comfort. Participants consistently emphasized respect, recognition, and being heard as more valuable than material facilities. The recurring narrative of “not wanting to be a burden” reflects deep psychological internalization of dependency fears. Therefore, elderly care must move beyond a welfare-oriented approach and adopt a dignity-centered model that prioritizes autonomy, participation, and identity preservation. Spiritual coping mechanisms emerged as a significant resilience factor, suggesting that culturally rooted support systems play a crucial role in psychological adaptation. Institutional frameworks should therefore integrate psychosocial and spiritual dimensions alongside medical care to promote holistic aging. 6. Policy Implications The findings of this study carry important policy implications. First, there is a need to strengthen intergenerational community programs that foster interaction between youth and older adults. Community-based engagement can help rebuild respect, reduce stereotypes, and restore emotional connectivity between generations. Second, regular psychological counseling services should be integrated into institutional settings. Mental health support, grief counseling, and group therapy sessions can address loneliness, identity crisis, and feelings of abandonment that are common among residents. Third, the strengthening of government pension schemes and financial security mechanisms is essential. Economic independence enhances dignity and reduces perceptions of dependency. Expansion of social pensions and timely disbursement can significantly improve elderly confidence and autonomy. Fourth, awareness campaigns promoting elderly respect and caregiving responsibility should be conducted at community and national levels. Public education initiatives can challenge negative aging stereotypes and reinforce cultural values of care and reciprocity. Overall, institutional care must shift from a “shelter-based” custodial model to a “dignity-centered” person-focused model , where elderly individuals are not merely recipients of care but active participants in social and emotional life. Such a shift requires integrated policy, professional training, and societal attitude transformation. 7. Limitations of the Study Despite its contributions, this study has certain limitations that must be acknowledged. First, the sample size was relatively small, consisting of 40 participants. While the qualitative approach allowed for in-depth exploration of personal experiences, the limited number of respondents restricts the statistical generalizability of the findings to the broader elderly population. Second, the study was confined to two institutional settings. Institutional culture, management style, and service quality may vary significantly across regions and types of old age homes (government-run, private, or charitable). Therefore, the findings reflect the specific contexts studied and may not fully represent all institutional environments in India. Third, the qualitative research design emphasizes subjective experiences and thematic interpretation. Although this approach provides rich, contextual understanding, it limits the ability to establish causal relationships or produce quantifiable comparisons at a national level. Additionally, responses may have been influenced by social desirability bias, as some participants may have hesitated to criticize institutional conditions openly. Emotional sensitivity surrounding family issues might also have affected the depth of disclosure. Future research could adopt a mixed-method design incorporating larger samples across multiple regions, enabling broader generalization. Comparative studies between community-dwelling elderly and institutionalized residents would also provide deeper insights into the impact of living arrangements on well-being. Declarations Data availability The data analyzed for this paper are available from the author upon reasonable request meeting institutional guidelines. Acknowledgements The authors sincerely thank all the participants for their valuable time, openness, and cooperation. Their willingness to share their lived experiences made this research possible. The authors also express gratitude to the authorities of the old age homes and the Department of Psychology, Acharya Narendra Dev Nagar Nigam Mahila Mahavidyalaya, Kanpur, for their support during the data collection process. Ethical Approval and Accordance The study involving human participants was conducted in accordance with established ethical principles for research involving human subjects. The research protocol was reviewed and approved by the Research Expert and Ethics Committee, Chhatrapati Shahu Ji Maharaj University (CSJMU), Kanpur, Uttar Pradesh, India (Ref. No. 20/12/2025). Institutional permission to conduct the study was also obtained from Acharya Narendra Dev Nagar Nigam Mahila Mahavidyalaya (ANDNNMM), affiliated to Chhatrapati Shahu Ji Maharaj University, Kanpur, Uttar Pradesh, India. All procedures performed in this study were in accordance with the ethical standards of the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct and other relevant national and institutional guidelines governing research involving human participants. Informed consent was obtained from all individual participants included in the study prior to data collection. Participants were informed about the purpose of the research, their voluntary participation, confidentiality of their responses, and their right to withdraw from the study at any stage without any consequences. Consent to Participate Informed consent was obtained from all individual participants prior to their inclusion in the study. Participants were informed about the objectives, procedures, and voluntary nature of the research. They were assured that their participation was entirely voluntary and that they could withdraw from the study at any stage without any penalty or negative consequences. Consent to Publish The manuscript does not contain any identifiable personal information, photographs, or images of participants. Therefore, specific consent for publication of identifying information was not required. All participant information has been anonymized to ensure confidentiality and privacy. Funding The authors received no financial support for the research, authorship, and/or publication of this article. Competing Interests The authors declare that they have no competing interests. Clinical Trial Registration Not applicable. This study does not involve a clinical trial. References United Nations, Department of Economic and Social Affairs, Population Division. World population ageing 2022: highlights . New York: United Nations; 2022. World Health Organization. Decade of healthy ageing: baseline report . Geneva: World Health Organization; 2021. Bloom DE, Canning D, Fink G. Implications of population ageing for economic growth. Oxford Rev Econ Policy . 2015;31(4):583–612. Rajan SI, Kumar S. Living arrangements among Indian elderly: new evidence from national family health survey. J Cross Cult Gerontol . 2013;28(4):423–435. Achenbaum WA. Crossing frontiers: gerontology emerges as a science . New York: Cambridge University Press; 1995. Bhat AK, Dhruvarajan R. Ageing in India: drifting intergenerational relations, challenges and options. Ageing Int . 2001;27(2):5–22. Goode WJ. World revolution and family patterns . New York: Free Press; 1963. Estes CL. The aging enterprise . San Francisco: Jossey-Bass; 1979. Cowgill DO. Aging and modernization: a revision of the theory. In: Late-life transitions. Springfield: Charles C Thomas; 1974. p. 123–146. Gupta R. Elder neglect in urban India: a growing concern. Indian J Soc Work . 2012;73(3):345–360. HelpAge India. Elder abuse in India report 2018 . New Delhi: HelpAge India; 2018. Dey A. Institutional care of the elderly in India: issues and challenges. Indian J Gerontol . 2016;30(2):215–230. Lamb S. Aging and the Indian diaspora: cosmopolitan families in India and abroad . Bloomington: Indiana University Press; 2009. Goffman E. Asylums: essays on the social situation of mental patients and other inmates . New York: Anchor Books; 1961. Cacioppo JT, Hawkley LC. Social isolation and health, with an emphasis on underlying mechanisms. Perspect Biol Med . 2002;46(3 Suppl):S39–S52. Chaudhuri A, Roy K. Adjustment patterns among elderly residents in institutional settings in India. J Gerontol Soc Work . 2020;63(5):456–472. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review. Curr Dir Psychol Sci . 2010;19(2):71–75. National Sample Survey Office (NSSO). Key indicators of social consumption: health among the elderly in India . New Delhi: Ministry of Statistics and Programme Implementation; 2017. World Health Organization. World report on ageing and health . Geneva: WHO; 2015. Palacios R, Sluchynsky O. Social pensions part I: their role in the overall pension system . Washington (DC): World Bank; 2002. Agarwal B. Gender and ageing in India: a review. Indian J Gender Stud . 2010;17(2):239–265. Das M. Widowhood and mental health among elderly women in India. J Women Aging . 2015;27(3):245–260. Cumming E, Henry WE. Growing old: the process of disengagement . New York: Basic Books; 1961. Havighurst RJ. Successful aging. In: Williams RH, Tibbitts C, Donahue W, editors. Processes of aging . New York: Atherton Press; 1963. p. 299–320. Atchley RC. A continuity theory of normal aging. Gerontologist . 1989;29(2):183–190. