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Preserving Dignity in Later Life

Published online by Cambridge University Press:  26 July 2016

José Manuel São José*
Affiliation:
Research Centre for Spatial and Organizational Dynamics, Faculty of Economics, University of Algarve, Portugal
*
La correspondance et les demandes de tire-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: José Manuel de São José, Ph.D. Faculty of Economics Campus de Gambelas Edifício 9 8005-139 Faro (Portugal) (jsjose@ualg.pt)

Abstract

This article examines how elders who receive social care in the community experience loss of dignity and how they preserve their dignity. Qualitative research revealed that loss of dignity is a major concern for these elders and that they preserve their dignity differently, ranging from actively engaging with life to detaching themselves from life. We conclude that, in later life, preserving dignity while receiving social care differs from preserving dignity in the context of health care, especially health care provided in institutional settings. Furthermore, preserving dignity in later life, while receiving social care, is a complex process, depending not only on performing activities and individual action and responsibility, but also on other actions, some of them involving a certain inactivity/passivity, and interactions with others, especially caregivers. This article offers some insights to developing better policies and care practices for promoting dignity in the context of community-based social care.

Résumé

Cet article examine comment les personnes âgées qui recoivent l’aide sociale dans la communauté subissent une perte de la dignité et comment ils conservent leur dignité. La recherche qualitative a révélé que la perte de dignité est une préoccupation majeure pour ces aînés, et qu’ils conservent leur dignité de differentes manières, variant de s’engager activement à la vie jusqu’à s’en détacher. Nous concluons que, dans la vie plus tard, la préservation de la dignité tout en recevant des soins sociaux diffère de conserver la dignité dans le contexte des soins de sante, en particulier les soins de santé fournis dans un cadre institutionnel. En outre, conserver la dignité en fin de vie, tout en recevant des soins sociaux, est un processus complexe, qui dépend non seulement de l’exécution des activités et la prise des actions individuelles et de leurs responsabilités, mais aussi d’autres actions, dont certaines impliquent une certaine inactivité/passivité, ainsi qu’interagir avec les autres, surtout les soignants. Cet article propose meilleures politiques et pratiques pour la promotion de la dignité des personnes âgeés dans le contexte de la protection sociale à base communautaire.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2016 

