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January 25, 2026Clinics and Practice5 citationsOpen Access

Attention to Elderspeak: A Call for Dignity-Affirming Communication in Advanced Nursing Care

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TNTakahiko Nagamine

Key Points

  • This review aims to synthesize evidence on Elderspeak and its effects on older patients in acute care settings.
  • Conducted a literature search in PubMed, CINAHL, and PsycINFO from 2018 to 2025.
  • Reviewed 24 key articles focusing on Elderspeak in acute and surgical settings.
  • Proposed intervention strategies and a qualitative self-reflection tool for clinicians.
  • Elderspeak is linked to increased patient distress and negatively affects vital signs.
  • It is a significant determinant of resistiveness to care (RTC) in older adults.
  • Standardized measurement like ICodE is being developed to address measurement inconsistencies.

Abstract

Elderspeak is a form of communication overaccommodation directed toward older adults, characterized by simplified language and an elevated pitch. While typically well-intentioned, it is rooted in ageist stereotypes and linked to negative health outcomes. A literature search was conducted in PubMed, CINAHL, and PsycINFO (2018–2025), yielding 24 key articles focusing on acute and surgical settings. The purpose of this narrative review is to synthesize current evidence on Elderspeak within acute care hospitals and propose a research framework and intervention strategies. Elderspeak is a key determinant of resistiveness to care (RTC), particularly in acute settings where it is triggered by functional impairment. Exposure increases patient distress and negatively impacts vital signs and cooperation with medical interventions. Inconsistent measurement is being addressed through standardized schemes like the Iowa Coding Scheme for Elderspeak (ICodE). This paper proposes that future research must employ mixed-methods, longitudinal designs to capture the impact of Elderspeak on long-term outcomes. Drawing on the ICodE, we propose a qualitative self-reflection tool for clinicians to enhance awareness in high-stakes acute settings. Eliminating Elderspeak is a foundational necessity for patient safety and dignity-affirming care in advanced nursing.

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Cite This Study

Takahiko Nagamine (2026) studied this question.

synapsesocial.com/papers/6975b36bfeba4585c2d6eef6https://doi.org/10.3390/clinpract16010021
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