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 14 May, 2026 Reviews received at journal 08 May, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviews received at journal 27 Apr, 2026 Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers invited by journal 13 Apr, 2026 Editor assigned by journal 26 Mar, 2026 Editor invited by journal 13 Mar, 2026 Submission checks completed at journal 13 Mar, 2026 First submitted to journal 12 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9035987","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":625425543,"identity":"ceaa1c52-7b35-4299-8e27-dac25b515de8","order_by":0,"name":"Jaya Bharti","email":"data:image/png;base64,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","orcid":"","institution":"Acharya Narendra Dev Nagar Nigam Mahila Mahavidyalaya (CSJM University","correspondingAuthor":true,"prefix":"","firstName":"Jaya","middleName":"","lastName":"Bharti","suffix":""},{"id":625425546,"identity":"4f18a455-f39e-4323-840b-7104dba83e66","order_by":1,"name":"Shyam Mishra","email":"","orcid":"","institution":"Vidya Mandir Degree College, Affiliated to C.S.J.M. University (Kanpur)","correspondingAuthor":false,"prefix":"","firstName":"Shyam","middleName":"","lastName":"Mishra","suffix":""},{"id":625425547,"identity":"a81ceb5f-3d96-4ddc-a2b8-37560a70fb59","order_by":2,"name":"Sandeep Verma","email":"","orcid":"","institution":"K.S. Saket P.G. College (Affiliated to Dr. Ram Manohar Lohia Avadh University","correspondingAuthor":false,"prefix":"","firstName":"Sandeep","middleName":"","lastName":"Verma","suffix":""}],"badges":[],"createdAt":"2026-03-05 05:08:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9035987/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9035987/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107486106,"identity":"5ae4d2a7-aac1-4dac-9a8b-f75308196bea","added_by":"auto","created_at":"2026-04-22 02:37:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":835832,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9035987/v1/233d2a6a-8145-4d1c-886b-d0ff6eca4dec.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Lived Experiences and Everyday Life of Elderly Residents Living in Old Age Homes","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003ePopulation aging is one of the most profound demographic transformations of the twenty-first century. Globally, improvements in public health, medical advancements, and socio-economic development have significantly increased life expectancy. According to the United Nations, the proportion of individuals aged 60 years and above is expected to double by 2050, reaching over 2\u0026nbsp;billion worldwide [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The World Health Organization further emphasizes that by 2030, one in six people globally will be aged 60 or older [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This demographic shift presents complex social, economic, and healthcare challenges, particularly in developing countries where institutional and policy frameworks are still evolving.\u003c/p\u003e \u003cp\u003eIndia is experiencing rapid demographic aging. Census projections indicate that the elderly population has grown substantially over the past two decades, with estimates suggesting over 138\u0026nbsp;million older persons in 2021 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Scholars argue that population aging in India is occurring at a much faster pace than the development of adequate social security systems [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Rajan and Kumar [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] observed that the traditional pattern of co-residence with children is declining, thereby increasing vulnerability among older adults.\u003c/p\u003e \u003cp\u003eHistorically, Indian society has been rooted in joint family systems where elderly individuals occupied respected positions within households. They served as custodians of tradition, decision-makers, and caregivers for grandchildren. However, sociological research indicates that modernization and industrialization have fundamentally altered family structures [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Bhat and Dhruvarajan [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] noted that intergenerational bonds have weakened due to migration, urban employment opportunities, and economic independence among younger members. Similarly, modern family theory suggests that nuclearization reduces daily interaction between generations, thereby weakening support systems [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe process of modernization has also contributed to what scholars describe as the \u0026ldquo;marginalization of aging\u0026rdquo; [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Cowgill\u0026rsquo;s modernization theory argues that industrialization diminishes the status of older persons in society [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Studies conducted in urban India have shown increasing instances of neglect and emotional abandonment [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The HelpAge India Report revealed that nearly 47% of elderly respondents experienced some form of neglect, including emotional, financial, or verbal abuse [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInstitutionalization of the elderly, once considered socially unacceptable in Indian culture, is gradually becoming more common. Research on old age homes indicates that such institutions provide safety and medical care but may fail to address emotional and psychological needs [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Lamb\u0026rsquo;s ethnographic study highlighted feelings of abandonment and loss among residents in Indian old age homes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Similarly, qualitative investigations reveal that relocation to institutional settings often results in identity crises and diminished self-worth [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLoneliness has emerged as one of the most critical concerns among institutionalized elderly individuals. The United Nations identifies social isolation as a growing global issue affecting older populations [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Psychological studies indicate a strong correlation between institutional living and depression [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Chaudhuri and Roy [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] found high levels of loneliness among elderly residents in care institutions, particularly among widowed individuals. Research in geriatric psychology also demonstrates that lack of meaningful social interaction increases the risk of cognitive decline and mental health disorders [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHealth vulnerabilities further complicate the aging experience. Studies show that chronic conditions such as diabetes, hypertension, and arthritis are prevalent among older adults in India [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The World Health Organization emphasizes that healthy aging requires more than medical intervention; it necessitates social participation, dignity, and inclusion [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Research in public health highlights the importance of community-based care models over purely institutional frameworks [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSocio-economic factors also influence elderly well-being. Economic insecurity remains a significant issue, particularly for those without pension coverage [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Feminization of aging is another emerging trend, with older women often facing compounded vulnerabilities due to widowhood and financial dependency [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Studies indicate that elderly women in institutional settings report higher levels of emotional distress compared to men [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTheoretical perspectives provide further understanding of aging experiences. Disengagement theory suggests that aging involves gradual withdrawal from social roles [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], whereas activity theory argues that continued engagement promotes well-being [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Continuity theory emphasizes maintaining consistent patterns of behavior and relationships throughout life [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. These theoretical frameworks highlight the importance of social interaction and meaningful participation in enhancing quality of life among older adults.\u003c/p\u003e \u003cp\u003eDespite extensive demographic and quantitative research, there remains limited qualitative exploration of the lived experiences of elderly individuals residing in semi-urban old age homes. Many studies focus on statistical trends, health indicators, or policy frameworks, but fewer studies capture the subjective emotions, narratives, coping mechanisms, and perceptions of institutional care from the residents\u0026rsquo; perspectives. Understanding these lived realities is crucial for designing policies that prioritize dignity, psychological well-being, and intergenerational solidarity.\u003c/p\u003e \u003cp\u003eTherefore, this study seeks to fill this research gap by conducting an in-depth qualitative investigation of elderly residents living in old age homes. By centering their voices through narrative inquiry and thematic analysis, the study aims to provide a holistic understanding of aging in institutional settings and contribute to the development of more humane and inclusive elderly care systems.