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References

Améry, J. (1994). On aging: Revolt and resignation. Bloomington, IN: Indiana University Press.Google Scholar
Baggott, R. (2008). Healthcare. In Alcock, P., May, M., & Rowlingson, K. (Eds.), The student’s companion to social policy (pp. 318325). Malden, MA: Blackwell.Google Scholar
Baillie, L. (2007). The impact of staff behaviour on patient dignity in acute hospitals. Nursing Times, 103(34), 3031.Google Scholar
Bauman, Z. (2000). The individualized society. Cambridge, ENG: Polity Press.Google Scholar
Bayer, T., Tadd, W., & Krajcik, S. (2005). Dignity: The voice of older people. Quality in Ageing: Policy Practice and Research, 6(1), 2229.CrossRefGoogle Scholar
Beck, U., & Beck-Gernsheim, E. (2002). Individualization: Institutionalized individualism and its social and political consequences. London, ENG: Sage.Google Scholar
Bettio, F., Verashchagina, A., & EU Expert Group on Gender and Employment. (2010). Long-term care for the elderly: Provisions and providers in 33 European countries. Rome, ITA: Fondazione G. Brodolini.Google Scholar
Black, K., & Dobbs, D. (2014). Community-dwelling older adults’ perceptions of dignity: Core meanings, challenges, supports and opportunities. Ageing and Society, 34(8), 12921313.Google Scholar
Bradshaw, S. A., Playford, E. D., & Riazi, A. (2012). Living well in care homes: A systematic review of qualitative studies. Age and Ageing, 41(4), 429440.Google Scholar
Carstensen, L. L., & Hartel, C. R. (Eds.). (2006). When I’m 64. Committee on Aging Frontiers in Social Psychology, Personality, and Adult Developmental Psychology. Board on Behavioral, Cognitive, and Sensory Sciences, Division of Behavioral and Social Sciences and Education. Washington, DC: National Research Council/The National Academies Press.Google Scholar
Chochinov, H. M., Hack, T., McClement, S., Kristjanson, L. J., & Harlos, M. (2002). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54(3), 433443.CrossRefGoogle ScholarPubMed
Colombo, F., Llena-Nozal, A., Mercier, J., & Tjadens, F. (2011). Help wanted? Providing and paying for long-term care. Paris, FRA: OECD.CrossRefGoogle Scholar
Coventry, M. L. (2006). Care with dignity: A concept analysis. Journal of Gerontological Nursing, 32(5), 4248.Google ScholarPubMed
Dahlin-Ivanoff, S., Haaqk, M., Fänge, A., & Iwarsson, S. (2007). The multiple meaning of home as experienced by very old Swedish people. Scandinavian Journal of Occupational Therapy, 14(1), 2532.Google Scholar
Fujisawa, R., & Colombo, F. (2009). The long-term care workforce: Overview and strategies to adapt supply to a growing demand. Paris, FRA: OECD.Google Scholar
Gallagher, A., Li, S., Wainwright, P., Jones, I., & Lee, D. (2008). Dignity in the care of older people – A review of the theoretical and empirical literature. BMC Nursing, 7(11), 112.Google Scholar
Gennip, I. E., Pasman, H. R. W., Oosterveld-Vlug, M. G., Willems, D. L., & Onwuteaka-Philipsen, B. D. (2013). The development of a model of dignity in illness based on qualitative interviews with seriously ill patients. International Journal of Nursing Studies, 50(8), 10801089.CrossRefGoogle Scholar
Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Cambridge, ENG: Polity Press.Google Scholar
Glasby, J. (2012). Understanding health and social care (2nd ed.). Bristol, ENG: Policy Press.Google Scholar
Glaser, B. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. San Francisco, CA: University of California.Google Scholar
Glaser, B. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA: Sociology Press.Google Scholar
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago, IL: Aldine.Google Scholar
Godfrey, M., Randall, T., Long, A., & Grant, M. (2000). Home care: Review of effectiveness and outcomes. Exeter, ENG: Centre for Evidence-Based Social Services.Google Scholar
Goffman, E. (1971). Relations in public: Microstudies of the public order. New York, NY: Basic Books.Google Scholar
Gorman, M. (2000). Development and the rights of older people. In Randel, J., German, T., & Ewing, D. (Eds.), The ageing and development report: Poverty, independence and the world’s older people (pp. 321). London, ENG: Earthscan Publications Ltd.Google Scholar
