In residential aged care facilities, the ticking clock no longer urges residents to rush to work, to meet a deadline, or to collect a child. Instead, time stretches endlessly before them. Minutes can feel like hours when waiting for lunch or the next medication round. Yet, months seem to slip away, blending into a seamless, repetitive blur. Clock time structures the routines and rhythms of the day. Meals, medications, personal care, staff shifts and activities are all scheduled on clock time. Despite this, residents experience that same time subjectively. 

Experienced Time versus Clock Time

One way of understanding these different experiences is to distinguish between clock time and what Stranz et al. (2022) describe as embodied or experienced time. Clock time is measurable: minutes, hours, schedules, rosters and response times. Embodied time is time as it is lived and experienced. The same fifteen minutes may therefore have quite different meanings for a manager monitoring response times, a staff member trying to meet several competing needs, and a resident waiting for assistance. Further, two residents can experience the same 15 minutes completely differently.

Stranz et al. (2022) capture this tension particularly well when they observe that “residents’ time is characterized by waiting and staff’s by running”. Qualitative research by Balkin et al. (2023) also highlights the tension between institutional time and residents’ lived experience of time.

Waiting and Patience

There is an implicit expectation for residents to be patient, and expressions of impatience can sometimes be met with frustration from busy staff. Residents may spend considerable time waiting for assistance, meals, visitors, activities, appointments, or simply for something meaningful to happen. They may have little control over how long they wait or when assistance will arrive. Ten or twenty minutes can feel exceptionally long when someone is uncomfortable, lonely, anxious, in pain or living with cognitive impairment. Conversely, meaningful engagement can make time seem to pass quickly.

Waiting is sometimes treated as though it is passive and doesn’t require any skill. Yet waiting involves tolerating delay, managing frustration and uncertainty, and maintaining some sense that what we are waiting for will eventually happen. From a Positive Behaviour Support perspective, learning to wait can itself be an important skill. Years ago, when behaviour support plans commonly included goals to address smoking frequency, I would sometimes ask staff what a person needed to learn to space out their cigarettes. The answer was not simply to smoke less, but to learn how to wait patiently, and manage waves of discomfort in between cigarettes.

Interestingly, residents themselves may recognise waiting as something that requires patience. In their study of call-bell use in residential care, Stranz et al. (2022) reported that one resident jokingly referred to call bells as “patience-testing gadgets”, adding “You have to learn to be patient”. Residents also associated waiting with anxiety, fear, frustration, and anger.

Rather than interpreting repeated requests or expressions of impatience simply as demanding behaviour, it may be more useful to ask what the experience of waiting is like for that person, and what staff might do to make the waiting more manageable. Stranz et al. (2022) found that residents valued being given a realistic timeframe rather than being told that help would come “soon” or “in a while”. Therefore, staff can help residents feel more secure by providing a realistic timeframe and reliably keeping to it.

Memory and Time

When every Tuesday looks exactly like every Thursday, it is perhaps unsurprising that the mind may drift to the past. Reminiscence can become a sanctuary. Memories from decades ago may feel sharper and more vibrant than the breakfast eaten just a few hours earlier.

Research with residential aged care residents suggests that reminiscence often occurs spontaneously, particularly when residents are alone, and can be an enjoyable and valued experience (Henkel et al. 2017). Revisiting the past can also provide a sense of agency and empowerment (Balkin et al. 2023).

For some people living with dementia, past autobiographical memories may remain accessible while memories of recent events are more fleeting. By engaging with these older memories, staff can foster connection, identity, as well as pleasure and emotional meaning for the resident.

Remembering isn’t simply retrieving something found in the past. Reminiscence is an active, present-moment experience. A resident remembering their childhood home, their wedding, a special holiday, or their deceased spouse is doing something now. Thus, memory can change the emotional quality of the present moment.

Clock time tells us how long ago something happened, but memory can bring all those somethings to the present moment.

