Abstract

BackgroundDespite well established national and local policies championing the need to provide dignity in care for older people, there continues to be a wealth of empirical evidence documenting how we are failing to deliver this. While we have evidence as to what older people and their relatives understand by the term ‘dignified care’ we have less insight into the perspectives of staff regarding their understanding of this key policy objective. This paper aimed to explore the meaning of dignified care from the perspective of health and social care professionals’ working with older people. In-depth interviews and focus groups with health and social care professionals were carried out across four NHS Trusts in England, as part of a larger study, to investigate how dignified care for older people is understood and delivered. A total of 48 health professionals took part in in-depth interviews and 33 health and social care professionals participated in one of eight focus groups.ResultsHealth and social care professionals defined the meaning of dignified care as: ‘dignity is the backbone of care’, ‘it’s the “little things”’, ‘feeling safe and secure’, ‘treat as you want to be treated’, ‘treat as an individual’ and ‘Dignity encompasses multiple factors’. ‘Hands on’ aspects of care were rarely mentioned when defining dignity. This suggests that policies around providing dignified care are being interpreted as an approach towards care and not with direct care provision. This limited interpretation of dignity may be one factor contributing to the continued neglect of older people in acute settings.ConclusionsThese findings highlight that proactive measures are required to ensure that both relational and ‘hands on’ aspects of care are met for all older people receiving care in NHS trusts.

Highlights

  • Despite well established national and local policies championing the need to provide dignity in care for older people, there continues to be a wealth of empirical evidence documenting how we are failing to deliver this

  • The care that older people receive has been the focus of intense public concern across the United Kingdom (UK) over recent years

  • This paper reports findings on a key research question from in-depth interviews and focus groups of health and social care professionals which forms part of a larger case study exploring how dignified care for older people is understood and delivered by health and social care professionals and; how organisational structures and policies can promote and facilitate, or hinder, the delivery of dignified care

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Summary

Introduction

Despite well established national and local policies championing the need to provide dignity in care for older people, there continues to be a wealth of empirical evidence documenting how we are failing to deliver this. In-depth interviews and focus groups with health and social care professionals were carried out across four NHS Trusts in England, as part of a larger study, to investigate how dignified care for older people is understood and delivered. A philosophical model of dignity and its relevance to older people has been advanced by Nordenfelt [16] and his comprehensive analysis divides dignity into four types including: merit, moral status, personal identity, and universal human dignity (referred to by the German word Menschenwürde). The first three types of dignity (merit, moral status and personal identity) are subjective and depend upon external influences. An older patient in hospital should be treated in the same way as younger patients as they have the same basic human rights

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