I Deserve the Best Treatment I Can Receive
As a manager of care services, I know that dignity is one of the most important aspects of caring and something that should be one of the easiest things to do for every person. Sadly, dignity can be lacking in the most basic of care that is offered and why? because people just don’t understand the meaning of dignity and dignity within care.
The Social Care Institute for Excellence give the definition that I practice within care and empower my teams to practice: “Dignity is a state, quality or manor worthy of esteem or respect, and by extension – self-respect. Dignity in care therefore means the kind of care which supports and promotes and does not undermine a person’s self-respect regardless of any difference. It means respecting other’s views, choices and decisions, not making assumptions about how people want to be treated and working with care and compassion.” (1)
As part of maintaining ‘dignity’ in care I must uphold the Code of Conduct (2) for Health and Social Care workers.
The Embarrassment Factor
I always feel that it is a privilege to share someone else’s life, to know them as they were known to their family and at times to know things that their family may not have known. It is amazing when people feel that they trust you enough to confide in you or to tell you something they have never felt able to tell anyone else. For me building that relationship with someone in my care is so vital and showing a person dignity and respect is the start to building trust.
Having supported people with personal care my entire working career I do not suffer with the embarrassment factor of seeing someone naked. Like many other carers I have seen breasts, genitals, talked about personal hygiene and sex with those that I support and care for. I know though that just because I am not embarrassed does not mean that the person I am caring for is not embarrassed. To some people the thought of getting undressed for a bath or having someone take you to the toilet and taking down their knickers is mortifying.
Very few of us would consider how we want to be cared for when we get older and the thought of wearing incontinence aids may never cross your mind. I always remind myself of this when supporting someone and acknowledging that it is ok for the person to feel embarrassed or uncomfortable with how they feel is perfectly fine. Knowing the person as an individual and asking them how they want to be supported or what you can do to help them puts them in control, reaffirms their sense of self-esteem and helps maintain their dignity.
When working with people diagnosed with dementia, dignity goes beyond personal care and for me being someone’s sister, aunt, mother is one of the little things that I can do when a person believes that is who I am. There is no need for me to correct the person, causing them confusing or upset. I can live in their world and be the person they see me as in that moment in time. I can validate their feelings and emotions, showing care and compassion to uphold their dignity.
I Cannot Care Any More
The role of caring for your loved on is one of the greatest responsibilities, and at times one of the hardest. When carers reach that point that they feel they can no longer care they reach out for help. In the blog ‘The Emotional Rollercoaster of Covid-19’, I referred to ‘Suicide Monday’, this particular Monday my team took four calls from carers so distraught they feel the only solution is to take their own life. Carers are not only balancing their own caring role, emotions, and feelings but also the needs and choices of their loved ones. It is a cry for help and for husband carers, it takes great courage to ask for assistance and sadly for some male carers, who feel so unable to cope. Saying you are suicidal is not a choice that anyone would take lightly and one that needs to be treated with extreme sensitivity. I get frustrated when my passion to ensure that everyone is given the best care they can is not upheld by others and when people’s lives don’t fit the tick boxes of local authorities who manage care budgets and safeguarding alerts. As I comply with the social care code of conduct and uphold my duty of care time and again, I am told that “suicide is not a safeguarding concern”. I argue that this is the most extreme need to keep both the carer and the person with dementia safe. There is no compromise to be made to maintain people’s sense of dignity in these situations.
I have been told in the past that I am not always viewed in the best light when I fight for the rights of carers or people in my care and that I should not rock the proverbial boat. To me however, it is not about how I am seen by others, more that I am doing the best for the person in my care. I am advocating for people and promoting their self-respect and maintaining their dignity to achieve the best care for everyone.
Dignity in Care
Showing dignity can be the smallest act such as knocking on someone’s bedroom door before you enter or asking someone what name they like to be known by. But more frequently I come across incidents where people in care are not having the hand of dignity extended.
One gentleman supported at Sage House had to go into a care home through lockdown, when he left the home his wife asked for various personal items that were not returned to them. These included a photo of his mother, his favourite hat, and a blanket that his daughter had made for him while he was away from home. These items do not have a monetary value and are irreplaceable and in not taking care of them and not returning them, I felt a total lack of respect and dignity was shown to his personal possessions and in extension to the gentleman himself.
Dignity in care is also taking into consideration how people want to be supported and with that being creative to offer personalised care. Part of the Care Quality Commission (CQC) inspection considers how caring and responsive services are. Care providers who demonstrate that their services are adaptive in offering care, responding to individuals needs and maintain dignity are clearly working towards outstanding care in meeting the social care code of conduct.
In dementia care I like to use the Tom Kitwood’s (3) ‘Dementia equation’ and ‘flower’ model to help with the planning of personalised care. This enables staff to look beyond a label of dementia and consider the person holistically, accounting for health needs, hobbies and interest, and the biography of the person being supported. Planning and supporting someone in a holistic manor guarantees that individual’s self-esteem and self-respect is met and upholds their dignity and rights as a human. Other models of care such as David Sherad’s ‘Butterfly’ model places each person at the heart of the service and promoting person centred relationships and “developing an emotionally resilient culture of care (4)”
Human Rights Rest on Human Dignity
Dignity is a key aspect to all humans and supports our self-esteem and self-worth. Considering people as individuals and respecting how they wanted to be treated and cared for is the start to maintain dignity. To be human there is a need to put aside our own perceptions when being a carer and take time to understand people as individuals and life in their world. If carers work to the principle, ‘I deserve the best treatment I can receive’ they should in turn be offering the best to every individual they care and support and they will instantly be upholding the dignity of the person that they’re providing care to.
Simple things such as calling people by the name they want to be known by, listening to who they are as a person and knowing that their life history is just as important as the job in hand. By taking these tiny steps now, we can build a happier future for those who will require kindness, comfort, and trust within our care system in their later years. Making connections and building relationships that are meaningful and that promote individual’s self-esteem and self-worth.
Preserving dignity for a person goes hand in hand with respect, identity, independence and maintaining a sense of pride. Every individual holds lifelong experience which is precious, the least we can do is value this in the highest esteem.
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3 – Tom Kitwood (1997) Dementia Reconsidered, The Person Comes First.