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Objectives of the Study\u003c/h2\u003e \u003cp\u003eThe present study was undertaken with the primary objective of exploring the lived experiences of elderly residents residing in old age homes. Aging is not merely a biological process but also a deeply social and emotional experience shaped by family relationships, socio-economic conditions, and institutional environments. Therefore, this study seeks to understand how elderly individuals perceive and interpret their everyday lives within institutional settings.\u003c/p\u003e \u003cp\u003eA second objective of the research is to identify the emotional, social, and psychological challenges faced by elderly residents. Issues such as loneliness, neglect, loss of identity, declining health, and reduced social interaction are often associated with institutional living. By examining these aspects in depth, the study aims to highlight the multifaceted vulnerabilities experienced by older adults.\u003c/p\u003e \u003cp\u003e The study further aims to analyze residents\u0026rsquo; perceptions of institutional care, including their level of satisfaction with facilities, staff behavior, healthcare support, safety, and social environment within the old age homes. Understanding these perceptions helps in evaluating whether such institutions serve merely as shelter homes or function as supportive living communities.\u003c/p\u003e \u003cp\u003eAnother important objective is to explore the expectations elderly individuals hold toward their families, younger generations, society, and government institutions. Their perspectives provide valuable insights into intergenerational relationships and societal attitudes toward aging. Finally, the study seeks to offer policy-oriented suggestions and practical recommendations for improving elderly well-being, with a focus on dignity, inclusion, emotional security, and community participation.\u003c/p\u003e \u003c/div\u003e"},{"header":"2. Methodology","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.1Research Design\u003c/h2\u003e \u003cp\u003eThe study adopted a qualitative research design, as the primary aim was to explore subjective experiences, emotions, and personal narratives of elderly residents. Qualitative research is particularly appropriate for understanding complex social phenomena where human perceptions, meanings, and interpretations play a central role. Instead of focusing on numerical measurement alone, this approach emphasizes depth, context, and richness of data. Thematic analysis was used as the primary analytical framework, allowing the researcher to systematically identify patterns, recurring ideas, and underlying themes emerging from participants\u0026rsquo; narratives.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Area\u003c/h2\u003e \u003cp\u003eThe research was conducted in two selected old age homes situated in a semi-urban region of India, chosen to reflect diverse geographic and socio-cultural contexts. One institution was managed by a non-governmental organization (NGO) catering to residents from multiple states, while the other was privately operated and drew elderly individuals from different regions of the country. This selection strategy ensured representation from northern, southern, eastern, and western parts of India, capturing variations in language, culture, and family backgrounds. Both institutions provided residential care, nutritious meals, and basic medical facilities for elderly residents. By including institutions with diverse management styles and resident profiles, the study enabled a comparative understanding of institutional experiences across regions and socio-cultural contexts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Sample\u003c/h2\u003e \u003cp\u003eThe total sample comprised 40 elderly residents aged between 60 and 85 years. Among them, 22 were female and 18 were male participants. A purposive sampling technique was employed, as the study required participants who were willing to share their experiences and were capable of engaging in detailed conversations. This method ensured that individuals with diverse backgrounds, varying lengths of stay, and different family circumstances were included. The sample represented widowed individuals, those without children, and residents who had been admitted due to family conflicts or financial difficulties.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data Collection Tools\u003c/h2\u003e \u003cp\u003eMultiple qualitative tools were used to ensure comprehensive data collection. Semi-structured interviews formed the primary method, allowing participants to freely express their thoughts while maintaining a guiding structure of key questions. Open-ended questionnaires were used to gather reflective responses related to emotional well-being, family relationships, and institutional satisfaction. Informal conversations were conducted to build rapport and capture spontaneous insights that might not emerge in formal interviews. Additionally, field notes were maintained to record observations regarding living conditions, interpersonal interactions, and non-verbal expressions, thereby enriching contextual understanding.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data Analysis\u003c/h2\u003e \u003cp\u003eAll interviews and discussions were transcribed verbatim to maintain accuracy. The data were analyzed using Thematic Analysis as proposed by Braun and Clarke (2006). The analytical process involved several systematic stages. First, familiarization with the data was achieved through repeated reading of transcripts. Second, initial codes were generated to identify significant statements and recurring ideas. Third, related codes were grouped to form broader themes representing patterns across participants. Fourth, themes were reviewed, refined, and interpreted in relation to the study objectives and existing literature. This step ensured coherence and conceptual clarity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Ethical Considerations\u003c/h2\u003e \u003cp\u003e Ethical principles were strictly maintained throughout the research process. Informed consent was obtained from all participants prior to data collection. Participants were assured that their identities would remain confidential and that pseudonyms would be used in reporting narratives. They were also informed that participation was voluntary and that they could withdraw at any time without any consequences. Special care was taken to conduct interviews sensitively, considering the emotional vulnerability of elderly participants.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results and Thematic Findings","content":"\u003cp\u003eThe qualitative analysis of in-depth interviews, open-ended responses, and observational field notes led to the identification of eight major themes reflecting the lived realities of elderly residents in institutional settings. The findings reveal complex interconnections between family dynamics, emotional well-being, health concerns, institutional adjustment, and social expectations. These themes emerged through systematic coding and thematic categorization of participants\u0026rsquo; narratives.\u003c/p\u003e \u003cp\u003eBefore presenting the thematic findings in detail, it is essential to understand the demographic profile of the participants, as age, gender, and marital status significantly influence experiences of aging, institutionalization, and emotional vulnerability. Demographic characteristics provide contextual grounding for interpreting the qualitative data and help in identifying patterns across different social categories.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Demographic Profile of Participants\u003c/h2\u003e \u003cp\u003eThe study included 40 elderly residents aged between 60 and 85 years residing in two selected old age homes. The demographic composition reflects diversity in age groups, gender distribution, and marital status. The consolidated demographic details are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic Profile of Participants (N\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026ndash;65 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66\u0026ndash;70 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u0026ndash;75 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u0026ndash;80 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81\u0026ndash;85 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried (Spouse not present)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced/Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e40\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e100%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs indicated in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the largest proportion of participants (25%) belonged to the 66\u0026ndash;70 years age group, followed closely by 22.5% in the 71\u0026ndash;75 years category. This suggests that many individuals entered institutional care during the early stages of old age rather than in advanced or dependent old age. The relatively higher percentage in the younger elderly categories may reflect early family breakdown, financial instability, or lack of caregiving support.\u003c/p\u003e \u003cp\u003eIn terms of gender distribution, females constituted 55% of the sample, slightly higher than males (45%). This pattern reflects the broader demographic phenomenon known as the feminization of aging, wherein women generally have higher life expectancy and are more likely to outlive their spouses. Additionally, older women often face greater socio-economic dependency, limited pension access, and vulnerability following widowhood.