The aging of the population in Western countries will increase the use of social and health services in the future. Employees in eldercare are at risk for experiencing moral distress, which is associated with poor work ability. The causes and consequences of moral distress among eldercare workers remain undiscovered. This scoping review investigates the existing studies of causes and consequences of moral distress among eldercare workers. Additionally, it seeks evidence of interventions designed to mitigate moral distress in eldercare workers. Fourteen studies were included in the final review. Most of the included studies were qualitative, aiming to increase understanding of morally challenging situations in eldercare. We also found quantitative studies with cross-sectional designs and small sample sizes. Thus, no reliable evidence of causal effects between moral distress and worker wellbeing in eldercare was found. We found no interventions undertaken to resolve moral distress among eldercare workers, either. More research is needed on the causes and consequences of moral distress and on interventions to mitigate moral distress among eldercare workers. This is of utmost importance to increase the attractiveness of eldercare as a workplace and to improve eldercare workers’ ability to work and sustain long working careers.

Elderly care practitioners are at specific risk of experiencing prolonged moral distress, which is associated with occupational health-related problems, low job satisfaction, and staff turnover. So far, little attention has been paid to the moral concerns specific to elderly care, a field whose importance is constantly growing as the populations in Western countries age. By drawing on seven workshop conversations as data and interaction-oriented focus group research, conversation analysis and discursive psychology as methods, we aim to study the ways in which elderly care practitioners discuss moral distress in their work. We found that the moral distress experienced was related to three topics that arose when client work and teamwork contexts were discussed: the power to influence, equal treatment of people, and collaboration. The interaction in client work and teamwork contexts differed systematically. The discussion on client work was characterised by negotiations on the rights and wrongs of care work, whereas the teamwork discussion engendered emotional outbursts, a potential manifestation of work-related burnout. Hence, attempts to improve the work-related health of elderly care practitioners require time and space for sharing the emotional load, followed by reflection on what could be improved in the work and what institutional solutions could help in morally distressing situations.

Purpose: An “open communication culture” in the workplace is considered a key contributor to high-quality interaction and providing means to address problems at work. We study how the ideals of “open communication” operate in healthcare.Design/methodology/approach: We use discourse analysis to investigate the audio-recorded data from 14 workshop team discussions in older people services.Findings: We found four imperatives concerning the interactional conduct of their colleagues in problematic situations that nursing professionals prefer: (1) Engage in direct communication and avoid making assumptions, (2) Address problems immediately, (3) Deal directly with the person involved in the matter and (4) Summon the courage to speak up. Through these imperatives, the nursing professionals invoke and draw upon the “open communication” discourse. Although these ideals were acknowledged as difficult to realize in practice and as leading to experiences of frustration, the need to comply with them was constructed as beyond doubt.Practical implications: Workplace communication should be enhanced at a communal level, allowing those with less power to express their perspectives on shaping shared ideals of workplace interaction.Originality/value: The expectation that an individual will simply “speak up” when they experience mistreatment by a colleague might be too much if the individual is already in a precarious position.