Grenier, A. (2005). The contextual and social locations of older women’s experiences of disability and decline. Journal of Aging Studies, 19(2), 131146.Google Scholar
Grenier, A. (2008). Recognizing and responding to loss and ‘rupture’ in older women’s accounts. Journal of Social Work Practice: Psychotherapeutic Approaches in Health, Welfare and the Community, 22(2), 195209.CrossRefGoogle Scholar
Grenier, A. (2012). Transitions and the lifecourse, challenging the constructions of ‘growing old’. Bristol, ENG: Policy Press.Google Scholar
Griffin-Heslin, V. L. (2005). An analysis of the concept dignity. Accident and Emergency Nursing, 13(4), 251–227.CrossRefGoogle ScholarPubMed
Hall, S., Longhurst, S., & Higginson, I. (2009). Living and dying with dignity: A qualitative study of the views of older people in nursing homes. Age and Ageing, 38(4), 411416.Google Scholar
Hammarström, G., & Torres, S. (2010). Being, feeling and acting: A qualitative study of Swedish home-help care recipients’ understandings of dependence and independence. Journal of Aging Studies, 24(2), 7587.Google Scholar
Hermus, G., Stonebridge, C., Thériault, L., & Bounajm, F. (2012). Home and community care in Canada: An economic footprint. Guelph, ON: Victorian Order of Nurses.Google Scholar
Hickman, S. E. (2004). Honoring resident autonomy in long-term care: Special considerations. Journal of Psychosocial Nursing and Mental Health Services, 42(1), 1216.Google Scholar
Hilário, P. (2015). Making sense of a changed physical body: Why gender matters at end of life. Journal of Aging Studies, 33, 5866.Google Scholar
Hillman, A., Tadd, W., Calnan, S., Calnan, M., Bayer, A., & Read, S. (2013). Risk, governance and the experience of care. Sociology of Health & Illness, 35(6), 939955.Google Scholar
Hofmarcher, M. M., Oxley, H., & Rusticelli, E. (2007). Improved health system performance through better care coordination. Paris, FRA: OECD.Google Scholar
Huber, M., Rodrigues, R., Hoffmann, R., Gasior, K., & Marin, B. (2009). Facts and figures on long-term care: Europe and North America. Vienna, AUT: European Centre.Google Scholar
Jacelon, C. S., Connelly, T. W., Brown, R., Proulx, K., & Vo, T. (2004). A concept analysis of dignity for older adults. Journal of Advanced Nursing, 48(1), 7683.Google Scholar
Janlöv, A., Hallberg, I., & Petersson, K. (2006). Older persons’ experience of being assessed for and receiving public home help: Do they have any influence over it? Health and Social Care in the Community, 14(1), 2636.Google Scholar
Konecki, K. T. (2008). Grounded theory and serendipity: Natural history of a research. Qualitative Sociology Review, IV(1), 171188.Google Scholar
Lawton, J. (1998). Contemporary hospice care: The sequestration of the unbounded body and ‘dirty dying’. Sociology of Health & Illness, 20(2), 121–43.CrossRefGoogle Scholar
Leichsenring, R. (2004). Developing integrated health and social care services for older persons in Europe. International Journal of Integrated Care, 4(3), 115.Google Scholar
Lin, Y., Watson, R., & Tsai, Y. (2012). Dignity in care in the clinical setting: A narrative review. Nursing Ethics, 20(2), 168177.Google Scholar
Lloyd, L., Calnan, M., Cameron, A., Seymour, J., & Smith, R. (2014). Identity in the fourth age: Perseverance, adaptation and maintaining dignity. Ageing and Society, 34(1), 119.CrossRefGoogle Scholar
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 6165.Google ScholarPubMed
Malderen, L. V., Mets, T., De Vriendt, P., & Gorus, E. (2013). The active ageing – Concept translated to the residential long-term care. Quality of Life Research, 22(5), 929937.CrossRefGoogle Scholar
Marin, B., Leichsenring, K., Rodrigues, R., & Huber, M. (2009). Who cares? Care coordination and cooperation to enhance quality in elderly care in the European Union. Stockholm, SWE: European Centre for Social Welfare Policy and Research.Google Scholar
Martinson, M., & Berridge, C. (2015). Successful aging and its discontents: A systematic review of the social gerontology literature. The Gerontologist, 55(1), 5869.Google Scholar
