‘My darling’ – elderspeak of nurses to acute hospitalised older adults: An integrative review

Introduction: Ageism may be defined as a prejudice by one group toward another age group, and the way that many patients are spoken to in health care (elderspeak) would be defined as an ‘interpersonal ageist practice’. Elderspeak is rife in the nursing care of older adults in all areas of health care and has adverse effects in most instances, particularly in those with a cognitive impairment who exhibit greater rejection of care behaviours in response. This integrative literature review explores the concept of elderspeak and its theoretical underpinnings and will provide some recommendations for mitigation of this practice in the future care of our older patients. Review methods: A comprehensive literature search was conducted using CINAHL, EBSCO and Scopus databases. Boolean operators, wildcards, subject headings, keywords and the ‘cite forward’ function in Scopus were used to filter articles and ensure more contemporary research was not omitted. Discussion: Born out of ageism, elderspeak manifests in well-meaning but misdirected communication overaccommodations in intergenerational interactions. These patronising overaccommodations are often received negatively by cognitively impaired older patients leading to rejection of care and subsequent difficulty in meeting the medical and psychological needs of these patients. This review highlights the frequency with which this practice occurs, the impact upon patients, theoretical underpinnings of the concept and interventions shown to both reduce the use of elderspeak by nurses and rejection of care behaviours by cognitively impaired older patients. Conclusion: Though reports are mixed as to whether elderspeak is a harmful or helpful practice, most literature condemns the practice as an ageist act that leads to adverse effects in patients, particularly those with a cognitive impairment. Educational interventions have shown substantial promise in reducing ageist attitudes and elderspeak in nursing staff internationally but to strengthen confidence, research in the Australian setting would be required.