Tabriz Valiasr International Hospital Publication International Journal of Aging 2980-9827 3 1 2025 01 12 Autonomy of the Elderly in the Hospital Environment: A Comprehensive Review e9131 e9131 10.34172/ija.9131 EN Abdolhassan Kazemi https://orcid.org/0000-0003-1219-5725 Mehmet Tatli Samad E J Golzari Ehsan Sarbazi https://orcid.org/0000-0001-8190-9942 Journal Article 10.34172/ija.9131 2025 08 03 2025 10 15 Objectives: This review examined the factors that impact elderly autonomy, including cognitive impairments, communication barriers, institutional policies, and family dynamics. Design: A review study. Setting(s): Hospital environment. Participants: Older adult patients. Outcome Measures: Information about the autonomy of the elderly in the hospital environment. Results: Cognitive disorders, such as dementia and delirium, can severely limit decision-making capacity, while sensory impairments and health literacy challenges impede effective communication. Rigid hospital protocols and environmental stressors can undermine patient engagement. Strategies to enhance autonomy included training healthcare professionals in geriatric care and effective communication, implementing tailored patient education initiatives, and fostering collaborative family involvement in decision-making. Furthermore, creating supportive hospital environments and adopting shared decision-making models were found to empower elderly patients to actively participate in their care. By addressing the barriers to autonomy and promoting patient-centered approaches, healthcare providers can improve the quality of care for elderly patients, ensuring their rights and preferences are respected. Conclusions: By identifying and addressing various factors that affect autonomy, from cognitive impairments to institutional policies, healthcare providers can implement effective approaches to enable elderly patients in their healthcare decisions. This comprehensive review indicates the necessity of integrating autonomy into the healthcare framework for elderly individuals, contributing to superior health outcomes and patient satisfaction.