Reports authored by Jenny Billings, Helen Alaszewski, Adrian Wagg.
In recent years dignity in care has become a priority and the focus of a number of government reports and policy initiatives (DH 2003, 2007; SCIE 2006; Healthcare Commission, 2007). The National Service Framework for Older People (DH 2001) and its follow up document, (DH 2006a) emphasised the pivotal position of maintaining and improving care for older people. However, despite considerable political support, there continues to be a problem in health and social care related to preserving the dignity of older people (Levenson, 2007). Generalised policy statements appear to have little effect on actual practice and care unless they are operational, supported by guidelines for practice and actively monitored.
There has been an increase in studies of dignity in health care over the past few years (Chochinov et al., 2002a, Woolhead et al., 2006) particularly focusing on the ways in which dignity is defined and what it means to people. There have, however, been far fewer studies on the relationship between dignity and personal care particularly when that care involves sensitive issues, of which continence care is a prime example. This report provides the initial analysis of emerging themes and findings from the first phase of a qualitative study of privacy and dignity in continence care for older people.
The overall objectives of this two year project were to:
• identify and validate person-centred attributes of dignity in relation to continence
• develop reflective guidelines for the provision of dignified care in this setting
• produce recommendations for best practice.
There are three phases to the entire project:
Phase 1: Attributes of dignified bladder and bowel care developed using:
i. a literature search
ii. interviews with older people in nursing homes and hospitals.
Phase 2: The development and refinement of person-centred attributes of dignity in continence care through observation and validation processes in nursing home and hospitals.
Phase 3: the development of guidelines for reflective practice with support tools using a validation process with continence and dignity experts.
Reports from the first two phases are now available from CHSS in PDF format