Creating Meaningful Time

So, what allows time to feel worthwhile for the residents, given that residential aged care organises residents’ days according to clock time?

A day can be full of scheduled activities without those activities holding any meaning for the person taking part. It is the quality and personal significance of what happens within that time that matter for the resident. Meaningful time could involve anything that fosters choice and agency, connection with other people, enjoyment, purpose, or simply being absorbed in something in the present moment.

Balkin et al (2023) use the example of Yvonne. She attended the weekly chair-gymnastics activity and appeared to engage well and enjoy it yet afterwards couldn’t verbalise any memory of having taken part. Some staff therefore questioned its value. Balkin et al (2023) concluded “The present moment has intrinsic value regardless of its imminent erasure from memory.” Therefore, an experience need not be remembered later for the time spent in it to have been worthwhile.

Balkin et al. (2023) recount another example where a resident said that when staff take even five or ten minutes simply to chat, “it makes you feel like you matter.” The authors argue that residents don’t experience care time simply in metric terms; its value lies in feeling seen, heard and valued. In residential aged care then, the meaningfulness of time is not equivalent to its duration. 

Temporal Wellbeing

Temporal wellbeing isn’t principally about whether residents have enough activities filling their hours. Temporal wellbeing can be understood as the quality of a person’s experience of time: whether time feels empty or inhabited, imposed or self-directed, interminable or absorbing, disconnected or relational, merely endured or worth living through.

Seen in this way, temporal wellbeing is shaped not only by what fills a resident’s time, but by how that time is experienced. The same period of clock time may feel brief or interminable; waiting may be manageable or distressing depending on uncertainty, control and what the person is waiting for.

Staff can ask residents questions like, “What parts of your day seem to drag?” “What do you look forward to?” “What are some of your special memories of the past?” and “What makes time pass quickly for you?” These questions can help identify where a resident’s experience of time might be better understood and where it might be improved. When a resident is unable to answer these questions for themselves, staff can draw on their observations and knowledge of the person, as well as information from family members.

Temporal wellbeing can be facilitated by our relationship with the past, present and future. The past can be brought into the present by reminiscing about people, experiences and identities. In the present, residents can be engaged, absorbed in and enjoy experiences, even when they cannot subsequently recall them. The future can influence the experience of the present through anticipation. Drawing on Galvin and Todres, Balkin et al. (2023) suggest that residents can be invited into a meaningful future by having something to look forward to. The relevant future may be lunch with a daughter on Sunday, some time in the garden this afternoon, or a favourite television programme tonight. For a person living with dementia, the pleasure of anticipation can have value in the present moment, even when the anticipated event, or the anticipation itself may not be remembered later.

Perhaps time itself can be understood as something we give. Stranz et al. (2022), drawing on earlier research with people approaching the end of life, describe time as a gift, “something that should be offered rather than demanded.” In residential aged care, offering someone our time may be as important as finding something with which to fill theirs. So, how can staff offer residents the gift of time when their own time is characterised by running?

Jane Turner
Senior Clinical Psychologist
Amazing Ageing Psychology

References:

Balkin, E., Martinsen, B., Kymre, I., Kollerup, M., & Grønkjær, M. (2023). Temporalities of aged care: Time scarcity, care time and well-being in Danish nursing homes. Medical Anthropology, 42(6), 551–564. https://doi.org/10.1080/01459740.2023.2235066

Henkel, L. A., Kris, A., Birney, S., & Krauss, K (2017). The functions and value of reminiscence for older adults in long-term residential care facilities. Memory, 25(3), 425-435. http://dx.doi.org/10.1080/09658211.2016.1182554

Stranz, A., Tishelman, C., Westerlund, B., Nilsson, F., Hilton, R., & Goliath, I. (2022). The call-bell in residential care homes: Experiences of residents and staff. Journal of Aging Studies 62:101056. DOI: 10.1016/j.jaging.2022.101056

Image Credits: Photographs sourced from Shuttertock and used under licence.

©Jane Turner 2026