Dementia, dignity and quality of life: nursing practice and its dilemmas

Int J Older People Nurs. 2010 Sep;5(3):235-44. doi: 10.1111/j.1748-3743.2010.00231.x.

Abstract

Aims: The need for healthcare practitioners to respect the dignity of older people is widely recognised in England, where it has been given attention by politicians, professionals and health service regulators. This article aims to provide examples of how such ambitions may be used in practice development.

Methods: This article reports the use of five vignettes discussed by dementia care practitioners that explored the areas of dementia diagnosis, lying, incontinence, behavioural and psychological distress, and end of life care.

Findings: Each vignette promoted discussion of differences of perspectives about the ways to enhance the dignity of people with dementia in hospital, care home and community settings. The discussion confirmed that while dignity may be one quality indicator of good care potentially enhancing quality of life, it is not always straightforward. It may be more easily conceptualised when talking of physical care and treatment than other areas.

Conclusion: The opportunity to debate the subject and to discuss practice examples revealed differences of opinion and moral perspectives between practitioners about the use and relevance of the term dignity. These need to be acknowledged in any debates about objective and subjective definitions of quality of life.

MeSH terms

  • Affective Symptoms / nursing
  • Affective Symptoms / psychology
  • Aged
  • Deception
  • Dementia / nursing*
  • Dementia / psychology*
  • Female
  • Geriatric Nursing / methods*
  • Humans
  • Hygiene
  • Male
  • Nursing Staff / psychology*
  • Personhood
  • Quality of Life*
  • Sexuality / psychology
  • Terminal Care / methods
  • Terminal Care / psychology
  • Urinary Incontinence / nursing
  • Urinary Incontinence / psychology