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"Just because people are old, just because they're ill..." dignity matters in district nursing
- Authors:
- STEVENS Emma, PRICE Liz, WALKER Liz
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.3-14.
- Publisher:
- Emerald
Purpose: This paper aims to explore the concept and practice, of dignity as understood and experienced by older adults and district nursing staff. The paper adds a new, nuanced, understanding of safeguarding possibilities in the context of district nursing care delivered in the home. Design/methodology/approach: The research used an ethnographic methodology involving observations of care between community district nursing clinicians and patients (n = 62) and semi-structured interviews with nursing staff (n = 11) and older adult recipients of district nursing care (n = 11) in England. Findings: Abuse is less likely to occur when clinicians are maintaining the dignity of their patients. The themes of time and space are used to demonstrate some fundamental ways in which dignity manifests. The absence of dignity offers opportunities for abuse and neglect to thrive; therefore, both time and space are essential safeguarding considerations. Dignity is influenced by time and how it is experienced temporally, but nurses are not allocated time to "do dignity", an arguably essential component of the caregiving role, yet one that can become marginalised. The home-clinic exists as a clinical space requiring careful management to ensure it is also an environment of dignity that can safeguard older adults. Practical implications: District nurses have both a proactive and reactive role in ensuring their patients remain safeguarded. By ensuring care is delivered with dignity and taking appropriate action if they suspect abuse or neglect, district nurses can safeguard their patients. Originality/value: This paper begins to address an omission in existing empirical research regarding the role of district nursing teams in delivering dignified care and how this can safeguard older adults. (Edited publisher abstract)
Older people's experiences of dignity and nutrition during hospital stays: secondary data analysis using the Adult Inpatient Survey
- Authors:
- VIZARD Polly, BURCHARDT Tania
- Publisher:
- London School of Economics. Centre for Analysis of Social Exclusion
- Publication year:
- 2015
- Pagination:
- 210
- Place of publication:
- London
The report uses the Adult Inpatient Survey 2012 to build up an in-depth quantitative evidence base on older people’s experiences of dignity and nutrition during hospital stays in England. It shows that just under one-quarter of inpatients reported that they were not treated with dignity and respect, or were only sometimes treated with dignity and respect during their hospital stay. The analysis estimates that this is equivalent to around 2.8 million people on an annual basis - of whom about 1 million are aged 65 or over. Inconsistent and poor standards of help with eating during hospital stays were also a key concern. In 2012, about a quarter of all survey respondents indicated that they needed support with eating during their hospital stay. This is a substantial proportion and points towards the issue of support with eating being a major issue for significant numbers of inpatients – just under three and a half million each year - rather than being a marginal or specialist issue. Of those who needed help with eating, more than 1 in 3 reported that they only sometimes received enough help with eating from staff, or did not receive enough help from staff. Logistic regression analysis suggests that, after other factors are controlled for, the risk of not being helped with eating is significantly higher for women rather than men and for individuals who experience a longstanding limiting illness or disability such as deafness or blindness, a physical condition, a mental health condition or a learning difficulty, or a longstanding illness such as heart disease, stroke or cancer. Perceptions of inadequate nursing quantity and quality, and lack of choice of food, stand out as having consistent, large associations with lack of support with eating during hospital stays. The report concludes that there was a widespread and systematic pattern of inconsistent or poor standards of dignity and respect, and help with eating, in hospitals in England in 2012, and these were a significant general problem affecting inpatients in the vast majority of NHS acute hospital trusts (Edited publisher abstract)
Dementia Action Alliance impact survey
- Author:
- KITCHEN Simon
- Publisher:
- Dementia Action Alliance
- Publication year:
- 2014
- Pagination:
- 25
- Place of publication:
- London
This is the first draft summary of the findings from the Dementia Action Alliance Impact survey for the DAA Board and DAA members, providing a snap shot of progress on the National Dementia Strategy and achievement of the National Dementia Declaration. The survey was completed by 1,352 respondents from a broad spread of geographic areas and perspectives including people with dementia, carers and professionals. The survey has found that the original objectives of the National Dementia Strategy were sound and continue to be relevant. The majority of valid responses said that there has been 'some' or 'lots' of progress against 16 of the 17 objectives from the original strategy. Raising awareness and understanding amongst the public and professionals has made the most progress. More respondents felt the NDS had 'got it right' for people with dementia than carers. A continuation of the NDS with modified objectives is strongly endorsed by DAA members and wider stakeholder network. People with dementia were most positive about 'I' statements related to dignity, choice, control and public attitudes to dementia but were much less positive about the support provided to those caring for them, with neutral scores on information and networks for carers and a negative score for access to respite care. There were significant negative scores for ongoing support from GPs, access to information and know-how and understanding by employers if they received an early diagnosis. (Edited publisher abstract)
Dignity in care survey in North Wales
- Author:
- MORGAN Gareth
- Journal article citation:
- Working with Older People, 16(4), 2012, pp.175-179.
