Health and ageing

This assignment is from the subject health and ageing Eassy topic is:
The Australian aged care quality agency identifies 44expected outcomes across four
standards. The third standard outlines ten outcomes in regard to the care recipent’s life
style.
Discuss the concepts of privacy and dignity found in outcom 3.6 using the scholarly
literature to support your conclusions. Indentify the ways in which the registrered nurse
can safeguard these rights and why it is essential that this occur?
Concepts of privacy and dignity

Introduction
The Australian agency for aged care acknowledges the need for privacy and dignity in order to
improve the patient outcomes. The agency’s insists that patient dignity must be respected.
However, findings indicate that patients (the elderly in particular) are increasingly vulnerable in
care settings. The studies also illustrates that the lack of privacy in healthcare settings threaten
patients dignity. Healthcare staffs who are curt or authoritative threaten patient’s dignity (Lyttle
&Ryan, 2010).
Studies indicate that good healthcare environments, one which promotes patient’s privacy and
dignity culture would make patients feel more comfortable and improve their health outcomes.
This is because patients –healthcare provider relationships and care settings environs influence
the patients’ healthcare (Hesse, 2012). For these reasons, this paper evaluates the importance of
maintaining privacy and dignity for the aged, in improving their quality of life. The paper will
explore the topic by examining the pieces of literature available of impact of privacy and dignity
in improving patient’s outcomes; legislation and professional regulations particularly for the
elderly; explore the role of nurses in ensuring that privacy and dignity are sustainably practiced.
Privacy and dignity concepts
Privacy and confidentiality include all the relevant duties in ensuring that patient’s
information including health diagnosis, prognosis, family history and drug use are protected. The

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patient’s cultural contexts values, decisions and information must be treated with respect. The
regulations require that the patient’s information must not be disclosed without the patient’s
consent. Privacy also refers that the patients autonomy. The patient should be in a position to
make decisions with minimal interference or coerced to make decision by the healthcare provider
or the relatives. It is supposed to ensure that patients must have the right to exert full control of
their healthcare decisions (Gaffney, Johnston, & Buchanan, 2014). It includes deciding on who
should access their health information. The Australian agency concepts on privacy regulate the
distribution of electronic data. These rights should never be over looked. However, most
healthcare providers and relatives often disregard the importance of this for the elderly. Privacy
and confidentiality really affects the patients; by keeping their information in privacy makes the
elderly feel that they are appreciated. The healthcare provider should not assume that the elderly
patients want their healthcare information shared with his/her relatives. The desire to keep
healthcare information private does not decrease with age (Lin, Tsai & Chen, 2011).
Again, the Australian healthcare policy has much rhetoric on concepts of dignity. There
have been increased reports on ageism, indignity and care deficits in healthcare services.
Nevertheless, the importance of dignity when dealing with the aged people cannot be
overlooked. Dignity in care provision is not a new aspect. It can be traced back to the great
philosophers such as the Aristotle. The first statement which integrated dignity in healthcare was
in 1948 during the Declaration of Human rights in the U.S. Since then, there has been increased
attention to dignity in care settings particularly in the health care settings. Diverging approaches
to the concept of dignity results to varying understanding of the concept. Philosophically, dignity
refers to the feeling of worth or valued. Aristotle’s definition of dignity refers to the virtue which
results to human eudemonia (happiness). In this case, if the person have little self-worth they

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may not be happy. Kant defined dignity as an intrinsic value which is priceless. In both Kant and
Aristotle definition, dignity is a human virtue which is associated with rationality or autonomy
(Hughes, 2011).
Dignity can be subcategorized into three sections. The first dignity is the dignity of
merit. This includes respect and value held for people who have higher status in the society. A
status is a position that is highly valued by others such as a governor, bishop etc. The next
dignity is that of moral status. It entails moral autonomy and integrity. This implies that if a
person lives according to their moral principles, then they develop a sense of self-respect and
self-worth (Taylor &Brian, 2014). The last dignity is that of identity. This paper focuses on this
dignity which reflects self-respect and identity to people. This is violated via physical
interference which negatively impacts emotional and psychological values. In this framework,
dignity is an inherent characteristic which should be present in everyone. Nurses are expected to
serve the elderly with uniqueness and autonomy. It is associated with concepts of honor and
respect. Care for the elderly presents unique challenge in the promotion and sustenance of
dignity in the daily care provision to the patient (Baillie, 2009).
The older people are vulnerable. Some may have health issues which put them to higher
risks of death. The dignity challenges experienced by the elderly in care settings includes under
treatment of people suffering from chronic illness. In other cases, the patients are over treated
that can be difficult to identify, thereby highlighting the need to integrate a family centered care
approach. By totally dependent on the nurses, the elderly patients can experience shame and
indignity. They often feel like they have totally lost control of their lives which could result to
deterioration. This causes the elderly feels like they have lost hope. There is increased threat to
their personal integrity (Fischer & Schenkman, 2011).

