How care professionals can promote dignity in care

The importance of dignity in care

One of the most crucial parts of being a home carer for older people is to understand the importance of dignity in care, as this can make a significant difference to the care journey and life of an older adult. This is particularly true if they are unable to do many tasks alone. 

Here, we will look at what ‘dignity in care’ really means, why it is so important, the key principles of preserving dignity, and the skills a carer should have for this. We will also provide practical strategies to help, cover what professional conduct means, explain how to handle challenges when they inevitably arise, and share how to support other carers to create a high standard of care. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. Whatever questions you have about our services and the roles we currently have available, we can help. 

What does ‘dignity in care’ mean?

Dignity in care is the act of treating an individual with respect and valuing their opinions and personal worth during the care process. This is especially true for vulnerable populations such as older people, disabled people, and those living with chronic illnesses who may be unable to do some things alone. This means acknowledging their preferences, maintaining their privacy, and involving them in decisions about their care as much as possible. By doing so, caregivers can help to meet their physical needs as well as maintain the person’s sense of self-respect and autonomy.

Dignity in care means treating the person in your care with kindness, respect and compassion, no matter the health conditions they have or how challenging their care may be. TheCare Quality Commission (CQC)defines dignity in care as:

“…care and treatment in a way that ensures people’s dignity and treats them with respect at all times. This includes making sure that people have privacy when they need and want it, treating them as equals and providing any support they might need to be autonomous, independent and involved in their local community.” 

For this reason, dignity in care should always be a key element of every Care Plan. The Social Care Institute for Excellence states that dignity in care involves a combination of: 

• Personal hygiene
• Pain management
• Practical assistance
• Nutrition
• Social inclusion
• Privacy
• Choice and control
• Communication

What are the key principles of dignity in care? 

Some of the key principles of dignity in care include having respect and compassion for the person being cared for, adhering to privacy and confidentiality best practice, communicating with the person so they understand what you are doing, allowing them to have autonomy when it comes to making decisions, creating a positive and safe environment where they feel comfortable, involving the person’s community network, and more. 

Respect 

Respect is a crucial part of maintaining dignity in care for older adults as it acknowledges their personal preferences, honours any cultural differences, and values their choices. By respecting their individual background, caregivers can foster a sense of worth and trust, and ensure care is tailored to the person’s bespoke needs to enhance their comfort and emotional wellbeing. 

This is important across all types of care, but especially so when care takes place in the home environment as caregivers will be coming into the person’s own space, using their belongings and potentially making choices about their daily routine and activities. It is important to recognise if the person you are caring for would prefer to have things happen in a particular way that is familiar or comforting for them, regardless of what your beliefs, values and preferences are as a home carer – this is the essence of person-centred care.

The best way to ensure respect in a carer-client relationship is to have open and honest conversations with them about their personal beliefs and preferences so you better understand what they would want in certain situations. 

Privacy

Privacy is important for everyone, but when an older person is being cared for–especially in a live-in care situation–they may lack the privacy they would prefer due to the nature of the care they need. Maintaining privacy is a key part of dignity in care as it preserves their personal space and makes intimate personal care activities such as bathing, getting dressed and undergoing certain medical treatments much more comfortable. 

Privacy can help to maintain their self-esteem and reduce feelings of vulnerability that are common in older people who do not have as much control over their day-to-day life. By respecting their privacy, caregivers can uphold the person’s dignity and make the care experience more respectful and comfortable for all involved. 

As an example, when helping an older person to get dressed, it may be more respectful to ask them what elements of dressing they are able to do themselves, and what they would like help with. They may be able to dress their top half alone but be unable to bend in order to put on trousers or a skirt, so allowing them to dress their top half in private first before entering the room to help dress their bottom half would be a good way of ensuring they have privacy where possible and minimising any embarrassment they may feel. Similarly, when getting things out of cupboards in the home, it may be respectful to ask about going into certain areas that hold personal items, such as the person’s bedside cabinet or their medication cupboard.

Communication 

Communication is vital in maintaining dignity in care for older adults as it ensures their needs and concerns are heard and addressed, as well as making them feel part of their care experience and able to make decisions. Active listening and using clear language can show respect and empathy, and avoid patronising older people who–despite any physical issues–may still have the mental capacity to understand your tone and know that they are not truly being listened to. 

