What is a dignified treatment?

Respect, integrity, self-determination, dignity, and core values. Many beautiful words are highlighted when it comes to elderly care. But how do we put this into practice? How do we create a dignified meeting in everyday life when we need to take care of intimate hygiene or when an accident has occurred? It is worthwhile to discuss core values and treatment.

We have on several occasions seen newspaper articles about employees at nursing homes who have violated and mocked the residents. Such things must not happen. There is a national core value for elderly care and special legislation, Lex Sarah, which is meant to prevent such incidents. There must always be a dialogue about treatment issues within the operation.

A manager spent a lot of time and energy discussing core value issues with her employees. After a few months, she felt that the employees became more caring about the residents, the relatives were more satisfied, and she received more and more competent applicants for vacant positions.

Elderly care is an important and sensitive part of society where the well-being and dignity of the elderly are at the center. A dignified treatment is fundamental to creating a safe and respectful environment for older individuals who need care and support. Understanding and integrating the principles of respect, empathy, and individual attention is crucial to ensuring that the elderly receive the quality care they deserve.

Respect for the resident's dignity

Caring for the elderly's dignity involves seeing each individual as a unique and valuable person with a rich life history and experiences. This means avoiding treating the elderly as if they were a homogeneous group and instead respecting what they like, their interests, and needs. Respect means listening to their voices, involving them in decisions that affect their care and treatment, and acknowledging their right to self-determination.

Compassion is a key component of dignified treatment. Putting oneself in the place of the elderly and trying to understand their feelings, thoughts, and worries shows that their feelings are important and taken seriously. A dignified treatment involves being present in the moment, showing care and understanding, and offering support based on the individual needs of the elderly. This can also help to alleviate feelings of isolation and loneliness that some elderly people may experience.

Communication as the foundation for dignified treatment

Communication is the key to dignified treatment in elderly care. Clear and open communication channels between caregivers, the elderly, and their relatives create an atmosphere of trust and understanding. Using respectful and clear communication helps avoid misunderstandings and frustration. Listening is a crucial part of this communication, as it gives the elderly the opportunity to express their wishes and needs.

Continuity and context

Dignified treatment involves understanding that each resident has a unique background, culture, and history. Taking these factors into account when providing care and support makes the elderly feel seen as individuals and not reduced to their medical needs. Continuity in the care relationship is also important. Having the same staff who are well acquainted with the elderly's situation creates a sense of security and trust.

Education and empowerment

To ensure that dignified treatment becomes an integrated part of elderly care, education and training are crucial. Health care staff should be trained not only in medical care but also in communication, ethics, and empathy. Understanding the specific needs of older individuals and knowing how to handle sensitive situations is part of this education.

Dignified treatment in elderly care is a moral and ethical obligation. It is about creating an environment where older individuals feel respected, seen, and cared for. By combining respect, empathy, communication, and individual attention, we can ensure that elderly care not only focuses on physical care but also promotes a high quality of life and dignity for each individual.

Dancing to the rhythm of the conversation

Fundamental to building trust is how we take care of visitors when they come to us. Employees who smile, welcome, and help visiting relatives to get settled, build trust. Clear information at the unit and via email with invitations to joint activities creates participation.

Communication is fundamental in society. Being able to communicate in an effective and meaningful way is crucial for building and maintaining relationships, exchanging ideas, and solving problems. One important factor that can elevate communication to a higher level is tact – the ability to understand and adapt to the rhythm of time in conversation.

What is tact in communication?

Tact in communication is about being aware of when to speak and when to listen. It's about being able to read signals from the conversation partner and being in harmony with their needs and feelings. Just like in a dance, where two people cooperate to move in harmony, successful communication requires us to adapt to the rhythm that arises between the speaker and the listener.

Listen to understand, not to respond

An important part of tact in communication is the ability to listen actively. Often we tend to think about our response while the other person is talking, which can lead to missing nuances and feelings behind their words. Listening with an open mindset and without rushing to respond gives us the opportunity to gain a deeper understanding of what the other person is trying to convey.

Body language and tone

Tact involves being attentive to both what is said with words and the non-verbal message. Body language, facial expressions, and tone of voice provide valuable clues about the emotional tone of the conversation. Being aware of these signals helps us to adjust our way of communicating and creates an atmosphere of mutual understanding and respect.

Balance between speaking and listening

One of the challenges in communication is finding the balance between talking and listening. Dominating the conversation with one's own thoughts and opinions can make the other person feel ignored or unseen. On the other hand, just listening without contributing your own thoughts and feelings can make the conversation feel one-sided. Finding the right balance is part of developing tact in communication.

Adjust to the rhythm of the conversation

Just like in a dance, we need to adjust to the pace and mood of the conversation. Sometimes it may be appropriate to be lively and engaged, while other times a more calm and thoughtful approach may be required. Being aware of the mood and dynamics of the conversation enables us to create a more harmonious and rewarding communication experience.

