Question

why is it essential to lead a life with dignity

Answer 1

There is some evidence within healthcare that one's health can actually improve and that one can cope better with illness when one isn valued and treated with respect. Therefore promoting dignity can lead to a better quality oflife. Dignity is sometimes associated with autonomy and having control over one's destiny

Answer 2

Dignity is sometimes associated with autonomy and having control over one's destiny. In terms of healthcare, and in particular in relation to older people, anecdotal evidence suggests that:


The Government health strategy, Quality and Fairness - A Health System for You, published in 2001 by the Department of Health and Children, included dignity as a key element. In terms of best practice in customer care, it says: "The vision adopted for the future health system places a high value on treating people with dignity and respect" (page 80). Also, in terms of staff, it says: "Strategies come and go, but the people who are an integral resource to the health system need to be appreciated, developed, motivated and effectively managed with respect and dignity if the desired vision, values, goals and objectives are to become reality" (page 53).

Older People's Views on Dignity

Definitions of Dignity

The predominant interpretation of dignity by participants over 65 was respect. Generally, this was spoken of in terms of treating others with respect and being treated with respect by others.

Respect was something many participants learned when they were young from their parents. It presented itself as a code of conduct on how to treat others and how to behave oneself. Once appropriated, it shaped one's character and gave one a sense of one's own dignity.

"Dignity is the way I was raised. We were reared with a set of codes, yes was yes and no was no. Respect, loyalty, good manners - being straight and honest, never be afraid to say hello or smile; your time is your character and your word is your bond, that is my dignity and I still hold it" (Male, Aged 65).

For older people to feel that they have a contribution to make to society is very important to them:

"Never feel that nobody wants you, always feel that you are you, that you have something to contribute to society in your own little way" (Female, Aged 80).
Some however expressed a doubt whether they could maintain their self-worth if they developed Alzheimer's. One participant reacted strongly to the suggestion that dying with dignity could justify euthanasia:
"I don't think suffering pain will take away dignity. You may have anguish but you can have anguish and also have dignity at the same time" (Female, Aged 65).
Hospital Experiences

On the whole, older people were very positive in their views on how they were treated in hospital. Ambulance staff, doctors, nurses and paramedics were all commended:
"I come out of there feeling somebody is looking after me so I don't mind in the least going in" (Male, Aged 77).

Making time for their patients is particularly appreciated:
"The nursing staff up here work very, very hard. They do. But I always find time to talk to them or they to me and they have always treated me with dignity. It didn't matter whether they were just passing, you were acknowledged and you were treated like the person you are" (Male, Aged 73)

Nursing Home Experiences

There was general praise for nursing homes by the majority of participants. Unlike in the past when older people were sometimes institutionalised against their will, today people have choices and going into a nursing home is not seen as something negative because of the quality of life afforded to the residents. As one participant said on visiting a friend in a home:
"They treated her with respect and she looked it, always beautifully dressed" (Male, Aged 75).

While the loss of a certain amount of independence did result from being in an institution, e.g. one could not always make a cup of tea when one wished, there was also a realisation that if one remained with relatives (depending on how well one was treated) one could also lose a lot of independence, and have to put up with noisy children and not being able to watch the TV programme one wanted.

Adjusting to life in a home can however be difficult, especially for those who lived for a long time on their own:
"It is hard to change or adapt. You are away from home. Your friends are gone. That is what I find hard. I can't get out or move about. The visitors get fewer the longer you are away" (Male, Aged 82).


Professionals' Views on Dignity

Definitions of Dignity

As was the case with the older people's focus groups, the preferred word by professionals as a substitute for the word dignity was respect. Other words used were empathy, freedom and individuality.


Conclusion

Respect is the key word used to describe dignity by older people. The three things that stand out in relation to treating older people with respect are: Equality, Choice and Belonging. Older people want to be treated the same as everyone else, they want to have choices about their care and they want to feel that they have something to contribute to society. They do not want to be discriminated against, have their independence undermined or be thrown out on the scrap heap.





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