Effective communication includes actions like letting the person know when you arrive, addressing them properly, clearly telling them what you plan to do so they are not surprised by actions you take, and asking if they are OK with your decisions. Simple things like this can help to build trust and rapport with your client, and can empower individuals to express their preferences and participate in their own care. By engaging in meaningful dialogue and giving clients the chance to give feedback on their own care, carers can make the process more personalised, respectful and dignified, which in turn can enhance the overall wellbeing of older adults.

Autonomy 

Autonomy is the concept of self-governance, whereby an individual can make decisions about their own life rather than having decisions made on their behalf. When caring for an older adult, this is important because it is easy for caregivers to begin making small decisions for them, and over time, allow this to escalate until the client no longer has any control over their own day-to-day activities. 

Promoting autonomy helps to support the independence and self-determination of older adults, encouraging them to make their own decisions and perform tasks independently where possible. Research even suggests that interventions to maintain independence in the home could improve health perception and self-efficacy in older adults, so there are many benefits to this approach. 

As a carer, you can do this by always obtaining the informed consent of your client before providing care, as this respects their right to choose and participate in their Care Plan. By doing this for any new decision that needs to be made, you can foster a respectful, empowering environment, and ensure care is aligned with the individual’s preferences and values to enhance their dignity and quality of life.

Examples of promoting autonomy as a carer might include things like:

• Asking the person what clothes they would like to wear each day 
• Giving your client a choice of multiple food options for all of their meals 
• Checking what time they prefer to get up in the morning and go to bed at night 
• Asking what activities they feel like doing each day (i.e. would they like to go out on a trip to the garden centre, or would they prefer to stay in and do some crafting?)
• Asking if they feel like socialising or having visitors over to their home 
• Checking what they would like to watch on TV before putting something on, or what books they would like checked out of the library
• Asking what medical treatments they would prefer, if their doctor has provided a choice of several options 

All of these things will help make older adults feel that they have a choice in how they spend their time, what they eat, what medical treatments they receive, and more. 

Compassion 

Compassion is something we should all strive to show, and this is essential in dignity in care for older adults as it involves empathising with their feelings and experiences, and demonstrating kindness and patience, particularly during challenging situations. When an older person becomes frustrated, it can help to build trust and a supportive relationship by acknowledging their emotions and providing comfort. This helps to enhance the person’s sense of worth and security, makes them feel heard, and ensures care is delivered with respect, understanding and compassion to maintain their dignity and emotional wellbeing.

Sometimes the care profession or family caregivers can experience a lack of compassion that seems out of character. This is known as carer’s burnout, and it can occur if your wellbeing is not considered and you are spending long hours caring for someone with minimal breaks. You can read more about this in our guide on how to deal with caregiver stress and burnout.

Environment 

The environment is a key part of ensuring dignity in care, as it can significantly impact an older person’s comfort and sense of security. Having a comfortable, safe and accessible home helps to promote wellbeing and encourage independence. Carers can facilitate this by creating a welcoming, comfortable and safe environment tailored to the client’s individual needs, that enhances their quality of life, and makes daily activities easier and more enjoyable for all involved.

Creating a positive environment like this might mean ensuring all areas of the person’s home are accessible and free from barriers that could limit their independence, such as clearing away clutter, maintaining a clean space, making home adaptations to make moving around safer, or obtaining adaptive utensils and other tools to make certain tasks easier. 

Professional Conduct and Confidentiality 

Maintaining professional conduct is so important as this ensures adherence to best practices and high standards of care. By engaging in ongoing training, you can stay informed about the latest approaches for promoting dignity, undergo reflective practice that allows you to continuously improve in care quality, and maintain professionalism to ensure care is always respectful, competent and tailored to the individual’s needs.

A 2020 study defined maintaining dignity as caregivers having the time and will to not only listen to patients, but also to “see what they did not want to see”. For example, instead of brushing something under the carpet for ease, or avoiding giving a client choices that may make your job more difficult, you should address any issues head-on and enable autonomy for your client no matter how inconvenient this may be for you. In the same study, ‘indignity’ was defined as caregivers not allowing patients to make decisions, ignoring them, or creating a dynamic of powerlessness for the person in their care. 

It is important to maintain confidentiality, for example, when it comes to an older person’s medical needs and health, or their private relationships with family and friends. 

Family and Community Involvement 

As a carer, you may be spending a lot of time with an older person, but it is important to help them maintain a strong relationship with their family, friends, and their wider community by encouraging them to remain involved, and facilitating visits, either to their family’s homes or within their own home. Collaborating with families and other caregivers can provide comprehensive care tailored to the older person’s needs. 

