User-oriented care is the prevailing approach in the care of older people today. In Sweden, standardised user surveys are used to measure older people’s satisfaction; however, these results are often misinterpreted, and older people experience difficulties in influencing their care and support within elderly care services. The aim of this licentiate thesis is to deepen the understanding of how older people experience everyday life in nursing homes and their opportunities for agency within the institutional residential environment.

To explore this, data were collected at four nursing homes using mixed methods, including qualitative observations in communal spaces totalling 68 hours, alongside nine qualitative interviews with older people. The study is grounded in the central theoretical foundations of actor autonomy and social interaction. Content analysis identified key aspects of everyday life for older people in nursing homes, which were thematised as space, body, time, and voice. These themes highlight the importance of the spatial environment, functional ability, the significance of time for care relationships, and the opportunities for older people to have their voices heard and influence their everyday lives.

The study shows that older people tend to adapt their everyday lives to the institutional structure, rather than the institution being adapted to their needs and preferences. The blurred boundary between communal spaces and private apartments within the nursing home setting poses a risk of unintentionally violating personal integrity. Care relationships are characterised by timepressure and task focus, which tend to reduce the depth of qualitative encounters, leaving only fleeting glimpses of connection. The analysis reveals that older people view their everyday possibilities through a “horizon of possibility”. A strong sense of personal responsibility for their own functional abilities and situation emerges, often expressed through loyalty and gratitude. Behind this façade lies a multitude of unspoken wishes, as many older people do not believe their wishes or preferences can be met. This leads to a significant loss of agency. The results offer an important contribution to applicable knowledge that can help improve the care and living conditions of older people.