Dignity

“Dignity” is defined as the quality of being worthy of esteem, respect or ethical treatment. Anyone who has ever been in a hospital can understand the feeling of loss of dignity when we have strangers coming in and out of our rooms while we are in bed. In some cases we are not allowed out of bed, and the indignity of bedpans is something we might have to endure. A few days of this treatment is all most patients have to go through, but what about the resident of a nursing home? Those of us not in institutions can go home, close our doors and be alone when we want to be. We can go into our rooms, shut out the rest of the world and think what we want to about ourselves. For the nursing home resident this is just not possible.

Dignity is bound up with our sense of self-esteem, which is important to all of us. How can certified nurses’ assistants perform all the healthcare procedures that must be done while still maintaining the resident’s dignity?

One way of maintaining dignity is by maintaining the patient’s privacy. If you spot a stain on a sheet, instead of pulling it off, spread another sheet on top of it and pull the old sheet out from under the new one.

Incontinence can make residents feel that they have no dignity. Taking residents to the restroom or offering the bedpan or urinal frequently can help to prevent accidents. When accidents do occur they should be cleaned up and dried promptly. Practice changing linens quickly, so that no resident will have to wait until the next shift to have his or her bed changed. If incontinence is a new concern, then discuss it with your supervisor and colleagues at the nursing station at change of shift rather than in front of the patient. This is also something that does not need to be discussed with family.

Being able to make decisions for themselves can help residents to feel that they control their own lives and have some dignity. Small children have little control over what happens around them, and residents want to feel that they are treated like adults, so offer options whenever possible. If a resident is supposed to have plenty of fluids, ask what kinds of juices he or she might prefer. If the resident has clothes from home, ask what he or she would like to wear today. Does the resident feel like going outside or staying in today?

Residents will feel that they still have their dignity if they are consistently well groomed. When we are sick and put off taking showers or coming our hair we begin to feel less than human. After the resident has had a shower and a good tooth brushing, be sure to comb his or her hair so that it is neat. Male residents should be shaven every day unless they prefer facial hair.

Doing what they are able to do will also help patients to feel dignified. If the patient is able to move around in bed, ask him or her to move rather than treating a living person like a non-living object.

Remember to treat patients as you would want to be treated, and their dignity will not be lost.

QNA’s

Q. True or False.  When working as a CNA for seniors, it is important to allow the patient to have as much self-sufficiency as possible?

A.  True.  One way to help preserve dignity for older individuals is to allow them as much self-sufficiency as possible.  People often like to know they can still do many things on their own with little or no assistance.

Explanation:  Everyone wants to feel as if they can take care of themselves.  As an individual grows older, they often need assistance with at least some of their daily activities.  As a CNA, you should not do everything for a patient when there are things that they can safely and effectively do on their own.  In fact, you should encourage patients to do some things on their own if they are things that their doctor has said they can and should do for themselves.

Q.  Should nursing assistants talk differently to an elderly patient than other adults?

A.  You should talk to patients in much the same way you would talk to any other adult.  Never communicate with patients in a way that would make them feel like a child or feel as if they are not important to you.  Do not talk down to your patients.

Explanation:  You need to always speak to patients with respect.  Communicating with patients in the same manner you would any other adult, does help to protect their sense of dignity.  Of course, some patients have medical conditions for which you might need to adjust communication slightly, but you should never talk to a patient as if they do not understand what you are saying of as if they are like a child.

Q.  Can it be harmful to a patient’s dignity to make him or her participate in activities and group settings for which he is not interested?

A.  In some cases it can be harmful to attempt to make a patient participate in activities at the nursing care facility that are not of interest to them.  You need to remember that each patient in a healthcare facility is an individual.  Not everyone likes to do the same things and trying to make someone do the same thing as their neighbor can affect their sense of dignity.

Explanation:  It is important to encourage patients to participate in events at the healthcare facility.  You should try to encourage your patients to interact with others and to leave their rooms when they feel up to it.  But it is also important to realize that if there are some activities a patient does not want to participate, they might simply not be interested in that activity.  For example, not all patients like to listen to the same music and not all patients wish to do arts and crafts.  Encourage your patients to select the activities they wish to do!