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Exploring emotional communication between older persons and nursing assistants in home care: a qualitative study

Gustafsson, T., Lindberg, E., Maurin Söderholm, H., Hedén, L., Dulmen, S. van, Sundler, A.J. Exploring emotional communication between older persons and nursing assistants in home care: a qualitative study. International Journal of Older People Nursing: 2025. 20(5), art. nr. e70048.

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Introduction
Communication between older persons and nursing assistants is important in providing high-quality, person-centred home care. While previous research has reported on older persons' emotional concerns during home care conversations, there is a need to gain an in-depth understanding of emotional concerns' role in such conversations and how to support the older persons' comfort and well-being. Therefore, this study aimed to explore the nature and focus of emotional communication between older persons and nursing assistants in home care.

Methods
A descriptive qualitative design using observational data from 83 audio-recorded home care visits was used to identify and analyse sequences of distressing emotional communication, analysed through thematic analysis.

Results
In this study, four themes were described illustrating how emotional communication between older persons and nursing assistants during home care visits creates opportunities for empathy: (1) recognising empathic opportunities, (2) identifying subtle and vague signs of emotional distress, (3) expressing needs for emotional support, and (4) striving to restore comfort in challenging conversations.

Conclusions
Conversations about older persons' emotions and worries can be complex. The findings indicate a fine line between meaningfulness and discomfort in emotional sequences. Expressions of emotional distress provide empathic opportunities that call for attentiveness and sensitivity from nursing assistants, implying a need for education and training in person-centred communication.

Implications for practice
Emotional communication acknowledging empathic opportunities enhances person-centred care by promoting trust, comfort, and well-being. Ultimately, emotional communication reinforces the importance of empathy in home care and creates space for emotional interactions, leading to more supportive relationships.