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Dignity in care

What is dignity?

Dignity consists of many overlapping aspects, involving respect, privacy, autonomy and self-worth. The provisional meaning of dignity used for this guide is based on a standard dictionary definition:

A state, quality or manner worthy of esteem or respect; and (by extension) self-respect. Dignity in care, therefore, means the kind of care, in any setting, which supports and promotes, and does not undermine, a person€™s self-respect regardless of any difference.€

While €˜dignity€™ may be difficult to define, what is clear is that people know when they have not been treated with dignity and respect.

What does €˜in care€™ cover?

This covers all care provided by paid workers in any setting (hospital, residential, nursing, day centres and in people€™s own homes), including care that is paid for either partially or wholly by the recipient.

Background

The issue of dignity features prominently in the new framework for health and social care services:The Department of Health€™s Green Paper, ‘Independence, well-being and choice’ (2005a) and subsequent White Paper, ‘Our health, our care, our say’ (2006f), are set around seven key outcomes identified by people who use services, one of which is personal dignity and respect.

The CQC  has incorporated these into their new assessment framework, ‘A new outcomes framework for performance assessment of adult social care’ (2006).The Department of Health€™s National Service Framework for Older People (2001) also supports a €˜culture change so that all older people and their carers are always treated with respect, dignity and fairness€™, and its ‘Essence of Care: Patient-focused benchmarking for health care practitioners’ (2003c) offers a series of benchmarks for practice on privacy and dignity.

Factors that have been held responsible for the absence of dignity in care include:

  1. Bureaucracy
  2. Staff shortages
  3. Poor management and lack of leadership
  4. Absence of appropriate training and induction
  5. Difficulties with recruitment and retention leading to overuse of temporary staff.

There are also wider societal issues, including ageism, other forms of discrimination and abuse. A great deal of work is needed to tackle negative attitudes towards older people, to bring about a culture change and to ensure that such attitudes have no place in the health and social care sectors.