\u003c/p\u003e \u003cp\u003eMarital status data further strengthens this interpretation. Half of the participants (50%) were widowed, indicating that spousal loss is a major contributing factor to institutionalization. Widowhood often results in emotional distress, social isolation, and financial insecurity, particularly for women who may have relied on their husbands for economic stability. Moreover, 15% of participants were married but living separately from their spouses, suggesting circumstances such as illness, abandonment, or geographic separation. A smaller percentage were divorced or separated (12.5%), while 22.5% remained unmarried, indicating varied life trajectories influencing institutional living.\u003c/p\u003e \u003cp\u003eThe demographic characteristics outlined in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e provide crucial context for understanding the subsequent experiences of elderly residents within institutional settings. Factors such as age, gender, and marital status are closely associated with reasons for institutionalization, emotional well-being, and patterns of adjustment. For instance, younger elderly residents may face early family breakdown or financial challenges, while widowed individuals\u0026mdash;particularly women\u0026mdash;may experience heightened vulnerability and social isolation. These background factors help explain the diversity in experiences reflected in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, which presents patterns of institutional entry, emotional loneliness, and adaptation among the participants. By examining these demographic influences alongside lived experiences, the study contextualizes how structural, relational, and personal variables interact to shape life in old age homes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInstitutionalization, Emotional Well-being and Adjustment Patterns (N\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReasons for Institutionalization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily Conflict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eTheme1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeglect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinancial Issues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo Children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-decision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExperience of Loneliness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOften\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTheme2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Adjustment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWell-adjusted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eTheme3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerately adjusted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoorly adjusted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e integrates three major themes that emerged from participants\u0026rsquo; narratives:\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 1: Family Disintegration and Institutional Entry\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 2: Loneliness and Emotional Isolation\u003c/b\u003e, and\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 3: Adjustment and Adaptation to Institutional Life\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eTogether, these themes illustrate that institutionalization is not a single event but an ongoing psychosocial process shaped by relational rupture, emotional vulnerability, and adaptive reconstruction.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 1: Family Disintegration and Institutional Entry\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe most dominant factor underlying institutionalization was family conflict. A significant proportion of participants reported strained relationships within the household, often involving intergenerational disagreements, property-related disputes, or feelings of exclusion from decision-making processes. The prominence of relational conflict over financial hardship indicates that emotional and interpersonal breakdown, rather than economic deprivation alone, plays a central role in the transition to institutional living.\u003c/p\u003e \u003cp\u003eNeglect emerged as the second most significant factor. Importantly, participants rarely described physical abuse; instead, they emphasized emotional distancing. Being ignored in conversations, excluded from family events, or left alone for extended periods were frequently cited experiences. Such forms of emotional marginalization appeared deeply distressing and often precipitated the decision to relocate.\u003c/p\u003e \u003cp\u003eFinancial instability was another contributing factor, particularly among residents without pension security or independent income. However, even in economically vulnerable cases, emotional dimensions remained intertwined with financial strain.\u003c/p\u003e \u003cp\u003eThe presence of residents without children reflects structural vulnerability in later life, highlighting the absence of immediate familial caregivers. Interestingly, some participants described institutional entry as a self-initiated decision. Yet even voluntary relocation was often framed as an act of self-sacrifice\u0026mdash;an attempt to avoid becoming a burden to children. This internalization of responsibility reveals deeply embedded cultural expectations regarding aging, dependency, and parental selflessness.\u003c/p\u003e \u003cp\u003eThus, Theme 1 demonstrates that institutionalization is rarely accidental or purely economic. It emerges at the intersection of relational strain, emotional invisibility, structural vulnerability, and internalized duty.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 2: Loneliness and Emotional Isolation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eLoneliness emerged as one of the most persistent emotional experiences among residents. A large proportion of participants reported feeling lonely either frequently or intermittently, despite living in a shared environment. This finding underscores a crucial distinction between physical proximity and emotional connectedness.\u003c/p\u003e \u003cp\u003eParticipants described communal living spaces as socially active yet emotionally insufficient. Conversations often remained surface-level, centered on routine activities rather than personal histories or deep emotional exchange. Many residents expressed longing not for company in general, but specifically for meaningful family interaction.\u003c/p\u003e \u003cp\u003eLoneliness was frequently linked to reduced contact with children and grandchildren. Even when visits occurred, participants described them as brief or formal. This limited interaction intensified feelings of emotional displacement.\u003c/p\u003e \u003cp\u003eImportantly, loneliness appeared not only as sadness but also as a diminished sense of relevance. Several narratives conveyed feelings of being \u0026ldquo;left behind\u0026rdquo; in rapidly changing social environments. Festivals and family celebrations were particularly triggering moments, amplifying awareness of separation.\u003c/p\u003e \u003cp\u003eTheme 2 thus reveals that institutional living does not automatically resolve emotional isolation. While the institution provides structure and safety, the absence of intimate familial bonds continues to shape residents\u0026rsquo; psychological landscapes.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 3: Adjustment and Adaptation to Institutional Life\u003c/b\u003e \u003c/p\u003e \u003cp\u003eDespite emotional challenges, many residents described themselves as moderately or well-adjusted over time. Adjustment, however, was not immediate. Several participants recounted initial feelings of shock, grief, embarrassment, or perceived social failure upon entering the institution.\u003c/p\u003e \u003cp\u003eOver time, routine formation, peer interaction, participation in activities, and spiritual engagement facilitated gradual adaptation. The structured environment appeared to offer predictability, which contributed to emotional stabilization.\u003c/p\u003e \u003cp\u003eYet, a critical nuance emerges from the coexistence of reported adjustment and persistent loneliness. Adaptation did not necessarily imply emotional fulfillment. Residents often learned to function effectively within institutional norms while continuing to experience internal sadness or longing.\u003c/p\u003e \u003cp\u003ePoor adjustment among a smaller segment of residents appeared linked to recent relocation, severe health problems, or unresolved family conflicts. This suggests that adaptation capacity varies based on psychological resilience, duration of stay, and support systems.\u003c/p\u003e \u003cp\u003eTheme 3 therefore highlights adaptation as a dynamic and negotiated process. Institutional living becomes normalized over time, but normalization does not equate to restoration of belonging.\u003c/p\u003e \u003cp\u003eWhen examined collectively, the three themes in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e reveal a sequential yet overlapping process:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eRelational rupture\u003c/b\u003e initiates institutional entry.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eEmotional isolation\u003c/b\u003e persists within the institutional setting.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAdaptive strategies\u003c/b\u003e gradually reconstruct functional stability.