This review paper synthesizes current knowledge on enhancing the quality of life for elderly residents in nursing

homes by addressing physical health, mental well-being, and social support through integrated approaches.

Recognizing the growing aging population and associated challenges, the review examines physical

interventions such as exercise and rehabilitation, mental health therapies including psychosocial support, and

strategies to mitigate social isolation. It highlights the emergent role of technology, including IoT monitoring

systems, AI-based emotional support, and virtual nursing home models, alongside the influence of architectural

and environmental design on resident well-being. Multidisciplinary care models that combine these elements

The global demographic landscape is undergoing profound transformation due to increasing longevity and

declining birth rates, leading to a burgeoning elderly population worldwide. This demographic shift has resulted

in a heightened reliance on nursing homes and long-term care facilities to support the growing number of older

adults, particularly those with chronic health conditions, functional limitations, and social care needs. Nursing

homes have become critical institutional settings where physical health management, mental well-being, and

social engagement are pivotal for ensuring quality of life (QoL) among residents. Understanding the context and

pressing importance of elderly care in nursing homes is fundamental to addressing the multifaceted challenges

faced by this vulnerable population.

Juutinen (2023) emphasizes the changing demands placed on integrated, multidisciplinary, and person-centered

culturally appropriate housing solutions in multi-storey settings, suggesting similar principles might enhance

nursing home environments. Moreover, Aliyari (2023) specifically examines architectural features in nursing

homes and their direct correlation to elderly residents’ sense of home, asserting that lighting, accessibility, and

green spaces fundamentally impact residents' environmental comfort and psychological security. Such

environmental considerations are paramount given the institutional nature of nursing homes, which may

otherwise induce feelings of alienation or loss of autonomy.

Challenges in maintaining quality of life within nursing homes are multifactorial. Rumawas and Wijaya (2023)

indicate that residents often experience poorer health outcomes and reduced physical independence compared to

elderly individuals living with family, exposing vulnerabilities linked to institutional care settings. These

These challenges necessitate robust infection control policies, alongside sustained efforts to promote holistic

well-being.

Further complicating the elderly care landscape is the complex interplay of psychosocial factors. Loneliness,

depression, and anxiety have been documented as common mental health conditions among nursing home

residents, often exacerbated by social isolation and dwindling family contact (Zead & Khadir, 2023; Ergin et al.,

2023). These aspects underscore a critical need for integrated strategies that not only deliver clinical care but

also foster emotional support and social inclusion.

In addition to resident-focused challenges, systemic issues such as staffing, job satisfaction, and organizational

culture significantly affect care quality. Eriksson et al. (2023) examine migrant care workers in nursing homes,

finding that despite high job demands and stress levels, relational satisfaction and pride in caregiving persist,

suggesting that improving workplace environments could enhance overall care standards.

This review aims to synthesize current knowledge surrounding elderly care in nursing homes by examining

from 2020 to 2024 were screened for relevance, methodological rigor, and applicability. The inclusion criteria

prioritized peer-reviewed studies focusing on physical, mental, and social health aspects of elderly care. Articles

were analyzed thematically to identify best practices and gaps across multidisciplinary domains.

The physical health of elderly residents in nursing homes is characterized by a progressive decline in functional

capabilities, muscle mass, balance, and mobility, which collectively contribute to diminished independence in

activities of daily living (ADLs). Barczyk et al. (2023) investigated how housing and family dynamics influence

elderly savings and care decisions, highlighting that homeowners dis-save more slowly and often sell houses

upon nursing home entry, suggesting significant lifestyle adjustments. More directly related to physical health,

multifaceted impact of muscle degradation.

Zhu et al. (2023) compared gait characteristics between nursing home residents and community-dwelling elderly,

identifying nursing home residents as having reduced lower extremity strength and postural balance, a higher

fear of falling, and altered gait mechanics during transitional walking phases, underscoring the increased

vulnerability to falls and mobility-related accidents in institutionalized settings. Nutritional deficiencies are also

prevalent, with Farapti et al. (2023) reporting that nursing home menus often do not meet recommended dietary

allowances, leading to undernutrition among elderly residents, which exacerbates physical decline. Rayanti et

al. (2023) similarly noted impaired nutritional status or risks of malnutrition in elderly women across nursing

Mental health challenges in nursing home populations are profound and multifactorial, with depression, anxiety,

loneliness, and death anxiety commonly reported. Zead and Khadir (2023) found that elderly in nursing homes

exhibit significantly higher levels of depression compared to community counterparts, suggesting that

institutionalization may exacerbate psychological distress. Ergin et al. (2023) further explored the relationship

between death anxiety, loneliness, and psychological well-being, revealing a negative correlation between

(2023) demonstrated that modified problem-solving therapy reduces depression and improves coping and self-

efficacy in elderly nursing home residents, while Lee and Park (2023) showed group art therapy's positive effects

on depression and subjective happiness. These findings support the crucial role of therapeutic programs tailored

to the psychological needs of elderly residents.

psychological well-being and acceptance of living circumstances in nursing homes. Similarly, Mireles et al.

