Dignity is the state or quality of being worthy of honour or respect. So, what is dignity in care?
When looking after someone regularly, whether it be during the day, night, or both, it’s important that we can balance the dignity we give them. Plus, the dignity we receive ourselves.
Plus, how do we know that the paid support our loved one is receiving is given with dignity? And how do we challenge it when it’s not?
It's Dignity in Action Day on 1st February - an important day to educate others on what good dignity in care should look like AND feel like every day.
"Dignity Action Day highlights a more respectful way of behaving towards vulnerable people."
Source: Dignity in Care
Topics:
What is Dignity in Care?
At its base level, dignity is about respect.
A good question to ask ourselves is - How would we feel as a result of someone’s actions (or inaction in our care). Or if someone else made all of our decisions or ignored our preferences?
From "small" things like how many sugars we want in our tea, to big things like what we wear home after a hospital discharge. Is a nighty ever appropriate?
How would we feel if this was happening to us?
As paid carers this mindset is critical. As unpaid carers, this may (uncomfortably) be balanced with how much we can give and still maintain our own self-dignity. What if meeting all of the person we care for’s needs, means we ignore our own? What if we burn out? And so true self-care (not just a wellness mantra) and boundaries are very important.
Depending on what wishes or basic human rights have been ignored, we, or the person we care for could experience a range of emotions.
It’s important to know that a lack of dignity can be ‘delivered’ very subtly too. Such as ‘the silent treatment’, known as psychological abuse in disguise. There may be a long term effect on mental health too. Studies show that when people are ignored or invalidated, they stop contributing and engaging.
"People who are ignored eventually become overwhelmed by feelings of sadness that can sometimes lead to depression."
A great resource is the "10 Dignity Do's" from Dignity in Care.
What does good dignity in care look like?
We believe that dignity in care is summed up really well by person-centred care.
"Being person-centred is about focusing care on the needs of individual. Ensuring that people's preferences, needs and values guide clinical decisions, and providing care that is respectful of and responsive to them."
This should extend to include dignity and respect for the carers too. A deeper understanding of our needs along with awareness and acknowledgement of us.
From the way our son is put into a hoist to ensuring our mother has a shower, not a bath, if we know this would be her preference.
Five ways unpaid carers can protect dignity
1. Pause to consider current care interactions
Pause and think about what we want. What the person we care for wants (if they can tell us), what is right, and what concessions we may have made previously that don't sit well now.
A time to pause and think - is everything OK right now? Are we happy? What is niggling us?
2. Set expectations for those around us
There is nothing awkward about setting expectations. In fact, most paid carers and professionals would appreciate the clear signposting of what, when and how care should be delivered.
Remember sometimes it's the seemingly small details that can lead to bigger problems, such as respecting that the person we care for likes their hair styled in a particular way. It's not always the big, obvious personal care moments. Details matter.
There are 'bigger' moments too - such as hospital discharge. Sadly, we hear many stories of the person we care for being discharged in nightwear, or too cold, empty homes. It's worth knowing this so that we can be forewarned to articulate what we expect and demand for the person we care for.
Our carers’ guide to hospital discharge sets out what a ‘good’ hospital discharge looks like, and what we can do if we aren’t receiving ‘good’. We can then express exactly what a dignified and respectful hospital discharge would look like to us.
We may also like to refer to The Human Rights Act 1998, which we talk about further down.
3. Don’t be afraid to challenge people
We are allowed to challenge paid care professionals. In fact, any service we engage with - from supermarkets to hairdressers and everything in between - when we experience something that doesn't feel right or is plain wrong.
Ways to escalate:
In hospital, we can raise issues with the Ward Matron or The Patient Advice and Liaison Service (PALS)
A simple chat with the person may be enough to resolve a situation. We can ask why someone does something a certain way. This often opens a conversation well.
If an escalation is required, log times and experiences and always use email or letters - not just phone calls, to build an evidence log.
4. Raise Awareness
Why not share moments of 'best practise' where respect and dignity were clearly demonstrated? Praise those that 'get it', either directly or publicly, using social media to raise the profile of dignity on Dignity in Action day and on every other day of the year.
Praising success inspires more success.
5. Know our Legal Rights
There are various legal frameworks we can refer to when we need to. These include The Human Rights Act 1998 and The Equality Act 2010. We have given a brief introduction below, but recommend seeking legal advice if you are faced with an apparent breach.
Human Rights Act 1998
"Human rights are the basic rights and freedoms that belong to every person in the world. In the UK, these rights are contained in the Human Rights Act 1998. If a public authority breaches or doesn't respect your human rights, you can take action under the Act."
Source: Citizens Advice
If a public authority has treated us or the person we care for poorly, we may have grounds to hold them accountable against the Human Rights Act 1998. Public bodies include (but are not limited to);
Social services
Private care homes funded by a local authority
Local authority and NHS funded care homes
The Human Rights, most applicable in a caring situation include:
Article 2 - The Right to Life
Article 3 - The Right not to be tortured or treated in an inhuman or degrading way
Article 5 - The Right to Liberty
Article 8 - The Right to respect for private and family life
Article 14 - The Right not to be discriminated against
Source: Citizens Advice
The Equality Act 2010
The Equality Act 2010 is about ensuring we are not at a disadvantage or treated unfairly by public bodies and employers, based on our personal characteristics, including disability.
The Equality Act also protects us against Discrimination by Association, that is - we may not be discriminated against because of the person we care for’s disability.
Our comprehensive guide to ‘Carers Rights and the Law’ is also a simple way of digesting the complicated ‘stuff’ around our caring rights.
How to take legal action
We would recommend taking legal advice. And in the first instance, the Citizen's Advice website offers support and advice on how to take legal action forward.
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