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eHowever, this reconstruction remains partial. Institutionalization addresses safety and structural stability but cannot fully compensate for fractured intergenerational bonds. The findings indicate that emotional marginalization\u0026mdash;more than overt abuse or poverty\u0026mdash;is a central pathway to institutional care. Furthermore, while residents demonstrate resilience and adaptive capacity, underlying loneliness continues to shape their lived experiences. Thus, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights a structural gap between functional adaptation and emotional fulfillment. Institutional living represents a negotiated compromise between security and belonging.\u003c/p\u003e \u003cp\u003eWhile Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights the reasons for institutionalization, the prevalence of loneliness, and patterns of adjustment among residents, it is also essential to consider how these experiences interact with other dimensions of daily life in old age homes. Physical health, social integration, satisfaction with institutional services, spiritual engagement, and self-perception play a critical role in shaping overall well-being. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents these interconnected domains, illustrating how chronic health conditions, quality of social relationships, emotional coping mechanisms, and perceived dignity influence the lived experience of institutionalized elderly. By examining these aspects in conjunction with adaptation patterns, the study provides a comprehensive understanding of how structural, relational, and psychosocial factors collectively impact aging with dignity.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: \u003cb\u003eHealth Status, Social Integration, Satisfaction, Spiritual Engagement and Self-Perception (N\u0026thinsp;=\u0026thinsp;40)\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTable 3 presents a multidimensional profile of institutional life by integrating five critical domains: chronic health status, social interaction patterns, perceived institutional satisfaction, spiritual engagement, and self-perception. When examined collectively, these dimensions illuminate the complex interplay between physical security and psychological identity within institutional settings. The findings demonstrate that while institutional care effectively addresses survival and safety needs, existential and relational needs remain partially unresolved.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003e\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic Health Conditions\u003c/b\u003e*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTheme 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eArthritis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart-related issues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo major illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNature of Social Interaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClose friendships\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTheme 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCasual interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinimal interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocially withdrawn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with Institutional Services\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighly satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTheme 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSpiritual Engagement\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTheme 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOccasional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot engaged\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Perception\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeel valued\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTheme 8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed feelings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeel burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeel irrelevant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e captures five interconnected themes that emerged from participants\u0026rsquo; narratives:\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 4: Health Vulnerability and Dependency\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 5: Social Relationships within the Institution\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 6: Perception of Institutional Care and Services\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 7: Spirituality and Coping Mechanisms\u003c/b\u003e, and\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 8: Self-Perception, Dignity, and Sense of Worth\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eTogether, these themes reveal the complex negotiation between physical security and psychological identity within institutional settings. While institutional care ensures structural stability, deeper existential and relational needs remain unevenly fulfilled.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 4: Health Vulnerability and Dependency\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA dominant reality shaping institutional life was the widespread presence of chronic illness. Hypertension, diabetes, arthritis, and heart-related conditions were commonly reported, reflecting the broader epidemiological profile of aging populations. However, participants did not describe illness solely as a medical condition. Rather, it emerged as a lived experience influencing autonomy, daily routine, and emotional stability.\u003c/p\u003e \u003cp\u003eChronic illness structured residents\u0026rsquo; everyday lives through medication schedules, dietary restrictions, and mobility limitations. Several participants expressed concern about progressive deterioration and the possibility of becoming fully dependent. Even though institutional healthcare provided regular monitoring and immediate assistance, illness remained a constant reminder of fragility and mortality.\u003c/p\u003e \u003cp\u003eHealth vulnerability therefore operated at both physical and symbolic levels. It reinforced dependence on caregivers and shaped self-perception. For some residents, declining physical capacity was closely associated with reduced self-confidence and diminished authority. Thus, health status influenced not only bodily well-being but also dignity and identity.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 5: Social Relationships within the Institution\u003c/b\u003e \u003c/p\u003e \u003cp\u003eInstitutional living created a shared social environment, yet the quality of relationships varied significantly. While many residents reported regular interaction with peers, most characterized these relationships as casual rather than deeply intimate.\u003c/p\u003e \u003cp\u003eParticipants often described companionship rooted in shared routines and collective living conditions. Conversations occurred during meals, recreational activities, or religious gatherings. However, emotional disclosure and profound attachment were less common. This distinction highlights a critical difference between social presence and emotional closeness.\u003c/p\u003e \u003cp\u003eA minority of residents remained minimally interactive or socially withdrawn. Withdrawal appeared linked to grief, chronic pain, introverted personality traits, or unresolved family conflict. For some, maintaining emotional distance served as a protective coping strategy.\u003c/p\u003e \u003cp\u003eThus, institutional social networks functioned as substitute communities but did not fully replicate the depth of familial bonds. Interaction reduced complete isolation, yet emotional belonging remained partial.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 6: Perception of Institutional Care and Services\u003c/b\u003e \u003c/p\u003e \u003cp\u003e Participants generally expressed satisfaction with institutional services, particularly in relation to food, cleanliness, medical supervision, and safety. For several residents, institutional life offered greater stability compared to previous living arrangements characterized by neglect or conflict.\u003c/p\u003e \u003cp\u003eHowever, satisfaction was predominantly associated with material and structural aspects of care. Residents appreciated predictable routines and accessible healthcare, which reduced anxiety about survival needs. Nevertheless, emotional fulfillment did not automatically accompany logistical adequacy.\u003c/p\u003e \u003cp\u003eThe presence of neutral or dissatisfied responses suggests variability in expectations and experiences. Some participants desired greater recreational engagement, increased privacy, or more personalized interaction. This indicates that institutional effectiveness cannot be evaluated solely on infrastructural grounds.\u003c/p\u003e \u003cp\u003eThe theme thus reflects a dual reality: institutions succeed in meeting basic and safety needs, yet higher-order emotional needs require additional attention.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 7: Spirituality and Coping Mechanisms\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSpiritual engagement emerged as one of the most powerful coping mechanisms within the institutional context. A majority of participants reported daily or regular involvement in prayer, meditation, or religious practices.