Dignity in care homes for older people : a qualitative study

Abstract

Dignity is a complex concept and according to research, dignity in care homes is a challenge. This study investigated the meaning of dignity for older people from their perspective as a resident in a care home. Therefore, the threats to residents’ dignity were explored, as well as, how resident dignity can be promoted in a long-term care setting. A qualitative research design employing a non-experimental, exploratory-descriptive phenomenological approach was adopted for this study. The study was carried out at St. Vincent de Paul Residence. Participants needed to have been residing at the facility for more than one year. An initial screening process was conducted using the standardised mini-mental state examination and the 15-item geriatric depression scale, as assessment tools. Fourteen cognitively and psychologically sound older adults from four different wards within the facility, between the ages of 68 to 91 years, were purposively selected using a maximum variation sampling technique. There were 9 women and 5 men of varied socio-economic backgrounds. Semi-structured interviews were carried out and all the participants were able to verbally communicate in Maltese. The data was collected during the month of March, 2016 and analysed using a thematic analysis approach. The findings revealed that the older people at SVPR are more vulnerable to a loss of dignity, partly because of their health conditions together with staff attitudes and assumptions about older people and their capabilities. The findings also exposed the inadequacy in supporting the National Minimum Standards for Care Homes for Older People and the 10 Dignity Do’s proposed by the National Dignity Council (2016). The core importance of this research study is to build awareness of dignity issues and to increase capacity among the care workforce within the healthcare system in dealing with these issues. Therefore, the study concludes that there is an urgent need to promote dignity-in-care and recommendations are being made to launch a dignity campaign across the board, in all local care homes. Educating staff on the meaning of dignity and what dignity means to older adults, and respect of the residents under the care of staff is deemed imperative.