- Publisher:
- Emerald
This paper describes the findings of a survey conducted in North Wales looking at the perceptions of older people on dignity in care issues in the services they received. The North Wales Dignity in Care Forum carried out the survey, driven by the question: What one change today could make a difference to you tomorrow? National Health Service and local authority organisations were involved and 499 responses were received. Thematic analysis of the responses revealed a number of key issues. The top three concerns were keeping independence, individual respect and personal care. There were some difference in the responses from the NHS and the local authority participants. In particular, the wide range of issues raised by the NHS group made these responses difficult to interpret. The authors highlight the limitations of this rapid study, including; absence of demographic data and an open sampling frame. However they believe the results show that there is value in using rapid and inexpensive methods to collect information from older people accessing services.
Maintaining dignity in later life: a longitudinal qualitative study of older people's experiences of support and care
- Authors:
- LLOYD Liz, et al
- Publisher:
- New Dynamics of Ageing
- Publication year:
- 2011
- Pagination:
- 3p.
- Place of publication:
- Sheffield
In later life, health problems can be complex and life-threatening and lead to a loss of independence, identity and dignity. This briefing summarises the findings of a study to examine preparations for the end of life made by older people with supportive care needs and the factors that support or undermine a sense of dignity. The participants were 34 individuals aged 70 years and over who lived at home and had health problems that required support and care to varying degrees. Participants were interviewed several times over the period between June 2008 and December 2010 about the changes occurring in their everyday lives and whether they felt the help they received promoted or undermined their dignity. All the participants talked about the challenges their health problems posed to their sense of self and their identity. Their accounts highlight the ways in which older people adapt to a growing need for help whilst also striving to maintain their independence. The evidence shows that thoughtless and unkind behaviour exacerbates the loss of dignity and sense of self whilst sympathetic and respectable care can help to maintain it.
Views on dignity in providing health care for older people
- Authors:
- CALNAN Michael, et al
- Journal article citation:
- Nursing Times, 16.08.05, 2005, pp.38-39.
- Publisher:
- Nursing Times
The aim of this study was to explore the salience and meaning of dignity and dignified care for care providers and the implications for the provision of care. The project forms part of an international study being undertaken in different European countries comparing health and social care workers' views on dignity. Twelve focus groups were carried out involving a total of 52 participants representing a range of occupational groups. All participants stated that dignity and respect were important for people of all age groups. The evidence the emerged from these focus groups showed that, in spite of the appropriate intentions of providers, older people were not consistently provided with dignified care.
Dignity in care: the views of patients and relatives
- Authors:
- GALLAGHER Ann, SEEDHOUSE David
- Journal article citation:
- Nursing Times, 22.10.02, 2002, pp.34-35.
- Publisher:
- Nursing Times
Preserving a patient's dignity is central to good care, but standards may often not live up to this ideal. Reports on a small pilot study that explores dignity in health care and the circumstances that may influence it.
Dignity on the ward; the future of hospital care for older people; a conference at London's Royal College of Physicians on Monday 29 November 1999
- Author:
- HELP THE AGED,
- Publisher:
- Help the Aged
- Publication year:
- 1999
- Pagination:
- 7p.
What defines quality of care for older people in aged care? A comprehensive literature review
- Authors:
- CLELAND Jenny, et al
- Journal article citation:
- Geriatrics and Gerontology International, 21(9), 2021, pp.765-778.
- Publisher:
- Wiley
The quality of the care provided to frail older people in aged care is a concern for all Australians and for the citizens of many other countries internationally. This paper summarizes the methods and findings from an Australian study commissioned by the Royal Commission into Aged Care Quality and Safety to identify and synthesize international literature relating to the quality of care in aged care. A comprehensive literature review was undertaken to search and identify the literature (grey and peer reviewed) relating to quality of care and/or person-centered care in aged care. The review identified nine key themes as salient to the quality of care experience, which include treating the older person with respect and dignity; acknowledging and supporting their spiritual, cultural, religious and sexual identity; the skills and training of the aged care staff providing care; relationships between the older person and the aged care staff; social relationships and the community; supporting the older person to make informed choices; supporting the older person's health and well-being; ensuring the delivery of safe care in a comfortable service environment; and the ability to make complaints and provide feedback to the aged care organization. In practice, particularly in the context of residential care, quality of care has traditionally been measured using clinical indicators of care quality. These findings highlight the central importance of person-centered care and care experience as fundamental tenets of the quality of aged care service delivery in Australia and internationally. (Edited publisher abstract)
Identity in the fourth age: perseverance, adaptation and maintaining dignity
- Authors:
- LLOYD Liz, et al
- Journal article citation:
- Ageing and Society, 34(1), 2014, pp.1-19.
- Publisher:
- Cambridge University Press
This article seeks to add an understanding of the fourth age by drawing on findings from a study of dignity in later life . The study examined the day-to-day experiences of a group of 34 people aged over 75 and older (with one exception aged 70) who were in need of support and care because of failing health. It discusses their accounts of the changes to their sense of self and their identity that came about as a result of their ageing and health problems and looks also at the ways in which the support and care they received helped to shape their adjustment to those changes. The accounts given by participants reveal a great deal about the physical, mental and emotional effort entailed in maintaining a sense of self and highlight the essential role played by social relationships in the maintenance of identity. These findings are analysed by reference to emerging theories of the fourth age. (Edited publisher abstract)