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Role of the nurse in maintain dignity
The healthcare staff attitudes and behavior are key elements towards maintaining positive
relations to the elderly patients and to empower their feelings of self-worth. The key elements of
providing the care includes attentive care which results to respectful patient- nurse relations.
Integrating elderly when making health care decisions is important because it makes them have
sense of control over their lives (Neir, 2013). The nurse providing care should listen attentively
to the older people desires, value and respect them. This includes preserving their privacy during
personal care and other health care services. Individualized care and acknowledgement of the
good memories would increase patient’s dignity considerably (Brennan, 2014). Providing quality
care when sustaining dignity in elderly people could be challenging. Old age is frequently
associated with memory loss. This threatens sense of personal integrity making the patient more
confused. This loss of cognitive function makes the patients more irritable which manifests
themselves as reduced cooperation and stubbornness. This is because they feel as a burden and
embarrassment to the family. However, coherent communication with the patients can take the
negative emotions way.
In terms of sustaining dignity in the elderly, the nurses have a big role to play. The first
step in sustaining dignity is by understanding the patient as a unique entity. The nurse should
understand the patient’s cultural contexts which could impede delivery of quality care
(Venturato, 2010). Valuing the patient’s attributes and beliefs will make the patient feel
appreciated; thereby enhance their dignity. This improves the connection between elderly
patients and the staff. Helping the patient retain the reduced sense of autonomy enhances the
patient’s sense of dignity. The patients should be supported and encouraged to participate in
group activities, this enhances the patient’s sense of autonomy (Oeffner Et al, 2011). The staff

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attitudes and behavior concerns the elderly person perception about dignity. If the nurse shows
reduced or lack of respect, intolerance or increasingly impatient can reduce the elderly persons
sense of identity. Staff attitudes influence the patient’s outcome considerably. One survey
indicated that use of endearments are patronizing and demeaning to the patient. Use of proper
names and language indicates empathy and respect, indicating that the nurse knows the
individual she is dealing with (Morris, 2012).
Despite the decreased cognitive function, the nurse’s goals should be heightening the
patient’s sense of purpose. This could be achieved by setting goals and achievements within their
social group. Such approaches makes the elderly patients retain their sense of independence.
Consequently, the maintaining of the functional status ensures that self-esteem is improved. In
cases where the patients have completely lost sense of dependence, providing treatment in
pleasant environs and constant presence of friendly healthcare providers can enhance the
patient’s dignity. The friendly environment bestows the feeling of safety, belonging and
continuity (Pirhonen, 2014). Environmental set up of the healthcare facility influences patient’s
perception of dignity and self-worth. This mainly pertains to the physical environment. For
example, how accessible is the lavatory, does the facilities have mixed sex wards or are the
wards separated and hygiene well kept. Unsatisfactory environment is associated with reduced
recognition of the patient value. For instance, if physical evaluations are conducted in public, a
shabby ward facility, unhygienic lavatory among others reduces identity dignity. This is because
it violates personal space and humiliates the elderly persons. In such type of environments, the
hospitalized patient falls reports are considerably high which increases chances of emergency
visits (Tadd, Vanlaere, & Gastmans, 2010).
Importance of privacy and dignity in healthcare

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In one study entitled dignity and older people indicated that people of all ages have needs
for dignity. Dignity is importance across all health care settings including the acute care and long
term health care settings. Most studies indicate that where there is loss of privacy and dignity,
the older patients are negatively affected. The impacts results to increased psychosocial disorders
such as anxiety and distress (Vorster, 2012). Dignity is one of the virtues used by patients in
rating the health care facilities. A survey conducted in U.S. on 27, 414 patients after discharge
indicated that their confidence and trust in health care professionals was influenced by respect
and dignity accorded during care. Approximately, 85% patients from the study reported that
being treated with dignity was associated with patient satisfaction. Another study assessed
nurse’s experiences in promoting patient’s dignity. The study found that nurses provided quality
care by defending patient’s quality had increased career satisfaction. Dignity is connected to self-
esteem. How a person is treated results to a more profound effect (Papastavrou, 2012).
Evidently, dignity promotion in elderly care is fundamental. Four attributes have been
identified as the driving force towards dignity including; individualized care, respect, sensitive
listening and advocacy. Nurses should identify each patient’s unique needs and demands
(Welford Et al, 2012). This implies making the patient to actively be involved in decision
making processes. Individuality is also enhanced through listening of the patient’s life
experiences and views about their healthcare. One intervention that has been found to be
effective intervention is reminiscence. This encourages the elderly patient to discuss about their
real life experiences. This attribute is also very important when relating to the wide range of
specific activities (Gallagher Et al., 2008). These activities include when doing regular activities
such as bathing, dressing toileting among others. Where patients are left to soil their beds, not
assisted during feeding or are put in areas where there is limited privacy reduces elderly

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perception on dignity. Nurses should learn to attend even to small details of care or patients
preferences. Showing respect to the elderly preserves patient’s dignity. This includes respecting
the communicated traditional values and believes. This can be enhanced by providing small
space where the patient can bring cultural symbols. This makes the elderly person feel
appreciated and at home. It is the nurse’s role to ensure that the patient’s rights are protected.
This is especially if the patient mental capacity is reduced (Sauchaud Et al, 2013).
Conclusion
The challenges attributed to providing privacy and dignified care to the elderly patients has been
discussed. The empirical data supporting the findings have been indicated. The increased
debates and raised concerns by the patients about health care service delivery have raised
attention in health care organizations. This paper has highlighted the role of nurses in ensuring
that privacy and dignity is sustained during care provision of the elderly. To integrate dignity and
privacy in the daily nursing practice, the healthcare provider must focus on the aforementioned
attributes including; healthcare environment, staff behavior and attitude, cultural competence and
special care activities. However, where an elderly person chooses to disregard the convectional
standard such as hygiene, and efforts to persuade them to bath are futile; then the nurse is
permitted to act according to the patent’s best interests. This calls for reaching equilibrium
between autonomy and potential health risks due to self-neglect.

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