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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 persons 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 peoples 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 Healths 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.
CQC checks about diginity during inspections. The Department of Healths 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:
Bureaucracy
Staff shortages
Poor management and lack of leadership
Absence of appropriate training and induction
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.
