RNSystematic ReviewScandinavian journal of caring sciences2025

Exploring the Ethical Dimensions of Care Dependency in Older People: A Transpersonal View.

Ana-María Porcel-Gálvez, Enrique-Octavio Iñiguez-Castro, Gloria Martínez-Lacovic and 1 others

PMID 41041897

WHAT IT FOUND

Care dependency in older adults is defined by four core attributes: loss of autonomy, erosion of identity, biographical rupture, and negative coping.

It is not just physical decline but an ethical and relational experience where preserving dignity requires shared decision-making and cultural respect.

Key findings

01The four defining attributes of care dependency are loss of autonomy, erosion of identity and self-image, biographical rupture, and negative coping.

02Care dependency involves a reconfiguration of identity and dignity that can lead to emotional suffering, rather than being solely a biomedical deficit.

03Transpersonal care practices, such as listening to life stories and respecting cultural values, can help preserve dignity and mitigate the negative consequences of dependency.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This is a concept analysis, not empirical research with patients, so it defines a framework rather than testing an intervention. The review excluded grey literature and was limited to publications up to 2022. Definitions of care dependency varied across the included studies, which may affect the consistency of the synthesized concept. The theoretical cases are constructed examples, not real patient data.

Declared interests

The authors declare no conflicts of interest.

The easy way to misread this

Do not treat this as evidence that a specific nursing intervention reduces dependency or improves outcomes. It is a theoretical framework for understanding the experience of dependency, not a clinical trial result.

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