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Elderspeak in Healthcare Settings: How Care, Control and Personhood Intersect in Care Communication-A Qualitative
Daniela Lillekroken1, Annemarie Röthig2, Ann Kristin Bjørnnes3
1Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Aim(S):
To synthesize qualitative evidence on how healthcare personnel experience, perceive and enact elderspeak, patronizing speech and infantilizing communication in interactions with older adults across healthcare contexts.
Design:
Qualitative meta-synthesis.
Methods:
A systematic database search identified studies reporting healthcare personnel's experiences, perceptions and use of elderspeak and other patronizing communication with older adults. Findings from the included studies were synthesized and interpreted.
Data Sources:
Medline, Embase, APA PsycINFO, CINAHL and Scopus were searched in July 2024 and updated in November 2025.
Results:
Thirteen qualitative studies were included. Two descriptive themes were generated: (i) Elderspeak as a communication practice that erodes personhood and (ii) Elderspeak as an institutionalized and normalized communication as behavioural regulation. These informed the analytical theme: Elderspeak as a tension between care, control and personhood. Findings suggest that elderspeak is often used with caring intentions and to facilitate care delivery, cooperation and organizational routines. However, these communication practices may simultaneously constrain older adults' autonomy, participation and personhood.
Conclusion:
Elderspeak is not merely an individual communication habit but a socially and institutionally embedded practice normalized in everyday care. While it may support care routines and cooperation, it can also position older adults as dependent, less competent or less autonomous, contributing to the erosion of personhood despite caring intentions. Addressing elderspeak requires attention to both communication practices and the organizational contexts in which they occur.
Implications For The Profession And/Or Patient Care:
Reducing elderspeak requires educational and reflective initiatives that help healthcare personnel recognize how communication practices, such as collective pronouns, terms of endearment, directive language and speaking on behalf of older adults, may unintentionally undermine autonomy and personhood. Promoting person-centred, dignity-affirming communication should be integrated into professional development and quality-improvement initiatives.
Reporting Method:
Reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines.
Patient Or Public Contribution:
This study is a meta-synthesis; therefore, it does not include patient or public involvement in its design, conduct or reporting.
Trial Registration:
PROSPERO: CRD42024557148.
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