“Should I Willingly Show Weakness?”: Exploring the Emotional Needs of Older Adults in Adapting to Life in Residential Care Facilities in China by Following the Traces of Stress

Residential care facilities in China often prioritize material needs over emotional well-being, leaving gaps in understanding psychological adaptation processes. This study aimed to explore the dynamic process by which older adults adapt emotionally to residential care facilities, focusing on how their needs and stressors evolve over time. Using a grounded theory methodology, semi-structured interviews were conducted with 30 residents from a large residential care facility in China, with data analyzed through open, axial, and selective coding. Findings revealed a three-stage adaptation process: (1) The adaptation stage, driven by security needs and familial burden reduction, where older adults primarily seek a comfortable environment; (2) The integration stage, addressing loneliness and fostering collective belonging, where older adults primarily seek to establish connections with others properly; and (3) The sublimation stage, focusing on self-identity, autonomy, and social value, where older adults primarily seek to find value and meaning in the remaining life. Emotional needs and stressors evolved dynamically across stages, reflecting shifts from external pressures to internal self-actualization. The study underscores the need for residential care facilities to adopt stage-specific interventions - ensuring safety, promoting group cohesion, and enabling self-directed engagement - to support holistic well-being and positive aging in China's rapidly aging society.