Ambiguous Loss Among Aging Migrants: A Concept Analysis- and Nursing Care-Oriented Model

Introduction: Ambiguous loss is a profound yet underexplored phenomenon in the lives of aging migrants. Older adults who have experienced migration often face disruptions to their sense of belonging, identity, and continuity across borders. These losses are compounded by aging, health challenges, and social isolation. Despite its significance, ambiguous loss among aging migrants has not been conceptually analyzed in depth, limiting the development of culturally responsive care practices. Aim: This concept analysis aimed to identify the defining attributes of ambiguous loss among aging migrants and to develop a conceptual definition that enhances our understanding of the phenomenon and informs future research and practice. Method: Walker and Avant's eight-step concept analysis framework was applied to examine the concept of ambiguous loss in the context of aging migrants. A systematic keyword search was conducted across four databases (CINAHL, Medline, SCOPUS, PsycINFO), Google Scholar, and relevant gray literature, covering the years of 2010-2024. Covidence software supported the screening process. From 367 records identified, 146 underwent full-text review, and 74 met inclusion criteria. The analysis drew on literature synthesis, case exemplars, antecedents, consequences, and empirical referents. This review followed PRISMA (2020) reporting guidelines. Results: Four defining attributes of ambiguous loss among aging migrants were identified: (a) physical, social, and emotional loss; (b) displacement and loss of homeland; (c) erosion of social identity and agency; and (d) cultural and transnational bereavement. A conceptual definition emerged, describing ambiguous loss as a multifaceted experience of disconnection, intensified by aging, illness, economic hardship, and social isolation. The analysis also highlighted antecedents such as forced migration and health decline, as well as consequences including diminished well-being, resilience challenges, and barriers to integration. Conclusions: Ambiguous loss among aging migrants is a complex construct encompassing intertwined physical, social, and cultural dimensions of loss. This conceptual clarity provides a foundation for developing culturally responsive care models that promote adaptation, resilience, and social inclusion among older migrants.