Ontological Security in Nursing Homes for Older Persons – Person-Centred Care is the Power of Balance

Inger James*, 1, Rebecka Ardeman-Merten2, Annica Kihlgren1
1 School of Health and Medical Sciences, Örebro University, Örebro, Sweden
2 Örebro Municipallity, Healthcare and Social Services, Örebro, Sweden

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© James et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Health and Medical Sciences, Örebro University, SE - 701 82 Örebro, Sweden; Tel: +46 19 30 10 95, + 46 19 30 30 00; Fax: +46 19 30 36 01; E-mail:



The Swedish national guidelines for elderly care describe how older persons should be able to trust that their care is permeated with security. Different theoretical perspectives can be found that describe what creates security. Many studies have been done about security. However, few studies have explicitly asked older persons what security in nursing homes means to them.


The aim of the study was to describe how older persons in nursing homes talked and reflected about security in their daily lives.


Nine older persons were interviewed in, in-depth interviews one to three times and the resulting data was analysed using content analysis.


The older persons adapted to having their own needs and those of the other older persons met and to the staff routines which created a sense of security. At the same time, they longed for security in which they could trust themselves and create their own daily life. Further to have a sense of belonging and of being liked for created an internal, interpersonal and external security. This can be linked to an ontological security which means having a sense of confidence in the continuity of self-identity and order in events, a being in the world.


Person-centred instead of institution- centred care can provide the balance of power that allows the older person to obtain ontological security in which the staff's ability to create a relationship with the older persons becomes crucial.

Keywords: : Adaptation, elderly care, nursing home, ontological security, person-centred care, relationship.