Tact in communication is a skill that can be developed and refined with awareness and practice. By being present, actively listening, and adapting to the rhythm of the conversation, we can create a deeper and more meaningful communication that contributes to building stronger and more rewarding relationships.

Violations decrease trust in the operation

Preventing discrimination in care is important. Discrimination occurs, sometimes thoughtlessly, based on gender, origin, age, or sexual orientation. In a nursing home, violations can occur based on practically all aspects. Both residents and employees and relatives can be subject to discrimination.

Gender discrimination

Studies show that care discriminates. For example, there are studies showing that men are granted more assistance than women for the same disability. Research has often been based on male disease patterns and the elderly are not always given the same right to care on equal terms as the law says. This can for example concern the opportunity for the elderly to meet a psychiatrist. We face new challenges. The proportion of elderly people who have lived in homosexual relationships will increase, which requires knowledge about LGBTQ issues. Likewise, the proportion of elderly people who were born in another country.

Core values are a recurring theme. The above issues are very much about core values. Here both the operation's and each employee's core values become important. Discrimination can occur on different grounds in care, for example employees who as a result of their prejudices or lack of knowledge treat someone worse.
Gender equality in care is about how the healthcare provider as an employer handles employees. The right to full-time for those who work in care is such an issue. Another is whether men and women are treated equally at work.

Lex Sarah is a good support for working against discrimination in the operation. One way to increase awareness and reduce risks is to repeatedly talk about core values and Lex Sarah. Some operations ensure that employees become LGBTQ-certified to increase awareness.

Age discrimination - ageism

Many elderly people feel limited by technological development. What feels liberating and easy for younger people can become an insurmountable obstacle for the elderly, creating a dependency on getting help from others.

In a post on LinkedIn, a woman had discovered that the neighbor who turned 75 had problems with the TV subscription. She had had it for five days. She had tried to reach the TV provider but it was impossible. The woman tried to help her neighbor, but since she lacked both mobile bank ID and an email address, it was impossible to get in touch with the operator.

Many elderly people do not have access to either mobile bank ID or email. If they do, they are often completely dependent on relatives to handle these. This means that their entire economy is exposed when they are forced to give out passwords and login information to relatives in order to handle the technology. This is something that can be exploited by fraudsters. It is not easy to keep track of codes and other things when memory fails. Both we who work with providing support to the elderly, associations, authorities, and companies that digitize have a common responsibility to facilitate for people, regardless of functional ability, to live an independent life.

Age discrimination can look different. During Covid-19, we have received reports of condominium associations that have not invited "older" people to joint activities so that they do not get infected. In this case, it is a kind of guardianship where someone believes that the elderly are incapable of making their own decisions about what risks they want to expose themselves to. Likewise, it has emerged that people have not been allowed to go to the hospital despite the need based on the fact that they live in a nursing home.

Discrimination as a result of age is one of the seven grounds of discrimination. The focus is often on discrimination in the workplace. There is also discrimination outside the workplace.

In care, there are situations where older people do not receive equal treatment with younger people in care. It can be about which medications are prescribed or the opportunity to meet a psychiatrist. Women over 75 are not called for mammography and disease conditions are not properly investigated. Age discrimination is prohibited in healthcare, but there is a vague wording that special treatment that has a "justified purpose" is allowed. Discrimination affects older women and people with a lower education to a greater extent. They often get worse care or have a harder time choosing how they get their care. Another type of age discrimination is when people address older people as if they were children.

At the same time, we are dealing with adult people with their own responsibility. By making it possible to learn to handle the new technology, elderly people can be given the conditions to maintain their independence. The focus must be to help our elderly solve "digital problems" in their everyday life based on their own individual needs. Not being able to participate fully in society probably gives a feeling of exclusion, which in turn leads to resignation and poorer quality of life in the long run.
Dagny Carlsson got her first computer when she was 93 years old. You do not become "intellectually" impaired just because we get older, but it may take a little longer to learn new things.

Reflection - tact and dignified treatment
Care staff:
• What do you as employees do to handle situations that may feel embarrassing for the individual?
• Does it happen that someone in the staff group expresses themselves condescendingly about other people or groups of people?
• Do you have any colleague or resident that you do not treat fairly?

Manager, nurse, occupational therapist, and physiotherapist:
• What do you do to follow up how treatment and core value issues are handled in practice by the employees?
• Do you have trainings to increase awareness of attitudes and violations?
• Do you have a written routine or policy for how gifts should be handled?

Resident and relative:
• How do you yourself treat employees?
• Do the employees behave correctly and professionally?
• Do you see factors that contribute to you or your relative being discriminated against?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day