Care participation of older adults in nursing homes: A cross-sectional study of older adults’ and caregivers’ perspectives

This study aimed to explore the perspectives of older adults and their caregivers regarding older adults’ participation in their own care in a nursing home. This descriptive, cross-sectional study included 441 participants (264 older adults and 177 caregivers) from a nursing home in Western Türkiye in 2025. Data were collected using structured questionnaires on sociodemographic characteristics, participation in care, information sharing, and involvement in care-related decisions. Among older adults, 33.7% reported making health-related decisions independently, whereas 62.1% reported making decisions after considering the opinions of both physicians and nurses. Older adults most frequently reported leaving decisions to the healthcare team for hospital check-ups (88.6%) and medication use (84.5%). Significant associations were found between the importance attributed to receiving explanations about care and treatment and gender, education level, and relatives’ visit frequency among older adults (p < 0.05). Among caregivers, 78.5% reported that participation in care was necessary, 83.6% reported that providing explanations was important, and 61.6% stated that such explanations were actually given. In this Turkish nursing home sample, both older adults and caregivers valued participation in care, but participation appeared to rely more on shared decision-making and information exchange than on independent decision-making. The discrepancy between caregivers’ views and reported practices may reflect organizational and communication-related barriers in institutional care.