Matiti, M. R., & Trorey, G. M. (2008). Patients’ expectations of the maintenance of their dignity. Journal of Clinical Nursing, 17(20), 27092717.Google Scholar
Nicholson, C., Meyer, J., Flatley, M., Holman, C., & Lowton, K. (2012). Living on the margin: Understanding the experience of living and dying with frailty in old age. Social Science & Medicine, 75(8), 14261432.Google Scholar
Nordenfelt, L. (2004). The varieties of dignity. Health Care Analysis, 12(2), 6989.Google Scholar
Nordenfelt, L. (2009). The concept of dignity. In Nordenfelt, L. (Ed.), Dignity in care for older people (pp. 2653). Oxford, ENG: Wiley-Blackwell.Google Scholar
North, M. S., & Fiske, S. T. (2012). An inconvenienced youth? Ageism and its potential intergenerational roots. Psychological Bulletin, 138(5), 982997.CrossRefGoogle ScholarPubMed
Plankey-Videla, N. (2012). Informed consent as process: Problematizing informed consent in organizational ethnographies. Qualitative Sociology, 35(1), 121.CrossRefGoogle Scholar
Randers, I., & Mattiasson, A. C. (2004). Autonomy and integrity: Upholding older adult patients’ dignity. Journal of Advanced Nursing, 45, 6371.Google Scholar
Rodrigues, R., Hofmarcher, M. M., Leichsenring, K., & Winkelmann, J. (2013). Active and healthy ageing for better long-term care: A fresh look at innovative practice examples. Vienna, AUT: European Commission.Google Scholar
São José, J., Barros, R., Samitca, S., & Teixeira, A. (2016). Older persons’ experiences and perspectives of receiving social care: A systematic review of the literature. Health and Social Care in the Community, 24(1), 111.Google Scholar
Scott, P. A., Valimaki, M., Leino-Kilpi, H., Dassen, T., Gasull, M., Lemonidou, C., & Arndt, M. (2003). Autonomy, privacy and informed consent 3: Elderly care perspective. British Journal of Nursing, 12(3), 158168.Google Scholar
Sipilä, J., & Kröger, T. (2005). Editorial introduction: European families stretched between the demands of work and care. In Kröger, T. & Sipilä, J. (Eds.), Overstretched European families up against the demands of work and care (pp. 18). Malden, MA: Blackwell.Google Scholar
Street, A. F., & Kissane, D. W. (2001). Constructions of dignity in end-of-life care. Journal of Palliative Care, 17(2), 93101.Google Scholar
Tadd, W., & Calnan, M. (2009). Caring for older people: Why dignity matters – The European experience. In Nordenfelt, L. (Ed.), Dignity in care for older people (pp. 119145). Oxford, ENG: Wiley-Blackwell.Google Scholar
Tadd, W., Hillman, A., Calnan, M., Calnan, S., Read, S., & Bayer, A. (2012). From right place – wrong person, to right place – right person: Dignified care for older people. Journal of Health Services & Policy, 17(2), 3036.Google Scholar
Tanner, D. (2010). Managing the ageing experience: Learning from older people. Bristol, ENG: Policy Press.Google Scholar
Timonen, V., Conlon, C., Scharf, T., & Carney, G. (2013). Family, state, class and solidarity: Re-conceptualising intergenerational solidarity through the grounded theory approach. European Journal of Ageing, 10(3), 171179.Google Scholar
Turnock, C., & Kelleher, M. (2001). Maintaining patient dignity in intensive care settings. Intensive and Critical Care Nursing, 17(3), 144154.Google Scholar
Twigg, J. (2000). Bathing, washing and the management of personal care. In Twigg, J. (Ed.), Bathing, the body and community care (pp. 4576). London, ENG: Routledge.Google Scholar
Wainwright, P., & Gallagher, A. (2008). On different types of dignity in nursing care: A critique of Nordenfelt. Nursing Philosophy, 9(1), 4654.Google Scholar
Wiles, J. L., Wild, K., Kerse, N., & Allen, R. E. S. (2012). Resilience from the point of view of older people: ‘There’s still life beyond a funny knee’. Social Science & Medicine, 74(3), 416424.CrossRefGoogle ScholarPubMed
Woogara, J. (2005). Patients’ rights to privacy and dignity in the NHS. Nursing Standard, 19(8), 3337.Google Scholar
Woolhead, G., Calnan, M., Dieppe, P., & Tadd, W. (2004). Dignity in older age – What do older people in the United Kingdom think? Age and Ageing, 33(2), 165170.Google Scholar