Elderly living in residential and nursing homes have specific psychosocial and spiritual needs which are in most cases not recognized and can thus not be addressed. As advised by Borg et al.  adequate health care for elderly should not only consider decreasing functional capacities of elderly, but also the individual’s perception of health and self-esteem. The focus on personal factors seems to be of outstanding importance, and the findings of this study support this recommendation. However, it remains an open issue how these factors can be adequately supported.