February 1st 2023 is dignity action day, something we all can stand behind and something people working in health and social care like to talk about frequently, “we provide dignified care”, “dignity is at the heart if what we do” etc.
But was is it and why is it such an important concept? The Care Quality Commission in citing the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 10; Dignity and Respect say:
The intention of this regulation is to make sure that people using the service are treated with respect and dignity at all times while they are receiving care and treatment. To meet this regulation, providers must make sure that they provide care and treatment in a way that ensures people’s dignity and treats them with respect at all times. This includes making sure that people have privacy when they need and want it, treating them as equals and providing any support they might need to be autonomous, independent and involved in their local community.
While the Social Care Institute for Excellence, https://www.scie.org.uk/dignity/care/defining, say dignity is hard to define, but is in some way attached to the concept of human rights. What then is it and how do we treat someone with it?
Dignity in care refers to the ways in which we treat the people people accessing the care we are delivering. It is perhaps easier to consider some of the features of dignified care than to describe it, because, in reality, it is many things and different things to different people at different times.
- Dignity in care recognises that each individual is different and provides for person-centred care.
- It recognises the individual in a holistic sense, it cares for the physical, emotional, psychological, social and spiritual whole, as opposed to treating a condition. It is seen in the way care planning is put together using questions which are focused on what the person wants and needs and the way they see the world. CAREis, our digital care management software system, “Care and Support”, https://www.careis.net/, can support care providers in collecting information in this way and developing holistic, person-centred, and hence dignified, care and support plans.
- It recognises humanity and that people deserve to be treated as individuals simply because they are people. Some ethicists call this respect for persons.
- Dignified care recognises autonomy and enables and supports the choices people make, recognising that we don’t have to agree with the choices people make to respect them and support them in exercising their choices.
- Dignity also does not stop when the person no longer is able to recognise it or exercise autonomy because, again dignified care treats the human being and not the disease or condition.
- Dignified care also enables people to stay connected to those people and places who and which are important to them. This is important because people are ore than just biological beings they are a complex amalgam of everything they have done, everywhere they have been, the experiences they have had and the people they have been around.
Dignified care is care that is delivered gladly, respectfully and with an eye to the privacy of the individual. For example it is dignified to take someone somewhere private to engage in supporting personal care even if the person is not aware of their surroundings. Many care staff also like to talk to people after their death when washing and dressing them because this is humanising and dignified.
In essence dignity is respecting the person for who they are, were and perhaps even who they want to be. Treating someone in a dignified way does not stop just because they are no longer aware. We know from environments where staff fail to treat people with dignity that care is poor and outcomes for people are not good.
In reality then dignity is what the person says it is, and when they can no longer say for themselves we have to understand about them from their loved ones. Dignity is both a state of being and a way of behaving, it requires a concerted effort to ensure the deliver of dignified care, but would you not want that for yourself?