(2023) developed a mobile robot to assist home-care nursing and vital signs monitoring, illustrating how

technology can aid social support by facilitating care. Wegener et al. (2023) conceptualized nursing homes as

community health hubs that promote social inclusion by arranging community activities and dissolving

traditional organizational boundaries, thus helping combat isolation.

The safety culture within nursing homes also significantly affects residents' health experiences. Indarwati et al.

(2023) identified training, risk assessment, incident management, and the presence of security staff as essential

components in improving safety culture, which can reduce injuries and enhance quality of care. Furthermore,

Jiang et al. (2023) highlighted the spiritual needs of elderly residents, including those with dementia,

emphasizing the importance of family interaction, faith expression, and social engagement as key to emotional

life.

Older adults residing in nursing homes frequently experience significant declines in muscle mass, mobility, and

overall functional independence, which profoundly impact their quality of daily life and autonomy. Tsukahara

et al. (2023) demonstrated a significant correlation between the level of independence in activities of daily living

(ADLs) and skeletal muscle mass index (SMI) among nursing home residents, finding that 84.6% of residents

had low skeletal muscle mass. This muscle loss is linked with reduced physical function and increased

dependency. Similarly, Soyuer et al. (2023) reported that decreased hand grip strength (HGS) correlates with

declines in muscle and bone mass, mobility assessed by timed up and go tests, and daily living activities. Since

frequently fell short of recommended dietary allowances, with about a quarter of residents classified as

undernourished based on BMI analysis. Inadequate nutrient intake exacerbates muscle wasting and compromises

immune function. Rayanti et al. (2023) further highlighted impaired nutritional status and risk of malnutrition in

with dementia and had poor nutritional intake. These physical health challenges collectively reduce functional

independence and worsen prognosis.

Exercise and rehabilitation programs have shown promising effects in mitigating the decline of physical function

among elderly nursing home residents. Wołoszyn et al. (2023) found that a 12-week clinical intervention

involving physical exercises with elements of dance significantly improved hand grip strength, arm curl test

results, and Barthel Index scores compared to basic exercises and routine care. This suggests that incorporating

rhythm and movement into exercise therapy may enhance muscle strength and functional capabilities. Weissbach

et al. (2023) evaluated a volunteer-supported walking intervention in nursing homes and illustrated that

participants valued the social interaction aspect, which motivated engagement while some residents reported

improvements in gait, physical performance, and independence.

Complementing physical interventions, combined cognitive and physical exercise programs yield improved

with physical activity supports holistic health.

Technology-assisted physical monitoring and assistance serve as innovative strategies to augment traditional

physical health interventions. Mireles et al. (2023) developed a mobile nursing robot capable of monitoring vital

signs and assisting gait cycles, providing continuous support to home-cared patients and potentially extending

to nursing home settings. The application of such technologies can optimize individualized care by tracking

health metrics and delivering physical assistance. Moreover, Rumawas and Wijaya (2023) suggested that health

promotion activities incorporating smart and energy-efficient technologies in nursing homes contribute

prevalent in this population and often coexists with anxiety disorders, significantly impacting their psychological

well-being. Wu et al. (2023) report depressive symptoms and anxiety as major concerns among elderly nursing

home residents, further complicated by coping challenges and reduced self-efficacy. Similarly, Ergin et al.

Addressing the mental health challenges in elderly nursing home residents calls for targeted psychosocial

art therapy has demonstrated significant beneficial effects; Lee and Park (2023) conducted a randomized

of helplessness, anxiety, and unhappiness, alongside improvements in subjective happiness. This therapy fosters

Collectively, these studies indicate that multidimensional approaches involving psychosocial therapies, family

and social engagement, and technology-assisted emotional monitoring and support are essential to improve

mental well-being among elderly nursing home residents.