\u003c/p\u003e \u003cp\u003eSpirituality provided emotional reassurance and a sense of continuity amidst change. Participants frequently described faith as a source of peace, acceptance, and inner strength. Rather than interpreting institutionalization purely as abandonment, some reframed it within a spiritual narrative of destiny or divine will.\u003c/p\u003e \u003cp\u003eSpiritual coping appeared to moderate distress related to loneliness, illness, and separation. In situations where external circumstances were difficult to alter, faith enabled internal adaptation. This reflects a shift from control over environment to control over interpretation.\u003c/p\u003e \u003cp\u003eThus, spirituality functioned not merely as religious observance but as a psychological stabilizer and meaning-making framework.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 8: Self-Perception, Dignity, and Sense of Worth\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSelf-perception emerged as one of the most sensitive and complex themes. While a portion of residents reported feeling valued and respected within the institution, a considerable number expressed ambivalence or internalized feelings of being a burden.\u003c/p\u003e \u003cp\u003eThe \u0026ldquo;burden narrative\u0026rdquo; appeared repeatedly across interviews. Many residents emphasized that they did not wish to inconvenience their children. Even those who voluntarily entered institutional care framed their decision as an act of responsibility toward their family rather than as personal choice.\u003c/p\u003e \u003cp\u003e Feelings of worth were closely linked to respectful treatment by staff, participation in activities, and opportunities to express opinions. Simple acts\u0026mdash;such as being consulted in decisions or addressed politely\u0026mdash;significantly strengthened dignity.\u003c/p\u003e \u003cp\u003eConversely, rigid schedules, restricted autonomy, and health-related dependency sometimes contributed to diminished identity. Residents who perceived themselves as socially irrelevant often associated this feeling with loss of previous roles within the family and community.\u003c/p\u003e \u003cp\u003eThus, dignity within institutional settings depends not only on physical care but also on symbolic recognition and participatory inclusion.\u003c/p\u003e \u003cp\u003eWhen the five themes are examined collectively, Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e reveals a layered and paradoxical reality of institutional living. Physical care and medical supervision are largely stabilized. Social interaction exists and provides moderate companionship. Spiritual practices foster resilience and emotional acceptance. Yet identity-related vulnerabilities persist beneath structural security. Chronic illness reinforces dependency, social interaction mitigates but does not eliminate loneliness, institutional satisfaction ensures safety without guaranteeing belonging, and spirituality provides coping without fully restoring relational intimacy. Institutional life therefore represents a negotiated balance between protection and selfhood. While survival and safety needs are effectively addressed, belongingness, esteem, and meaningful contribution remain areas of ongoing struggle.\u003c/p\u003e \u003cp\u003eThe findings indicate that holistic elderly care must extend beyond infrastructure toward emotional validation, autonomy support, identity preservation, and opportunities for meaningful engagement. Without such efforts, institutional systems risk achieving structural efficiency while leaving existential needs only partially fulfilled.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe present study examined the lived experiences of elderly residents in institutional settings, identifying eight major themes that reflect structural, emotional, health-related, and psychosocial dimensions of aging. These findings are situated within the context of global demographic shifts, Indian socio-cultural transformation, and established gerontological theories, highlighting the multifaceted nature of institutionalized aging.\u003c/p\u003e \u003cp\u003ePopulation aging is a defining demographic trend of the 21st century. The United Nations (2022) reports that the global population aged 60 and above is growing faster than any other age group. Similarly, the World Health Organization (2021) emphasizes that aging encompasses not only biological changes but also structural, social, and cultural processes that require integrated policy interventions. Bloom et al. (2015) note that demographic aging reshapes family systems, dependency ratios, and welfare arrangements. Against this backdrop, the experiences of institutionalized elderly must be interpreted as part of broader societal and demographic transformations.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Family Disintegration and Structural Transformation\u003c/h2\u003e \u003cp\u003eFamily conflict and emotional neglect emerged as the most prominent reasons for institutionalization. This aligns with Lamb (2009), who emphasized that emotional abandonment increasingly drives elderly displacement in India, and with HelpAge India (2018), which documented rising emotional neglect in urban households.\u003c/p\u003e \u003cp\u003eThe observed shift from joint to nuclear families corroborates Goode\u0026rsquo;s (1963) thesis on global family transformation, highlighting how industrialization and urbanization weaken extended kinship structures. Rajan and Kumar (2013) similarly noted declining co-residence trends among Indian elderly, particularly in urban areas.\u003c/p\u003e \u003cp\u003eCowgill\u0026rsquo;s Modernization Theory (1974) provides further explanatory insight: modernization diminishes the authority, economic productivity, and symbolic status of older persons. Participants\u0026rsquo; narratives reflected this declining relevance, as older adults experienced reduced decision-making influence and moral authority within their families.\u003c/p\u003e \u003cp\u003eBhat and Dhruvarajan (2001) describe this as a \u0026ldquo;care gap,\u0026rdquo; where traditional family-based support erodes more rapidly than institutional alternatives develop. Many residents framed institutionalization as a \u0026ldquo;last resort,\u0026rdquo; reflecting tensions between cultural expectations of filial duty and modern socio-economic realities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Emotional Neglect and Loneliness\u003c/h2\u003e \u003cp\u003eLoneliness and emotional isolation were pervasive, even among residents with regular peer interaction. This resonates with Cacioppo\u0026rsquo;s (2002) conceptualization of loneliness as perceived social isolation and Hawkley \u0026amp; Cacioppo\u0026rsquo;s (2010) findings linking chronic loneliness to depression, cognitive decline, and cardiovascular risk.\u003c/p\u003e \u003cp\u003eThe NSSO Elderly Health Survey (2017) similarly reports high levels of emotional distress among institutionalized or isolated elderly individuals, and Gupta (2012) identifies emotional neglect\u0026mdash;not physical abuse\u0026mdash;as the most prevalent form of elder mistreatment in urban India.\u003c/p\u003e \u003cp\u003eGoffman\u0026rsquo;s (1961) analysis of institutional life provides further interpretive depth. Structured routines, regulated mobility, and limited autonomy create subtle forms of depersonalization. Participants\u0026rsquo; experiences of invisibility, marginalization, and loss of voice reflect this dynamic. Emotional neglect, therefore, emerges as a critical determinant of psychological vulnerability within institutional settings.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Health Vulnerability and the Biomedicalization of Aging\u003c/h2\u003e \u003cp\u003eChronic health conditions, particularly hypertension and diabetes, were highly prevalent, consistent with global aging reports (UN, 2022; WHO, 2021). While institutions successfully addressed medical needs, residents reported that psychosocial integration and emotional support were insufficient.\u003c/p\u003e \u003cp\u003eEstes (1979) critiques the \u0026ldquo;biomedicalization\u0026rdquo; of aging, arguing that an overemphasis on medical management neglects dignity and social meaning. This study supports this critique: institutional care ensured medication adherence and routine health monitoring but did not necessarily alleviate fear of dependency or existential anxiety.\u003c/p\u003e \u003cp\u003eEconomic insecurity compounded these vulnerabilities. Participants without stable pensions expressed heightened dependency and psychological fragility, echoing Palacios (2002) on the inadequacy of financial protection among Indian elderly.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Adaptation and Theories of Successful Aging\u003c/h2\u003e \u003cp\u003eAdjustment to institutional life varied widely. Atchley\u0026rsquo;s Continuity Theory (1989) helps explain why residents who maintained familiar habits\u0026mdash;religious practices, reading routines, or social roles\u0026mdash;demonstrated smoother psychological adaptation.\u003c/p\u003e \u003cp\u003eIn contrast, Cumming \u0026amp; Henry\u0026rsquo;s Disengagement Theory (1961) posits that aging involves natural withdrawal from social roles. Findings here suggest that institutional withdrawal was often involuntary, stemming from structural or relational limitations rather than developmental necessity.\u003c/p\u003e \u003cp\u003eHavighurst\u0026rsquo;s Activity Theory (1963) aligns closely with observed outcomes. Residents participating in group discussions, recreational activities, and spiritual routines reported higher life satisfaction, confirming the importance of engagement and meaningful activity in promoting well-being. Chaudhuri \u0026amp; Roy (2020) similarly report that adaptation improves with peer integration and supportive institutional culture.