Enhancing psychological well-being of nursing home residents: incorporating homelike interior design attributes into supportive design theory

Abstract

The world’s population is rapidly aging, and societies will face a significant rise in the proportion of older adults. While much research on aging emphasizes physical health and safety, fewer studies focus on psychological well-being (PWB). This dissertation introduces a new perspective by examining how supportive design and homelikeness influence the PWB of nursing home residents. It identifies design-related features of Supportive Design Theory (SDT) and homelikeness that positively affect older adults’ experiences, while also investigating which attributes are most valued by residents. In addition, the study evaluates the physical and architectural characteristics of Turkish nursing homes, highlighting strengths and shortcomings, and offers recommendations for designing future facilities that enhance quality of life while reflecting cultural expectations—an area where research remains limited. The study was conducted in two phases. Part 1 assessed seven nursing homes using the Physical and Architectural Features (PAF) checklist. Results indicated strengths in urban accessibility and staff facilities but revealed shortcomings in amenities, social-recreational spaces, and orientation aids. Part 2 examined residents’ perceptions through the Supportive Design Theory and Homelikeness (SDTH) questionnaire in four nursing homes, combined with PWB measures. Findings emphasized privacy and sense of control as the most valued features, while natural elements and personalization showed the strongest correlations with PWB. Overall, the findings extend SDT by showing that homelikeness—through personalization, atmosphere, and culturally resonant design—amplifies its predictive validity. The study concludes that nursing home standards in Türkiye should adopt a two-tiered framework: Ensuring safety and accessibility while embedding homelike, resident-centered features that foster autonomy, comfort, and belonging.