Experiencing long-term care in later life: Urban indigenous elders' perspectives from Taiwan

As populations age, long-term care (LTC) systems increasingly shape older adults' everyday experiences of aging. However, how these systems are encountered and interpreted by marginalized older populations remains underexplored. This qualitative study examines the lived experiences of urban Indigenous elders in Taiwan, with a specific focus on Bunun elders living outside tribal contexts, and explores how long-term care is navigated under conditions of cultural displacement and structural inequality. Drawing on in-depth interviews with urban Indigenous (Bunun) elders and key care- and community-related actors-including family caregivers, a home-care provider, and a church leader-this study investigates how interactions with LTC services influence elders' sense of belonging, dignity, and cultural safety in later life. The findings reveal persistent tensions between standardized care practices and culturally grounded expectations of care, resulting in experiences of invisibility, misrecognition, and emotional withdrawal. Participants described how linguistic barriers, culturally insensitive service routines, and institutional assumptions about aging contributed to feelings of marginalization within ostensibly supportive care environments. By foregrounding the perspectives of urban Indigenous elders, this study contributes to aging studies by illustrating how long-term care systems function not only as sites of support but also as arenas where cultural identities and social inequalities are reproduced in later life. The findings highlight the importance of culturally responsive approaches to aging services and extend discussions of cultural safety and structural inequality within contemporary gerontology.