Reframing Elderly Institutionalisation in India: A Process-Oriented Conceptual Framework of Psychosocial Transition and Adjustment

Abstract

Demographic shift towards ageing, rapid socio-economic change, and transformations in traditional family structures have led to a growing reliance on institutional care for elders. The elderly institutionalisation is often conceptualised narrowly as a relocation event or as an outcome of individual decline, overlooking its broader psychosocial and socio-cultural dimensions. This conceptual paper reframes the transition from home to old age homes as a processual and meaning-laden transition, shaped by structural conditions, lived experiences, and institutional environments. By critically examining Theories related to Transition and their limitations, the paper account for pre-transition experiences, cultural meanings, and contextual diversity particularly within collectivist society like India. Through a theory-informed synthesis of gerontological and transition literature, the paper proposes a process-oriented conceptual framework for transition that integrates structural determinants, pre-transition conditions, the transition event, subjective interpretation, coping and adjustment strategies, and person environment interactions. The framework highlights that the psychosocial consequences of institutionalisation are not determined solely by relocation, but are mediated by how older adults interpret and experience the transition through moral, cultural, and emotional lenses. It further incorporates active coping processes such as relational autonomy, peer support, spiritual coping, and acceptance or resistance to institutional norms and identifies key moderating factors including gender, health status, voluntariness of transition, type of institution, and duration of stay. These elements collectively influence outcomes such as psychosocial well-being, dignity, sense of belonging, and adaptation to institutional life,this paper contributes a culturally grounded and theoretically integrated framework for understanding elderly institutionalisation. The framework offers a foundation for future empirical research and has important implications for social work practice, institutional care planning, and elder-care policy in rapidly ageing societies.