Living and dying in dignity among older migrants

BackgroundDignity is a foundational ethical principle in the care of older adults. Although widely discussed in nursing ethics, little is known about how older foreign-born adults themselves understand ageing with dignity, or how migration may shape this process in a welfare-state context.AimTo explore how foreign-born older adults in Sweden perceive and articulate dignity while ageing.Research designA Glaserian Grounded Theory approach guided data collection and analysis.Participants and research contextFive language-specific focus groups and one individual interview were conducted with 23 foreign-born adults aged 60 years and older living in Sweden.Ethical considerationsEthical approval was granted by the Swedish Ethical Review Authority.FindingsThe core category - Living and Dying in Dignity: A Lifelong Negotiation of Control and Connection - conceptualises dignity as an ongoing process shaped by balancing agency and communion. Four interrelated categories were identified: The Prerequisites of Dignity, in which selfhood, autonomy, and connection were foundational; Maintaining Dignity in Everyday Life, which captured strategies for preserving control, meaning, and continuity; The Art of Letting Go, involving adaptation, acceptance, and moral boundary-setting in the face of loss and suffering; and Surrendering with Trust, in which dignity was sustained through confidence in family, care systems, or existential frameworks when agency waned. Migration-related conditions, especially language, home, and cultural recognition, shaped how this negotiation unfolded.ConclusionDignity in later life was understood not as a fixed state but as a lifelong negotiation between control and connection. For older foreign-born adults, this negotiation was reconfigured by migration-related transitions, making recognition, home, and relational continuity especially significant.