Exploring Emotional Communication Between Older Persons and Nursing Assistants in Home Care: A Qualitative Study.
Tanja Gustafsson, Elisabeth Lindberg, Hanna Maurin Söderholm and 3 others
PMID 40996362WHAT IT FOUND
During home care visits, older people's sadness, worry and pain often appeared as hints, jokes, repeated concerns or mismatched tone.
When nursing assistants noticed these cues, they could respond with comfort; when tasks dominated, the concerns were missed or redirected.
Key findings
01Emotional expressions such as discomfort, insecurity, sadness, irritation or anger could open empathic conversations when nursing assistants recognised them and responded sensitively.
02Distress was sometimes hidden in metaphors, humour, or a tone that did not match the words, and could be overlooked while practical tasks continued.
03When nursing assistants focused on practical tasks, older people sometimes repeated emotional concerns, and tense topics were often redirected.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample from two home care units in a medium-sized municipality in western Sweden, so the themes may not apply to other services or staff groups. Only older persons fluent in Swedish, aged 65 years or older, living at home and without severe cognitive impairment were included, and no participants with language difficulties were included. Audio recordings captured tone, sighing and silence but not body language or gestures, so some emotional signals may have been missed. The researchers could not ask follow-up questions, so it is unclear whether missed emotional cues were deliberate strategies or the result of task-oriented focus and communication challenges. The analysed emotional communication sequences came from 42 recordings involving 12 nursing assistants and 18 older persons, a limited number of participants. Cultural, ethnic and socio-economic background were not collected, although the authors note that language and migrant background may shape interactions.
The easy way to misread this
Do not read these themes as proof that emotional communication improves health outcomes. The study describes recorded conversations in 42 of 83 home care visits from a limited number of participants and does not test whether any nursing response helped.