Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Ethical Challenges in Nursing Care for Older Adults: A Narrative Review

Document Type : Review

Authors
1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
10.22118/jsmj.2025.558704.4076
Abstract
Background and Objective: Experiencing ethical challenges in clinical nursing is a common phenomenon. Nurses, in providing nursing care and fulfilling their responsibilities toward older adults, encounter various challenges and difficulties. These include patients leaving the hospital against medical advice, decision-making in end-of-life care, neglect in caregiving, shortages of staff, equipment, and time. Given the phenomenon of population aging and the importance of ethical principles in elderly care, the present study was conducted with the aim of reviewing ethical challenges in caring for older adults.
Methods: This narrative review study was conducted by searching GoogleScholar, PsycInfo, PubMed, ScienceDirect, and Persian databases Irandoc, Magiran, SID in the period 2017–2025 with the Keywords “ethical challenge,” “ethical dilemma,” and “elderly.” Inclusion criteria were age above 65 years and exclusion criteria were lack of relevance to the study objectives and unavailability of full text. Ultimately, 10 articles relevant to the topic were included, and data were extracted from them.
Results: Overall, nine major ethical challenges in elderly care were identified: Autonomy and self-care, decision-making and informed consent, collaboration with relatives, direct caregiving for older adults, ageism, human resources, value and respect, justice in care, and financial support.
Conclusion: The results of this study demonstrated that significant ethical challenges exist in elderly care, which affect not only the quality of nursing care but also the improvement and promotion of older adults’ health. Therefore, it is essential that elderly care be grounded in respect, preservation of human dignity, and adherence to ethical principles.
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  • Receive Date 09 November 2025
  • Revise Date 20 December 2025
  • Accept Date 24 December 2025