More than ever, we are living into very old age. This raises the question not only of how to structure our healthcare systems to cope with increased care needs, but also more existential questions about what it means to live well in very old age. For the ‘younger old’, a good life is typically defined by the ideals of the successful ageing paradigm, in which avoiding disease, staying active and productive and – perhaps most pertinently – retaining independence, are the foundations for well-being. However, for the oldest old (85+ years) these goals become increasingly difficult to attain. As mobility decreases and chronic illnesses take hold, the ability to remain independent is compromised. In Denmark, like most Western cultures, dependence is considered antithetical to well-being. This dissertation, therefore, sought to examine whether there are still possibilities for well-being in the midst of the many losses and vicissitudes of very old age in institutional care.

The project contains two studies: 1) a meta-ethnography which reviews and reinterprets existing findings on well-being in nursing homes, and 2) an ethnographic fieldwork study which examines the lived experiences of the oldest old living in nursing home care in Northern Denmark. Taking an existential well-being approach, the dissertation considers well-being, not as objectively measurable, but as a particular experience of being in the world. Through an engagement with the discourses and practices of everyday life it considers how well-being comes into being (or not) in particular landscapes of meaning.

The dissertation shows that residents lean into dependence, not as a desire to relinquish autonomy, but as a modality for a new relationality. Above all, residents have a need to matter in relation to others. At the same time, the nursing home is structured towards maximum independence and care is highly task-oriented, creating a tension between staff and resident expectations of care time. The dissertation also finds that despite the best intentions of the aged care system, tacit ageism is present in the nursing home, leading to the conclusion that taking seriously the well-being of oldest old nursing home residents, hinges in part on dismantling implicit ageism.

Throughout, the dissertation interweaves the broader macro perspectives of structural limitations and culturally embedded values, with everyday social (inter)actions and care practices. In doing so, it contributes ethnographic insights into everyday life for oldest old nursing home residents in Northern Denmark, all the while pointing to broader issues of what (oldest) old age means to us socially, culturally, and existentially.