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The purpose of this research was to develop a better understanding of how community-dwelling older adults with multiple chronic conditions manage their dignity, and how these strategies compare to those used by older adults in hospital settings.
Dignity is important for the health and wellbeing of older adults. Many situations, particularly interactions with healthcare professionals threaten older adult’s dignity. Vulnerable older adults, like those with chronic health problems, are more at risk for experiencing indignity than their healthier counterparts. However, little is known about how these older adults respond to perceived threats to their dignity.
Methods:
Nineteen community dwelling older adults with multiple chronic health problems, were interviewed regarding how they managed their dignity. Grounded theory methods were used to identify the characteristics of situations in which the dignity of older adults was either enhanced or threatened. The strategies employed by older adults to manage his or her dignity in these situations were identified including variation in those strategies in relation to individual characteristics. Finally, similarities or differences between strategies used by community-dwelling and hospitalized older adults who participated in a previous study were explored.
Results:
Older individuals told stories of every-day interactions with other people in which their dignity was supported or diminished. Interactions that enhanced dignity were focused on the unique contributions of the older individual and included honor and respect from others. Interactions that diminished dignity included evidence of racism, classism, or ageism. The older adult explained actions to manage dignity in the face of indignities. Three types of strategies to manage dignity: introspective, interactive, and active, were identified. Community dwelling older adults used the same classes of strategies as did their hospitalized counterparts, but exhibited greater breadth in their responses. The greater breadth in strategies was related to the different power structures within the interactions of the community-dwelling older adults and the hospitalized older adults.
Conclusion:
Understanding interactions that affect the dignity of older individuals have an indirect effect on the health of these individuals. Healthcare providers must learn patterns of interactions that enhance the dignity of older individuals and avoid interactions that are perceived to be ageist, classist, or racist.