palliative care education conference dignity in care julia ryan director of research and graduate...

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Dignity in CareDignity in CareJulia RyanJulia RyanDirector of Research and Graduate Studies Director of Research and Graduate Studies Senior Lecturer in Older Adult NursingSenior Lecturer in Older Adult [email protected]@salford.ac.uk0161 29527900161 2952790


What is dignity?What is dignity?

Isn’t it obvious?Isn’t it obvious?


The Healthcare Commission identified the The Healthcare Commission identified the most common complaints they receive most common complaints they receive which impact on older people’s experience which impact on older people’s experience of dignity in careof dignity in care

What do you think might in the Commission’s What do you think might in the Commission’s list?list?

Spend two minutes talking to the person next Spend two minutes talking to the person next to you about what you think.to you about what you think.


Being addressed in Being addressed in an inappropriate an inappropriate mannermanner

Being spoken about Being spoken about as if you are not thereas if you are not there

Not being given Not being given proper informationproper information

Not being asked for Not being asked for consent consent

Being left in soiled Being left in soiled clothesclothes

Being exposed in an Being exposed in an embarrassing mannerembarrassing manner

Not being helped to Not being helped to eat and drinkeat and drink

Being in mixed sex Being in mixed sex accommodationaccommodation

Being left in painBeing left in pain Being in a noisy Being in a noisy

environment at nightenvironment at night Lack of protection of Lack of protection of

personal propertypersonal property Being subject to Being subject to

mistreatment and mistreatment and abuseabuse


Dignified careDignified care

‘‘When you feel that they treat you with loving care, When you feel that they treat you with loving care, affection, attention, gentleness it makes you feel good. affection, attention, gentleness it makes you feel good. It makes you feel like a human being’It makes you feel like a human being’

‘‘They always find time to talk to me and treat me with They always find time to talk to me and treat me with dignity. It didn’t matter whether they were just passing, dignity. It didn’t matter whether they were just passing, you were acknowledged and you were treated like the you were acknowledged and you were treated like the person you are.’ person you are.’

‘‘They never make me feel like another old woman. They They never make me feel like another old woman. They remember who I am, a mother, a grandmother, and that remember who I am, a mother, a grandmother, and that I bring another life with me’ I bring another life with me’


Undignified careUndignified care ‘‘He was, well, a sort of dignified man. Marvellous mind. He was, well, a sort of dignified man. Marvellous mind.

And he had to go into hospital towards the end of his life And he had to go into hospital towards the end of his life and he did tell me, when I went in to see him once, and he and he did tell me, when I went in to see him once, and he told me that he couldn’t stand this business of ‘Come on told me that he couldn’t stand this business of ‘Come on love’ or them calling him ‘George’ . That just wasn’t his love’ or them calling him ‘George’ . That just wasn’t his language, he was very dignified.’ language, he was very dignified.’

‘‘The doctor and the nurse just chatted together while he put The doctor and the nurse just chatted together while he put in the drip- it was awful. They just moved him as if he were in the drip- it was awful. They just moved him as if he were an object. Not one word, not one smile, nothing’. an object. Not one word, not one smile, nothing’.

‘‘They would not do any deliberate harm to her but they did They would not do any deliberate harm to her but they did a lot of negative harm in the way in which they treated her, a lot of negative harm in the way in which they treated her, because she was still able to make certain kinds of because she was still able to make certain kinds of decisions for herself. But somehow even these were taken decisions for herself. But somehow even these were taken away from heraway from her’ ’


Why does dignity matter?Why does dignity matter?

Positive health and Positive health and social outcomessocial outcomes

Legal and Legal and professional professional requirementsrequirements

Fundamentals of careFundamentals of care

It is rightIt is right


Dignity: a Human Right? Dignity: a Human Right?

The right to life Freedom from

degrading treatment

The right to liberty

The right to respect for

private and family life

Freedom of thought, conscience and religion Freedom of

expression

The right to peaceful enjoyment

of your property

The right not to be discriminatedagainst in any of these

rights or freedoms


IT’S NOT ROCKET SCIENCE?IT’S NOT ROCKET SCIENCE?

OR IS IT? OR IS IT?

What do you do to What do you do to ensure dignity in ensure dignity in care?care?


Care which enhances dignityCare which enhances dignity

RespectRespect

PrivacyPrivacy

AutonomyAutonomy

Sense of selfSense of self


The Senses FrameworkThe Senses FrameworkNolan et alNolan et alSecuritySecurity

BelongingBelonging

ContinuityContinuity

PurposePurpose

AchievementAchievement

SignificanceSignificance


Relationships and sense of Relationships and sense of communitycommunity

PragmaticPragmaticTask focusedTask focused

Personal and responsivePersonal and responsiveResident focusedResident focused

ReciprocalReciprocal

Relationship focusedRelationship focused

Brown Wilson 2009Brown Wilson 2009

Residents•Family•Friends•Neighbours

Staff


Leadership Leadership

Shared valuesShared values TeamworkTeamwork

Continuity and consistency Continuity and consistency Mutual Trust Mutual Trust

Reciprocity Reciprocity


Enhancing dignityEnhancing dignity

Trust

Fairness

Respect

EqualityIndependence

Autonomy

Participation

Privacy Security

Belonging

ContinuityPurpose

Achievement

Significance


Do the mirror test!Do the mirror test!

What do you see?

palliative care education conference dignity in care julia ryan director of research and graduate...

Documents

loving care

right slide

abuse slide

human right

dignity matter

family life freedom

commissions list

religion freedom of