EXPLORING THE DIMENSIONS OF HOLISTIC CARE FOR THE ELDERLY: A CONCEPT ANALYSIS FOR COMPREHENSIVE GERIATRIC SUPPORT

Abstract

Holistic care for the elderly is widely recognised as a cornerstone of person-centred geriatric nursing; however, the concept remains inconsistently defined and variably applied. Older adults present with complex physical, psychological, social, cultural, spiritual, and functional needs, and the absence of a unified conceptual framework limits nurses' ability to provide coordinated, comprehensive, evidence-based care and weakens the development of assessment tools and policy. To clarify holistic care for the elderly by identifying its defining attributes, antecedents, consequences, and empirical referents using Walker and Avant's (2011) eight-step concept analysis, and to propose an evidence-based definition applicable to geriatric nursing practice, education, and policy. A concept analysis followed Walker and Avant's eight-step model. A systematic search of PubMed, Web of Science, and CINAHL (2020–2025) identified 176 records; following two-stage screening of titles, abstracts, and 50 full texts, fifteen studies were retained. Thematic synthesis extracted definitions, attributes, antecedents, consequences, and empirical referents, illustrated through model, borderline, related, and contrary cases. Four defining attributes were identified: person-centred, dignity-preserving, and autonomy-affirming engagement; multidimensional integration of physical, psychological, social, cultural, and spiritual care; salutogenic, strengths-based, and resource-activating orientation; and continuity, interdisciplinary collaboration, and coordinated care delivery. Antecedents included comprehensive geriatric assessment, nurse competency in holistic practice, enabling organisational infrastructure, and co-designed care planning. Consequences included enhanced psychological wellbeing and dignity, reduced social isolation, improved physical outcomes and functional independence, dignified end-of-life experience, and greater older-adult empowerment and self-care capacity. Holistic care for the elderly is a dynamic, person-centred, and structurally embedded nursing practice integrating physical, psychological, social, cultural, and spiritual dimensions of wellbeing within a framework of dignity, autonomy, salutogenic resource activation, and interdisciplinary continuity. The proposed definition strengthens conceptual clarity and supports geriatric nursing research, education, and policy, including in resource-limited settings such as Nigeria.