The real experience of older people with schizophrenia: A qualitative meta-synthesis

Schizophrenia is a severe, chronic mental disorder. Global ageing and improved survival rates have increased the proportion of older people living with schizophrenia, a population whose complex subjective experiences and needs require deeper understanding.

This study systematically synthesizes qualitative evidence to elucidate the lived experiences and needs of older people with schizophrenia, thereby providing a theoretical foundation for developing targeted interventions.

A comprehensive search was conducted across PubMed, Web of Science, Cochrane Library, CINAHL, MEDLINE, Embase and PsycINFO for qualitative studies on the illness experiences, perceptions and needs of older schizophrenia patients. The search spanned from database inception to November 2024. The methodological quality of included studies was assessed using the 2016 Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Findings were synthesized via meta-aggregation.

Twelve studies were included, yielding forty - seven themes categorized into nine groups and further synthesized into four key findings: (1) Multifaceted physical and psychological burdens; (2) Social marginalization and relational strain; (3) Strong desire for multidimensional support; (4) Ageing reframed as an adaptive 'window of opportunity' for meaning-making and growth.

The synthesis reveals ageing with schizophrenia as a dynamic narrative of adversity and adaptation. It argues for a paradigm shift in psychological practice-from a deficit-focused model to a strength-based and developmental approach. Effective support must address internalized stigma and psychological trauma while actively fostering resilience, autonomy and a sense of purpose, thereby promoting psychological growth in later life.