Meaning of home among community-dwelling older adults with health concerns: a reflexive thematic analysis

PURPOSE: Home is more than a place of care delivery, yet little is known about how community-dwelling older adults with health concerns in Japan understand its meaning. This study explored the shared meanings of home among them and derived implications for home care. METHODS: This qualitative study involved reflexive thematic analysis within a non-positivist framework. Fifty-four adults aged 65-95 years living in urban, suburban, and rural areas were purposively recruited through home-visit nursing services and an online survey panel. Semi-structured interviews were conducted in Japanese. Interview data were transcribed verbatim and analyzed iteratively in Japanese. FINDINGS: Four themes were generated: "autonomy and independence," "residential environment that sustains daily life," "familiar place with attachment," and "personally meaningful connections with others." Home was understood as more than a physical residence: a familiar, cherished, and personally meaningful foundation for sustaining a self-determined and independent life, personal identity, and relationships with others, extending beyond the dwelling to the surrounding community. CONCLUSIONS: The findings suggest that home care professionals should understand what home means as a lived place to each older adult, support independence and safety while respecting autonomy, familiarity, and preferences, and facilitate meaningful connections at their preferred relational distance.