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Institutional Relationships and Identity Reconstruction\u003c/h2\u003e \u003cp\u003eSocial networks within institutions functioned as surrogate family systems, providing support but lacking the depth of biological bonds. Achenbaum (1995) observes that institutionalization transforms identity from family-based roles to \u0026ldquo;resident\u0026rdquo; status, requiring residents to renegotiate self-perception.\u003c/p\u003e \u003cp\u003eSymbolic respect\u0026mdash;from peers and staff through consultation, polite address, and inclusion in activities\u0026mdash;significantly reinforced dignity. This aligns with WHO\u0026rsquo;s community-based care framework (2015), emphasizing person-centered approaches over custodial care.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Gendered Dimensions of Aging\u003c/h2\u003e \u003cp\u003eFemale residents slightly outnumbered males, reflecting the feminization of aging. Agarwal (2010) highlights gendered economic disparities among older adults, while Das (2015) links widowhood to social marginalization and depressive symptoms.\u003c/p\u003e \u003cp\u003eIn the present study, half of the participants were widowed, underscoring compounded emotional and economic vulnerabilities for women. Widowhood not only limits companionship but often reduces decision-making autonomy and access to resources.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.7 Spiritual Coping and Cultural Context\u003c/h2\u003e \u003cp\u003eSpirituality emerged as a central coping mechanism, consistent with Lamb (2009) and culturally contextualized aging experiences in India. Residents often reframed institutionalization and familial separation as part of divine will or karmic destiny, reducing emotional resentment.\u003c/p\u003e \u003cp\u003eSpiritual engagement also aligns with Atchley\u0026rsquo;s Continuity Theory (1989), enabling residents to maintain identity and routine through long-standing religious practices. In contrast to many Western secular models, spiritual coping is integral to daily psychological resilience among Indian elderly.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.8 Structural Policy Gaps and Implications\u003c/h2\u003e \u003cp\u003eIndia\u0026rsquo;s rapid demographic transition is occurring without proportionate expansion of formal eldercare infrastructure (UN, 2022; Bloom et al., 2015). While old age homes provide shelter and medical supervision, participants consistently framed institutional living as a \u0026ldquo;last resort.\u0026rdquo;\u003c/p\u003e \u003cp\u003eEstes (1979) notes that aging policy often prioritizes survival over quality of life. In this study, limited psychosocial services highlight a policy gap: infrastructure alone cannot ensure dignity, emotional well-being, or meaningful engagement. WHO (2015) emphasizes community-based models as culturally appropriate alternatives, which resonate with participants\u0026rsquo; desire for intergenerational contact and social inclusion.\u003c/p\u003e \u003cp\u003eThe findings underscore that holistic eldercare must integrate physical safety with psychosocial support, relational belonging, identity affirmation, and dignity-centered interventions. Aging with dignity thus requires a balance between structural provision and emotional, social, and spiritual recognition.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe present study examined the lived experiences of elderly residents in institutional settings and revealed that while old age homes provide essential physical security, structured routine, and medical supervision, they are unable to fully replace the emotional depth and attachment associated with family life. Institutional care ensures shelter, food, and safety; however, the findings clearly demonstrate that emotional belonging, dignity, meaningful communication, and intergenerational connection remain central to elderly well-being.\u003c/p\u003e \u003cp\u003eA major conclusion emerging from this study is that institutionalization in the Indian context continues to be perceived as a last resort rather than a preferred living arrangement. Unlike Western societies where assisted living facilities are often normalized as part of retirement planning, elderly individuals in this study associated old age homes with family breakdown, emotional neglect, or unavoidable circumstances such as widowhood and financial insecurity. This highlights the continued cultural significance of filial responsibility and joint family traditions in India, even amid rapid modernization and urbanization.\u003c/p\u003e \u003cp\u003eThe study further concludes that emotional well-being is more strongly influenced by quality of relationships than by infrastructural comfort. Participants consistently emphasized respect, recognition, and being heard as more valuable than material facilities. The recurring narrative of \u0026ldquo;not wanting to be a burden\u0026rdquo; reflects deep psychological internalization of dependency fears. Therefore, elderly care must move beyond a welfare-oriented approach and adopt a dignity-centered model that prioritizes autonomy, participation, and identity preservation.\u003c/p\u003e \u003cp\u003eSpiritual coping mechanisms emerged as a significant resilience factor, suggesting that culturally rooted support systems play a crucial role in psychological adaptation. Institutional frameworks should therefore integrate psychosocial and spiritual dimensions alongside medical care to promote holistic aging.\u003c/p\u003e"},{"header":"6. Policy Implications","content":"\u003cp\u003eThe findings of this study carry important policy implications. First, there is a need to strengthen \u003cb\u003eintergenerational community programs\u003c/b\u003e that foster interaction between youth and older adults. Community-based engagement can help rebuild respect, reduce stereotypes, and restore emotional connectivity between generations.\u003c/p\u003e \u003cp\u003eSecond, \u003cb\u003eregular psychological counseling services\u003c/b\u003e should be integrated into institutional settings. Mental health support, grief counseling, and group therapy sessions can address loneliness, identity crisis, and feelings of abandonment that are common among residents.\u003c/p\u003e \u003cp\u003eThird, the strengthening of \u003cb\u003egovernment pension schemes and financial security mechanisms\u003c/b\u003e is essential. Economic independence enhances dignity and reduces perceptions of dependency. Expansion of social pensions and timely disbursement can significantly improve elderly confidence and autonomy.\u003c/p\u003e \u003cp\u003eFourth, \u003cb\u003eawareness campaigns promoting elderly respect and caregiving responsibility\u003c/b\u003e should be conducted at community and national levels. Public education initiatives can challenge negative aging stereotypes and reinforce cultural values of care and reciprocity.\u003c/p\u003e \u003cp\u003eOverall, institutional care must shift from a \u0026ldquo;shelter-based\u0026rdquo; custodial model to a \u003cb\u003e\u0026ldquo;dignity-centered\u0026rdquo; person-focused model\u003c/b\u003e, where elderly individuals are not merely recipients of care but active participants in social and emotional life. Such a shift requires integrated policy, professional training, and societal attitude transformation.\u003c/p\u003e"},{"header":"7. Limitations of the Study","content":"\u003cp\u003eDespite its contributions, this study has certain limitations that must be acknowledged. First, the sample size was relatively small, consisting of 40 participants. While the qualitative approach allowed for in-depth exploration of personal experiences, the limited number of respondents restricts the statistical generalizability of the findings to the broader elderly population.\u003c/p\u003e \u003cp\u003eSecond, the study was confined to two institutional settings. Institutional culture, management style, and service quality may vary significantly across regions and types of old age homes (government-run, private, or charitable). Therefore, the findings reflect the specific contexts studied and may not fully represent all institutional environments in India.\u003c/p\u003e \u003cp\u003eThird, the qualitative research design emphasizes subjective experiences and thematic interpretation. Although this approach provides rich, contextual understanding, it limits the ability to establish causal relationships or produce quantifiable comparisons at a national level.\u003c/p\u003e \u003cp\u003eAdditionally, responses may have been influenced by social desirability bias, as some participants may have hesitated to criticize institutional conditions openly. Emotional sensitivity surrounding family issues might also have affected the depth of disclosure.\u003c/p\u003e \u003cp\u003eFuture research could adopt a mixed-method design incorporating larger samples across multiple regions, enabling broader generalization. Comparative studies between community-dwelling elderly and institutionalized residents would also provide deeper insights into the impact of living arrangements on well-being.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003eData availability\u003c/h3\u003e\n\u003cp\u003eThe data analyzed for this paper are available from the author upon reasonable request meeting institutional guidelines.