DIGNITY IN CARE

					                     Department of Health
                         Dignity Champions
     The purpose of the Dignity Champions
  network is to ensure everyone involved in
the provision of care has the confidence to
                     challenge bad practice



                                    Version 2
                                    October 2009
DIGNITY
Defined as being identified with 4 overlapping ideas
1. Respect shown to you by others and
   demonstrated by courtesy, good communication
   and time.
2. Privacy in terms of personal space, modesty and
   privacy in personal care and confidentiality in
   personal information and treatment.
DIGNITY
3. Self-esteem, self worth, identity and a sense of
  oneself. A clean and respectable appearance,
  pleasant environments, choice and being listened
  to.
4. Autonomy, including freedom to act and freedom
  to decide, opportunities to participate and clear,
  comprehensive information.
The Aim for Care Homes
 Peoples wellbeing is promoted in care homes which
  includes enrichment, fulfilment and recognition.
 People have a meaningful life until the end, and
  peace of mind.
 The people who work the closest to the residents
  are VALUED.
Factors Affecting Wellbeing
 Lack of motivation, powerlessness, hopelessness
 Lack of daily structure and roles
 Limited social opportunities
 Low self esteem and lack of confidence
 Unchallenging and limited opportunities
 Restricted autonomy, control
 Lack of opportunities for positive risk taking
How Do We Take Dignity
Away From People?
It is inherent in our society that we think of older
people as being of less value and we can act
unconsciously using the following methods of
communication
               MALIGNANT SOCIAL PSYCHOLOGY

It is the direct opposite of a holistic person centred model of care.
It is task orientated. The symptoms are:-

1. TREACHERY
   Using some form of deception in order to distract or manipulate
   a person, or force them into compliance.

2. DISEMPOWERMENT
   Not allowing a person to use the abilities that they do have;
   failing to help them to complete actions that they have initiated.

3. INFANTILISATION
   Treating a person very patronisingly (or 'matronisingly') as an
   insensitive parent might treat a very young child.
                                  1
              MALIGNANT SOCIAL PSYCHOLOGY



4. INTIMIDATION
   Inducing fear in a person through the use of threats or physical
   power.

5. LABELLING
   Using a category such as dementia or 'organic mental disorder'
   as the main basis for interacting with a person and for
   explaining their behaviour.

6. STIGMATISATION
   Treating a person as if they were a diseased object an alien or
   an outcast.

                                 2
               MALIGNANT SOCIAL PSYCHOLOGY

7. OUTPACING
   Providing information, presenting choices, etc., at a rate too fast
   for a person to understand; putting them under pressure to do
   things more rapidly than they can bear.

8. INVALIDATION
   Failing to acknowledge the subjective reality of a person's
   experience and especially what they are feeling.

9. BANISHMENT
   Sending the person away or excluding them physically or
   psychologically.


                                  2
              MALIGNANT SOCIAL PSYCHOLOGY

10. OBJECTIFICATION
    Treating a person as if they were a lump of dead matter; to be
    pushed, lifted, filled, pumped or drained without proper
    reference to the fact that they are sentient beings.

11. IGNORING
    Carry on (in conversation or action) in the presence of a person
    as if they were not there.

12. IMPOSITION
    Forcing a person to do something, over-riding desire or denying
    the possibility of choice on their part.


                                 3
              MALIGNANT SOCIAL PSYCHOLOGY


13. WITHHOLDING
    Refusing to give asked for attention or to meet an evident
    need; for example, for affectionate contact.

14. ACCUSATION
    Blaming a person for actions or failures of action that arise
    form their lack of ability or their misunderstanding of the
    situation.

15. DISRUPTION
    Disturbing a person's action or inaction, crudely breaking their
    'frame of reference.'


                                 3
              MALIGNANT SOCIAL PSYCHOLOGY



16. MOCKERY
    Making fun of a person's 'strange' actions or remarks;
    teasing, humiliating, making jokes at their expense.

17. DISPARAGEMENT
    Telling a person that they are incompetent, useless, worthless
    etc., giving them the messages that are damaging to their
    self-esteem.




                                3
Person Centred Interactions
1. Warmth- demonstrating genuine affection, care
   and concern for the person
2. Holding- providing safety, security and comfort
   for the person
3. Relaxed Pace- recognising the importance of
   helping create a relaxed atmosphere
4. Respect- treating the person as a valued
   member of society and recognising their
   experience and age
Person Centred Interactions
5. Acceptance – entering into a relationship based
  on an attitude of acceptance of positive regard
  for the person
6. Celebration- recognising, supporting and taking
  delight in the skills and achievement
7. Acknowledgement- recognising, supporting and
  taking delight in the skills and achievements of
  the person
Person Centred Interactions
8. Genuineness- being honest and open with the
  person in a way that is sensitive their needs and
  feelings
9. Validation- recognising and supporting the
  reality of the person.Sensititvity to feeling and
  emotion take priority
10. Empowerment- letting go of control and
  assisting the person to discover or employ
  abilities and skills
Person Centred Interactions
11. Facilitation- assessing level of support required
  and providing it
12. Enabling- recognising and encouraging a persons
  level of engagement within a frame of reference
13. Collaboration- treating the person as a full and
  equal partner in what is happening, consulting and
  working with them
Person Centred Interactions
14. Recognition- meeting the person in their own
  uniqueness, bringing an open and unprejudiced
  attitude
15. Including- enabling and encouraging the person
  to be and feel included, physically and
  psychologically
16. Belonging- providing a sense of acceptance in a
  particular setting regardless of abilities and
  disabilities
Person Centred Interactions
17. Fun- accessing a free, creative way of being and
  using and responding to the use of fun and humour
What Would The Service Look
Like That Maintains Dignity?

ZERO TOLERANCE OF ALL TYPES OF ABUSE
And
 Support people as you would want to be supported
 Offering a personalised service
 Maintain independence, choice and control
 Listening to expressed needs
 Respecting people’s privacy
And
 Promoting complaining without retribution
 Treating family as care partners
 Assisting people to maintain confidence and
  build self-esteem
 Acting to alleviate isolation and loneliness
Person Centred Care- What
To Look For
 What is the quality of the relationship between
  staff and residents?
 What is the quality of the relationships between
  residents and staff?
 What is the importance of the relationship?
 How much interaction is there?
 What are residents engaged in doing?
Meaningful Activity
 What activities are available to residents?
 Do they have meaning?
 Are they part of the day to day running of the
  home?
 How much chance do residents have to take
  responsibility for what happens in the home?
 How many residents are asleep or on their own?
 What choices are being offered?
 Would you feel comfortable in this home? If
  not why not?
The Challenge For All Of Us Is

 To feel confident that we will be listened to if we
  have concerns

 To ensure the service we provide or are visiting
  maintains dignity

				
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posted:11/7/2011
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