Unmet care needs among older people in residential care: a scoping review

BACKGROUND: As the proportion of older people increases, the demand for health and social care is expected to rise substantially, along with the potential for unmet care needs. For individuals whose needs cannot be adequately met by home or community-based services due to various health and social reasons, residential care settings may provide an alternative. However, evidence indicates that the care needs of older people in residential care (RC) are often unmet or only partially met. The review aimed to map and summarise the existing literature to identify unmet care needs among older people residing in RC and explore the factors that influence the delivery of appropriate care. METHOD: The Joanna Briggs Institute (JBI) scoping review methodology, a priori scoping review protocol, and PRISMA-ScR guidelines were followed. A comprehensive search of seven databases (CINAHL, EMBASE, PsycINFO, MEDLINE, Web of Science, CNKI and Wan Fang) and grey literature was conducted on the 2nd of March 2024 and updated on the 30th of June 2025. RESULTS: A total of 40 studies were included in this scoping review, most of which were conducted in Europe. Methodologically, 52.5% employed quantitative designs. The findings indicate that older adults living in RC settings experience diverse unmet care needs across the physical, psychological, social, and environmental domains, with considerable variation across regions. The review identified recurring factors at the micro, meso, and macro levels, encompassing individual characteristics, institutional practices and resource constraints, and broader systemic and policy-level factors. CONCLUSION: Evidence suggests that older adults living in RC settings experience diverse unmet care needs which vary across regions, and appear to be influenced by the interaction of micro, meso, and macro factors. TRIAL REGISTRATION: This scoping review protocol was registered in the Open Science Framework on 6 December 2023 (DOI https://doi.org/10.17605/OSF.IO/NVRKE).