\u003c/p\u003e\n\u003ch3\u003eAcknowledgements\u003c/h3\u003e\n\u003cp\u003eThe authors sincerely thank all the participants for their valuable time, openness, and cooperation. Their willingness to share their lived experiences made this research possible. The authors also express gratitude to the authorities of the old age homes and the Department of Psychology, Acharya Narendra Dev Nagar Nigam Mahila Mahavidyalaya, Kanpur, for their support during the data collection process.\u003c/p\u003e\n\u003ch3\u003eEthical Approval and Accordance\u003c/h3\u003e\n\u003cp\u003eThe study involving human participants was conducted in accordance with established ethical principles for research involving human subjects. The research protocol was reviewed and approved by the Research Expert and Ethics Committee, Chhatrapati Shahu Ji Maharaj University (CSJMU), Kanpur, Uttar Pradesh, India (Ref. No. 20/12/2025). Institutional permission to conduct the study was also obtained from Acharya Narendra Dev Nagar Nigam Mahila Mahavidyalaya (ANDNNMM), affiliated to Chhatrapati Shahu Ji Maharaj University, Kanpur, Uttar Pradesh, India.\u003c/p\u003e\n\u003cp\u003eAll procedures performed in this study were in accordance with the ethical standards of the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct and other relevant national and institutional guidelines governing research involving human participants.\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study prior to data collection. Participants were informed about the purpose of the research, their voluntary participation, confidentiality of their responses, and their right to withdraw from the study at any stage without any consequences.\u003c/p\u003e\n\u003ch3\u003eConsent to Participate\u003c/h3\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants prior to their inclusion in the study. Participants were informed about the objectives, procedures, and voluntary nature of the research. They were assured that their participation was entirely voluntary and that they could withdraw from the study at any stage without any penalty or negative consequences.\u003c/p\u003e\n\u003ch3\u003eConsent to Publish\u003c/h3\u003e\n\u003cp\u003eThe manuscript does not contain any identifiable personal information, photographs, or images of participants. Therefore, specific consent for publication of identifying information was not required. All participant information has been anonymized to ensure confidentiality and privacy.\u003c/p\u003e\n\u003ch3\u003eFunding\u003c/h3\u003e\n\u003cp\u003eThe authors received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003ch3\u003eCompeting Interests\u003c/h3\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch3\u003eClinical Trial Registration\u003c/h3\u003e\n\u003cp\u003eNot applicable. This study does not involve a clinical trial.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUnited Nations, Department of Economic and Social Affairs, Population Division. \u003cem\u003eWorld population ageing 2022: highlights\u003c/em\u003e. New York: United Nations; 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. \u003cem\u003eDecade of healthy ageing: baseline report\u003c/em\u003e. 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New Delhi: Ministry of Statistics and Programme Implementation; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. \u003cem\u003eWorld report on ageing and health\u003c/em\u003e. Geneva: WHO; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePalacios R, Sluchynsky O. \u003cem\u003eSocial pensions part I: their role in the overall pension system\u003c/em\u003e. Washington (DC): World Bank; 2002.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAgarwal B. Gender and ageing in India: a review. \u003cem\u003eIndian J Gender Stud\u003c/em\u003e. 2010;17(2):239\u0026ndash;265.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDas M. Widowhood and mental health among elderly women in India. \u003cem\u003eJ Women Aging\u003c/em\u003e. 2015;27(3):245\u0026ndash;260.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCumming E, Henry WE. \u003cem\u003eGrowing old: the process of disengagement\u003c/em\u003e. New York: Basic Books; 1961.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHavighurst RJ. Successful aging. In: Williams RH, Tibbitts C, Donahue W, editors. \u003cem\u003eProcesses of aging\u003c/em\u003e. New York: Atherton Press; 1963. p. 299\u0026ndash;320.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAtchley RC. A continuity theory of normal aging. \u003cem\u003eGerontologist\u003c/em\u003e. 1989;29(2):183\u0026ndash;190.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-aging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Aging](https://link.springer.com/journal/44518)","snPcode":"44518","submissionUrl":"https://submission.springernature.com/new-submission/44518/3","title":"Discover Aging","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Aging, Old Age Homes, Elderly Care, Qualitative Research, Thematic Analysis, Social Change, Loneliness, Institutional Living, Intergenerational Gap, NSS Study","lastPublishedDoi":"10.21203/rs.3.rs-9035987/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9035987/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRapid socio-cultural transformations, including urbanization, migration, and the restructuring of joint family systems, have significantly altered traditional models of elderly care in India. Old age homes, once perceived as culturally stigmatized institutions, are increasingly emerging as alternative residential arrangements for senior citizens. This qualitative study explores the lived experiences, emotional well-being, social integration, health concerns, and identity perceptions of elderly residents residing in institutional settings. The research was conducted under the framework of the National Service Scheme (NSS) community engagement initiative and involved in-depth interviews and open-ended survey responses from 40 elderly residents across two old age homes.\u003c/p\u003e\n\u003cp\u003eThematic analysis generated eight interconnected themes: (1) Family Disintegration and Changing Social Values, (2) Loneliness and Emotional Isolation, (3) Health Vulnerability and Medical Dependency, (4) Adjustment and Adaptive Coping, (5) Social Relationships within Institutional Settings, (6) Perceptions of Institutional Care and Services, (7) Expectations from Youth and Broader Society, and (8) Spirituality as a Meaning-Making Resource.\u003c/p\u003e\n\u003cp\u003eFindings indicate that while institutional environments largely ensure physical security, routine medical care, and basic material support, emotional fulfillment and identity affirmation remain only partially addressed. Residents frequently negotiate feelings of abandonment, diminished authority, and perceived burden alongside gradual adaptation and spiritual resilience. The coexistence of structural care and emotional vulnerability reveals a critical gap between functional adjustment and psychosocial well-being.\u003c/p\u003e\n\u003cp\u003eThe study underscores the urgent need for holistic elderly care models that integrate emotional recognition, intergenerational engagement, community participation, and dignity-centered policy reforms. Strengthening relational belonging and identity preservation within institutional contexts is essential to ensuring not merely extended life, but aging with dignity.\u003c/p\u003e","manuscriptTitle":"Lived Experiences and Everyday Life of Elderly Residents Living in Old Age Homes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-20 17:56:27","doi":"10.21203/rs.3.rs-9035987/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-14T22:45:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-08T17:05:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"101495906886358340943786277066686631904","date":"2026-04-29T15:35:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-27T07:35:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-14T20:19:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11144218240931922296809078994253504251","date":"2026-04-14T14:49:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283188121188500752101500197170054011857","date":"2026-04-14T07:05:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17342531024866480329319795198697539239","date":"2026-04-13T17:38:46+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-13T12:23:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-26T16:20:06+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-13T21:51:15+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-13T14:15:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Aging","date":"2026-03-12T20:43:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-aging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Aging](https://link.springer.com/journal/44518)","snPcode":"44518","submissionUrl":"https://submission.springernature.com/new-submission/44518/3","title":"Discover Aging","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0615e6cd-b07d-4df4-8e26-7297f24dac29","owner":[],"postedDate":"April 20th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-14T22:45:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-08T17:05:57+00:00","index":62,"fulltext":""},{"type":"reviewerAgreed","content":"101495906886358340943786277066686631904","date":"2026-04-29T15:35:29+00:00","index":59,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T19:38:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-20 17:56:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9035987","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9035987","identity":"rs-9035987","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}