The research team, led by Federica Vernile and Michela Di Trani of Sapienza University of Rome, together with colleagues from the University of Naples Federico II, Tor Vergata University of Rome and Pegaso University, set out to explore a question that sounds simple but is not: what do care operators actually feel and think about their relationships with residents, with families, and with the organization around them? The problem is sharpened by a paradox at the heart of geriatric care. Developmental psychology is built on the idea that every stage of life carries goals for growth, but in the final phase of the lifespan those goals are difficult to identify and promote. When staff cannot see a developmental horizon for the people they care for, the work risks collapsing into routine bodily maintenance, and the emotional weight of that collapse lands on the operators themselves.

Italy offers a particularly interesting setting for this kind of investigation. The care of older adults there has traditionally been managed either by religious institutions or within the family, and the modern residential care home is a relatively recent arrival in that cultural landscape. That history matters, because it shapes expectations. Families may experience guilt and ambivalence about placing a parent in institutional care, while operators inherit a system whose cultural scripts about aging and family obligation were never designed for professionalized residential settings. The researchers wanted to understand how these cultural tensions play out in the semiotic processes, the meaning-making flows of signs and emotions, that organize daily relational life inside a nursing home.

Eighteen operators of a single retirement home took part in the study, with an average age of 45.4 years and a standard deviation of 12.3, meaning the group spanned a wide range of career stages and life experiences. The instrument was a narrative interview, deliberately open-ended, designed to gather the emotions of the operators regarding two distinct relational arenas: the psychodynamics of their relationships with patients, and the psychodynamics of the organizational processes that regulate the institution. The interviewer introduced herself as a psychologist-psychotherapist following a master’s program in psychogeriatrics, and asked participants to tell everything that came to mind about their daily work and about what contribution psychology could make to improve it. This single-stimulus format, borrowed from clinical tradition, invites free association rather than answers to pre-set questions, letting the emotional structure of the workplace surface in the language itself.

The analytical engine of the study was Emotional Textual Analysis, a mixed method developed by Italian psychologists Romolo Carli and Rosa Maria Paniccia and implemented here with the T-LAB software package. The method rests on a specific theoretical claim: that language is never emotionally neutral. The words people choose, and the ways those words cluster together in discourse, carry the traces of emotional dynamics that operate below conscious awareness. By treating interview transcripts as textual data and applying statistical procedures to the co-occurrence of words, the researchers could map the emotional dimensions of professional discourse without imposing predefined categories on it. In this sense the technique functions like a microscope for culture, revealing the shared affective organization of a work group that its members may themselves be unable to articulate directly.

The statistical output came in the form of multiple correspondence analysis, which positioned the textual material along underlying factors and grouped it into clusters of words. Three clusters emerged. The first concerned expectations addressed to psychology, capturing what operators hoped a psychological presence in the institution might provide. The second concerned the relationship with users, the residents themselves. The third concerned the relationship with families. These clusters were distributed along two factors that the authors interpret as organizing axes of the institution’s psychological culture: a first factor opposing psychological intervention to health intervention, and a second opposing the relationship with operators to family ties. In other words, the discourse of the care staff is structured around two fundamental tensions, one about whether their work is essentially clinical-psychological or essentially medical-physical, and one about where emotional bonds properly belong, with the professional community or with the residents’ kin.

What the researchers found within that structure is the study’s most provocative claim. The culture of psychological work in the nursing home, they report, conceives its purpose mainly through an individualistic approach, one that is constantly anchored to bodily care. Rather than imagining the elderly person as a subject with developmental potential, the dominant professional culture frames its task as attending to the body, hour after hour, day after day. This finding resonates with earlier research on dehumanization in health settings, which has shown how implicit representations of death and decline can erode the recognition of patients as full persons. When the endpoint of life is seen as developmentally empty, care risks becoming a sequence of physical procedures stripped of relational meaning, and the operators who perform those procedures are left carrying emotions that have nowhere to go.

The second major finding concerns the institution’s relational function. In relational terms, the authors conclude, the nursing home proposes itself as an emotional substitute for all the significant ties that existed before internment, and in doing so it violently breaks the bond between the family of origin and the patient. The word choice is deliberate and dramatic: the admission of an elderly parent into residential care is experienced not as a gentle transfer of responsibility but as a rupture, an abrupt severing of attachment relationships that the institution then attempts to replace. Operators find themselves cast into an emotional role, substitute family, for which their training and their professional identity have not prepared them. Meanwhile the third cluster of discourse, expectations addressed to psychology, suggests that staff sense this gap and wish for psychological support and intervention that the current, health-dominated culture of the institution does not adequately provide.

The implications of the study reach into practice and training. If the emotional structure of care work in nursing homes is organized around bodily care and individualistic intervention, then introducing psychologists into these settings is not simply a matter of adding a service; it requires transforming the professional culture itself. Training programs in psychogeriatrics, such as the one that framed this research at Sapienza University of Rome, aim to prepare practitioners to work with individuals and with contexts, both family and organizational. The study’s results argue that such preparation must address the emotional dynamics of the staff group, not only the needs of residents, because the two are inseparable. Burnout research on long-term care staff has repeatedly linked stress and inadequate social support to emotional exhaustion, and the present study adds a cultural dimension to that picture: the very way an institution defines the purpose of care shapes the emotional burden its workers must carry.

The research also carries a broader message about aging as a psychological and cultural question. The authors’ framing, echoed in their related work asking simply who the elder is, insists that old age is not a developmental void but a phase of life that demands its own meaning-making. Narrative approaches in psychology have shown how constructing continuity of identity through storytelling helps people navigate even traumatic transitions, and the transition into residential care is among the most disruptive an elderly person can face. If institutions are to serve residents well, they must recognize that breaking family bonds, however necessary in some circumstances, creates an emotional debt that must be acknowledged and worked through, both for the older person and for the operators who become the new attachment figures. This study, with its unusual method of listening to the emotions embedded in professional speech, offers a template for how care organizations might begin that work: by taking seriously what their own staff, in their own words, are already trying to tell them.

Subject of Research: The emotional and relational psychological culture of care operators in Italian elderly care homes

Article Title: The Psychological Culture of Operators in Italian Elderly Care Homes: An Emotional and Lifespan Perspective

Article References: Vernile, F., Di Trani, M., Capone, V., Leone, L., & Carbone, A. (2025). The Psychological Culture of Operators in Italian Elderly Care Homes: An Emotional and Lifespan Perspective. Trends in Psychology. https://doi.org/10.1007/s43076-025-00478-4

Image Credits: AI Generated

DOI: 10.1007/s43076-025-00478-4

Keywords: nursing homes, elderly care, care operators, Emotional Textual Analysis, aging, lifespan psychology, family bonds, organizational psychology, Italy, narrative interviews, psychogeriatrics, burnout