A qualitative study exploring growth needs on Maslow's hierarchy of older adults at nursing homes

Older adults in nursing homes often experienced a neglect of comprehensive needs, focusing on predominantly fulfilling their basic physiological and safety needs. This oversight has resulted in a significant gap in addressing growth needs. This qualitative study used immersive observation and semi-structured interviews conducted within 5 nursing homes in Shanghai, China from March to May 2024. Trained researchers observed and engaged with residents and staff to gather in-depth insights into the experiences and perceptions of growth needs. Nine participants were included in this study. Five dimensions and twelve aspects of growth needs and unmet needs have emerged: (1) unmet needs (including team activities, desire for autonomy in daily routines, easier access to health services, and return to disease-free status);(2) cognitive needs (including renewed view of life, self-priority, and personal interests and habits formed from past living); (3) aesthetic needs (including demand for living environment, and self-expression through clothing); (4) self-actualization (including adaptive coping learning, and social approval); and (5)transcendence needs (including pursuit of a meaningful life beyond the traditional roles of elders). Addressing the growth needs of older adults in nursing homes is critical for improving their overall quality of life. This study highlights the necessity for care providers to adopt a more holistic approach that encompasses not only the deficiency needs but also the growth needs of the residents.