“There’s no place like home, but…”: dependent older adults’ narratives on the health and well-being limits of ageing in place

Abstract

Background: In ageing societies, understanding the lived experiences of dependentolder adults is essential for designing care policies that support health, dignity, andwell-being. While ageing in place is widely promoted, less is known about howdependent older adults themselves define its limits.Aim: This study examines how dependent older adults describe the conditions underwhich ageing in place supports—or undermines— their dignity and quality of life. Methods: We conducted 30 in-depth interviews with individuals aged 65 and older inBarcelona, Spain, all officially recognized as having some degree of dependency. Interviewswere analysed using a thematic approach, according to environmental gerontology andperson–environment fit frameworks. Results: Ageing in place emerged not as a fixed preference but as a fragile and continu-ously negotiated process of the person-place relationship. Remaining at home is sustainedby symbolic autonomy and attachment to familiar environments, supporting control overdaily routines and a sense of dignity. At the same time, participants described a state ofcare liminality, continuously reassessing their ability to remain at home in light of antici-pated health decline. Three interconnected boundaries emerged: deteriorating health,perceived burden on family members, and loneliness. Conclusions: Ageing in place among dependent older adults should be understood asa conditional and relational process rather than a universal ideal. Recognising olderadults’ own definitions of its limits is essential for designing responsive care policies.