Social inclusion and interaction can also help to reduce feelings of isolation and loneliness, which are prevalent in an estimated 1.4 million older people in the UK. Participation in community activities can help older adults to make a contribution to their community and feel a sense of purpose. Social support is known to be key in dignity in care, with one study finding older adults perceived social support as a way to maintain a sense of dignity.

Teamwork and Support 

Although in many cases home carers will be required to work alone, it is important to utilise the skills, expertise and assistance of your fellow carers and your wider network of carers through Home Instead. Teamwork and support from other caregivers are crucial in maintaining dignity in care for older clients, as this can help to foster a culture of mutual respect and collaboration in order to reach the best results. 

Promoting teamwork can ensure care is comprehensive and consistent, and makes the concept of dignity a shared responsibility. You can do this by encouraging open communication and peer support to allow caregivers to share experiences and strategies. This can help to positively influence your own care process and enhance the overall quality of care your client receives. A collective approach supports a respectful and effective care environment, benefiting both caregivers and the individuals they care for.

What are some practical strategies to promote dignity in care? 

Dignity in care can often be thought of as a natural carer response, but this is not always the case, particularly when under pressure. While a level of personal initiative is required, certain practical strategies and rules can be put in place to ensure dignity is prioritised in all situations. These might include things like: 

• Ensuring the Care Plan is highly personalised and located in a place where all caregivers can access and consult it easily – you can read more about this in our guides to the Care Plan and Care Needs Assessment
• When developing the Care Plan, try to involve the older person in the process in order to better understand their personal values and address their specific health conditions and lifestyle choices
• Book in regular reviews of the person’s Care Plan to keep the information relevant, and involve their family and doctor in this to ensure everyone continues to meet the individual’s evolving needs and preferences for care 
• Have open communication with the individual and their family, and adjust daily activities and plans based on their feedback and any new health developments
• Make sure all carers and family caregivers are on the same page when it comes to the person’s routine, preferences and daily needs 
• Encourage independence for activities the older person is still capable of doing unassisted, and only intervene on activities they cannot do alone 
• Create a habit of asking the person for their thoughts and ideas before any new task or activity is started, to maintain their autonomy 

What should carers do when challenges arise? 

When promoting dignity in care, carers must handle everyday challenges with sensitivity and professionalism. During these instances, it is important to remain calm, communicate clearly, and show empathy for the older person who may be experiencing frustration or pain. 

It is during these times that communication strategies like active listening are so important, as this is what can help you to better understand the person’s worries and concerns so you can tailor solutions to their needs – maintaining a personalised approach during challenging times can help to ensure dignity is upheld.

Challenging behaviours can sometimes be the most difficult to overcome, for example, if you are helping a client with dementia who is experiencing sundowning symptoms and is not acting like their usual self. Trying to figure out what they want and need during these difficult times can be a real challenge, but maintaining patience and having compassion for how they might be feeling will help you in maintaining their dignity. 

Remember, if you are finding a situation particularly challenging, you can always seek support from colleagues, supervisors or the wider professional network in order to gain outside perspective and a helping hand, and maintain high-quality care. Regular training can also help carers to navigate difficult situations while upholding the dignity of clients. 

How do I apply for a job as a home carer with Home Instead?

Maintaining dignity in care is one of the most important elements of the care profession, and should never be overlooked. At Home Instead, we provide extensive training and support so you never feel out of your depth in a care situation, and can always turn to someone else in your team for help to continue creating a positive impact on the lives of older adults. By adopting many of the above principles and strategies, you can ensure high-quality, compassionate care that centres dignity and is highly valued in many care agencies, like Home Instead. 

If you are interested in applying for a job as a Care Professional with us, we are always on the lookout for reliable, experienced, positive people who can be an asset to our team. 

You will find information about the positions we have available here, or if you do not see what you are looking for, reach out to our friendly team to discuss the opportunities that may be available.

You can find more helpful information in our other guides: 

• What To Expect From A Domiciliary Care Interview

• Do You Have What It Takes To Be A Complex Care Assistant?
• What Skills & Qualities Does A Good Carer Need?
• A Guide To Typical Care Interview Questions

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Learn more about joining our team today, or see if the bigger step of becoming a franchisee could be right for you.