Negative Experiences and Maladjustment Following Long-Term Care Facility Admission: A Meta-Synthesis of Qualitative...

Long-term care facilities have become an increasingly common option for older adults. Although admission is often a practical response to care needs, this major life transition may profoundly affect older adults' psychosocial well-being. However, examinations of negative experiences following admission have been fragmented, limiting an integrated understanding of factors influencing maladjustment. This study comprehensively synthesized qualitative evidence on older adults' negative experiences and identified factors that contribute to maladjustment following admission to long-term care facilities. A qualitative meta-synthesis was conducted using a line-of-argument approach based on meta-ethnography. Systematic literature searches performed in PubMed, CINAHL, and ProQuest, following PRISMA guidelines, identified 18 qualitative studies published in peer-reviewed journals. Study quality was appraised using the Critical Appraisal Skills Programme checklist. Rigor was ensured following Lincoln and Guba. Six overarching themes were identified: admission to a long-term care facility without choice, loss of autonomy and sense of control in everyday life, disruption of previous life and identity, weakening of social relationships and deepening isolation, persistent negative mood, and lack of respect in the care process. These findings show that maladjustment is shaped by interconnected and cumulative experiences. Admission to long-term care facilities is a complex and ongoing process that disrupts continuity, identity, and emotional stability in later life. The findings highlight the need for long-term care practices and nursing interventions that prioritize older adults' choices, participation, and psychosocial needs.