In a care home setting, the word ‘dignity’ is one that often crops up, but do we understand the true meaning of dignity in health and social care? It’s a lot simpler than you may think.
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Fundamental to the current social care policy, dignity means ensuring the wellbeing of residents is always a top priority.
As defined by the Social Care Institute for Excellence, dignity in care means providing care that supports the self-respect of the person, recognises their capacities and ambitions and does nothing to undermine it.
High-quality person-centred or patient-centred care is tailored to the exact needs of the resident, this personalisation provides carers with the opportunity to learn what each individual likes and dislikes and how they like to be treated.
This method supports the person’s sense of self-respect and shows the provider’s commitment to treat each individual with dignity and respect.
The bottom line of care homes is for residents to be safe, looked after and be as happy as possible, in order for them to feel this way, they must be treated with dignity and respect in all aspects of their life and their needs must be attended to.
Carers working in care homes have a role to fulfil that prioritises the needs and safety of residents.
Moving into a care home may be a big enough change in itself for some older adults, so carers have a duty to help them feel as comfortable as possible.
It is not uncommon for residents to feel uncomfortable in a care home as they may have come from living independently to being dependent on carers to upkeep personal hygiene, be fed and move around.
As a carer or anyone who works in a care home, it’s vital to remember that for a resident, it is their home, not a workplace. Everyone comes from different backgrounds and it’s important to make everyone feel included, safe and dignified in their own environment.
According to the Social Care Institute for Excellence, there are eight dignity factors. They help health and social care workers, nurses and other care home staff understand that upholding dignity is in the small and seemingly inconsequential things.
By thinking about the decisions a normal day entails, it’s easy to see a range of opportunities to provide residents with choice and control over their own life.
From deciding what time to wake up and choosing their own clothes, to what they feel like eating and deciding how they want to spend their afternoon, just because an individual is dependent on others to live their life safely, it doesn’t mean they can’t make choices for themselves.
By allowing someone to make their own decisions, residents can feel empowered and it can help provide a sense of self-respect.
When it comes to talking to each individual, speaking respectfully and listening to what they have to say is an important way to ensure clear dialogue between resident and carer.
By involving the resident in any decisions regarding their care, such as a change in medication, they can feel safer and in control over their care.
Residents should also always be addressed with respect and by their preferred name and gender.
Methods of communication should also be thought about in order to ensure residents don't feel patronised, high-pitched tones and nicknames like ‘darling’ or ‘love’ may be upsetting for some.
Mealtimes are the highlight of the day for some, so it’s crucial to make this time as enjoyable as possible for residents. Some residents may not enjoy the same type of food as they once did so it’s important that they always have a choice over what they eat.
Carers should always make residents feel comfortable around food as it can cause issues for some, for example, if a resident eats particularly slow, give them enough time to enjoy their meal and wait until they are finished to clear the table rather than rushing them in order to finish a shift.
When creating meal plans, it’s important to involve the resident as much as possible, this helps them have a sense of control over their life in the care home.
The kitchen staff should be skilled at cooking with fresh, quality ingredients and present food well.
Elderly people are at more risk of experiencing pain but are less likely to complain or want medication, so learning how to detect pain can be tricky, but it’s vital to their wellbeing.
Knowing how to detect pain can help residents enjoy the remainder of their life. There are many ways to identify signs of pain without being told, some include restlessness, social isolation and changes in regular behaviour.
Detecting pain in residents can be easier for those who care for the same individually regularly as it may be easier to notice changes in behaviour.
This also enables carers to build stronger relationships with the resident and it could mean they are willing to tell you about pain in the future.
A human beings personal appearance and hygiene are integral to their self-respect, for residents who require support to maintain these standards, carers have a duty to give the level of support necessary.
Moving into a care home can be a big change for some residents, it’s easy for residents to feel uncomfortable and awkward when it comes to needing help washing and getting dressed.
In order to maintain dignity, carers should always ask for consent and use the time to talk and explain what is happening as it happens, this may help reduce how hyperaware they are about their body.
Some residents may prefer the radio or television on to act as a distraction, it’s important to understand that everyone has different boundaries and just because carers may be used to handling these situations, it’s normally unfamiliar to residents.
Carers have a responsibility to look after and provide practical assistance to residents - whether it be cleaning up after the resident, helping with ironing, gardening, pets, healthcare and other practical areas that residents may need assistance with, these small tasks can help someone feel a lot more dignified when they cannot perform them themselves.
Everyone has different preferences when it comes to their surroundings, for example, living in a clean environment is generally important to older people in terms of maintaining their dignity.
Privacy is important to every human being, there are small yet meaningful ways carers can practice privacy with residents, such as knocking before entering, not going through belongings and not discussing any personal endeavours with others.
By maintaining this trust, residents may begin to feel more comfortable and in turn, it will create a stronger relationship between the resident and the carer.
Respecting residents’ personal space and boundaries is important as moving into a care home with other residents can be a big shift from living independently.
Social inclusion is vital to an individual’s wellbeing. It’s important to ensure resident’s feel included during social activities and day to day life in care, these opportunities to participate and make a positive contribution to their community is integral for their dignity.
Most care homes have extensive activity programmes including arts and crafts, light exercise and much more, these are a great way to encourage residents to socialise with others.
It should also be said that carers should not force residents to partake in activities they don’t want to as this is a breach of boundaries and personal preferences should be respected.
Whilst care is proven to be a particularly demanding job, maintaining dignity of residents is an important aspect of care and one that should never be overlooked.
Luckily, the National Dignity Council identified seven key principles in 2014, giving guidance and help to those working in social care, from registered nurses to social care practitioners.
Here are the best ways to offer care and support according to the National Dignity Council:
As you now know, promoting dignity is in the little things, from letting residents choose their own outfits to speak with them in a respectful manner, there is a multitude of simple yet effective ways to promote dignity in a care home.
Unfortunately, there are many challenging care environments where there are cultures of callous indifference to older people.
Especially during times of staff shortages and heavy workloads, the feelings and needs of residents are usually one of the first things to be overlooked.
By making small adjustments through staff training and change in management’s attitude, residents can live a dignified and happy life in a safe environment.
If you work in a care home or have a loved one receiving care and are concerned about the level of care and dignity in a care home, it’s important that you raise these concerns to management if appropriate.
You can also make a report to the Care Quality Commission.