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Dignity in Care

Dignity in Care

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Dignity in Care

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  1. Dignity in Care Julia Ryan Director of Research and Graduate Studies Senior Lecturer in Older Adult Nursing j.ryan@salford.ac.uk 0161 2952790 palliative care education conference

  2. Isn’t it obvious? What is dignity? palliative care education conference

  3. The Healthcare Commission identified the most common complaints they receive which impact on older people’s experience of dignity in care • What do you think might in the Commission’s list? • Spend two minutes talking to the person next to you about what you think. palliative care education conference

  4. Being addressed in an inappropriate manner Being spoken about as if you are not there Not being given proper information Not being asked for consent Being left in soiled clothes Being exposed in an embarrassing manner Not being helped to eat and drink Being in mixed sex accommodation Being left in pain Being in a noisy environment at night Lack of protection of personal property Being subject to mistreatment and abuse palliative care education conference

  5. Dignified care • ‘When you feel that they treat you with loving care, affection, attention, gentleness it makes you feel good. It makes you feel like a human being’ • ‘They always find time to talk to me and treat me with dignity. It didn’t matter whether they were just passing, you were acknowledged and you were treated like the person you are.’ • ‘They never make me feel like another old woman. They remember who I am, a mother, a grandmother, and that I bring another life with me’ palliative care education conference

  6. Undignified care • ‘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 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 love’ or them calling him ‘George’ . That just wasn’t his language, he was very dignified.’ • ‘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 an object. Not one word, not one smile, nothing’. • ‘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, because she was still able to make certain kinds of decisions for herself. But somehow even these were taken away from her’ palliative care education conference

  7. Positive health and social outcomes Legal and professional requirements Fundamentals of care It is right Why does dignity matter? palliative care education conference

  8. Dignity: a Human Right? The right to life Freedom from degrading treatment Freedom of thought, conscience and religion Freedom of expression The right to liberty The right not to be discriminated against in any of these rights or freedoms The right to respect for private and family life The right to peaceful enjoyment of your property palliative care education conference

  9. IT’S NOT ROCKET SCIENCE? • OR IS IT? What do you do to ensure dignity in care? palliative care education conference

  10. Care which enhances dignity • Respect • Privacy • Autonomy • Sense of self palliative care education conference

  11. The Senses FrameworkNolan et al Security Belonging Continuity Purpose Achievement Significance palliative care education conference

  12. Pragmatic Task focused Personal and responsive Resident focused Reciprocal Relationship focused Brown Wilson 2009 Relationships and sense of community • Residents • Family • Friends • Neighbours • Staff palliative care education conference

  13. Leadership Shared values • Teamwork Continuity and consistency • Mutual Trust Reciprocity palliative care education conference

  14. Enhancing dignity Fairness Autonomy Continuity Doing Purpose Respect Trust Belonging Achievement Being Significance Security Privacy Independence Equality Participation palliative care education conference

  15. Do the mirror test! What do you see? palliative care education conference