Autonomy has been recognised as a key principle in healthcare, but we
still need to develop a consistent understanding of older people’s
perceived autonomy in residential care. This study aimed to identify,
describe and synthesise previous studies on the perceived autonomy of
older people in residential care. Ethical approval was not required, as
this was a review of published literature. We carried out an integrative
review to synthesise previous knowledge published in peer-review
journals in English up to September 2019. Electronic and manual searches
were conducted using the CINAHL, Philosopher’s Index, PubMed, SocINDEX,
Scopus and Web of Science databases. The data were analysed using the
constant comparison method. The review identified 46 studies. Perceived
autonomy referred to the opportunities that older people had to make
their own choices about their daily life in residential care, and
achieving autonomy promoted both health and quality of life. Autonomy
was linked to older people’s individual capacities, including their
level of independence, physical and mental competence, personal
characteristics, and whether relatives shared and supported their
perceived autonomy. Professionals could facilitate or hinder older
peoples’ autonomy in a number of ways, including providing opportunities
for autonomy, how daily care needs and activities were managed, and
controlling older people’s choices. Professionals’ characteristics, such
as education and attitudes, and the older people’s living environments
were also associated with their perceived autonomy and included
organisational characteristics and physical and social care
facilitators. Older people’s perceived autonomy promoted health and
quality of life in residential care. However, their autonomy was
associated with a number of protective and restrictive individual and
environmental factors, which influenced whether autonomy was achieved.