Ageing in place or stuck in place: A critical qualitative study on older adults’ independence across six municipalities in Norway

The concept of ageing in place (AIP) has garnered substantial international attention, especially with the global rise in the ageing population. Despite extensive research and policy support, the practical complexities of implementing AIP policy, particularly in diverse living situations, places, social contexts and evolving family structures, remain unclear. The purpose of this study was to critically examine the key factors influencing experiences of AIP among older individuals, family caregivers and municipal health and social care employees across six diverse Norwegian municipalities. This qualitative study utilised an explorative interpretative design, involving focus group interviews with municipal employees (N = 36) and semi-structured individual interviews with older persons (N = 17) and family caregivers (N = 18). The municipalities varied in several key dimensions, including population size, geographic extent, centrality, demographics and the economy. The reflexive thematic analysis identified four themes: i) Ageing-Related Preparation: Balancing Personal and Municipal Responsibility, ii) Access to Proper Services: Aligning the Person-Environment Fit, iii) Family Caregiving: Bridging the Gap between Services and Actual Needs, and iv) Transitional Housing: Supporting Aging in Place with Dignity. Together, these themes highlight the need to promote 'independence literacy' for older adults, ensuring they have the necessary knowledge, access, and support to live independently and maintain their quality of life while AIP. The findings urge a re-evaluation of local factors shaping safe and proper person-environment fit, emphasising access to proper services, caregiver support, housing options, resource allocation and the enhancement of skilled healthcare staff to optimise safe AIP. The findings may be relevant for policy makers, municipal leaders and health service employees in developing equitable AIP policies tailored to the local context.