Ensuring Dignified Nursing Care for Hospitalized Elderly Patients

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This essay delves into the crucial topic of dignified nursing care for elderly patients, particularly within hospital settings. It highlights the rising global elderly population and emphasizes the importance of respectful and effective care, citing statistics on increased hospital admissions among older adults. The essay explores various factors influencing the perception of dignity, including interpersonal violence, inadequate communication, and lack of privacy. It examines existing research on the experiences of hospitalized elderly individuals, highlighting the need for person-centered care and addressing issues like shared decision-making and patient safety. The discussion emphasizes the essential elements of dignified care, such as a secure environment, positive staff attitudes, and specific care activities, drawing on ethical guidelines and scholarly definitions. The essay concludes by identifying key factors that both support and hinder dignified care, like family involvement, cultural and religious beliefs, and environmental considerations. The study stresses the importance of practical knowledge and a comprehensive understanding of patient experiences to improve geriatric practice and healthcare plans.
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Introduction:
As the number of elderly people in communities across the world rises, providing
older patients with dignified nursing home care is crucial for ensuring their safety and
effectiveness of care (United Nations, Department of Economic & Social Affairs Population
Division, 2019). For instance, according to the United Nations, Department of Economic and
Social Affairs, and Population Division (2015), the average age of people worldwide has
increased from 67 years in the early 2000s to just over 73 years in 2019 and is expected to
ascend by such an approximate 4.5 years between 2020 and 2050. (United Nations,
Department of Economic & Social Affairs Population Division, 2019). Due to a variety of
physical and mental comorbidities that come with becoming older, older persons continue to
be the main users of medical services (Sommerlad et al., 2019). Only 9% of Belgium's
population in 2014 were older people (>75 years), but they were responsible for more than
25% of all hospital admissions (Van den Heede et al., 2019). Evidence shows that older
persons with age-related organ dysfunction and chronic medical disorders make up the bulk
of hospitalised patients in Ghana (Narh et al., 2021). (Amegbor & Rosenberg, 2020).
Significantly poorer capacity and age-related comorbid conditions were discovered by
Sommerlad et al. (2019) as risk variables for hospitalisation using a meta-analytic method.
Individuals who have dementia are particularly vulnerable to violations of their fundamental
rights to liberty, dignity, as well as tolerance, as well as to equal access to the best possible
health care, including addressing their needs as a result of impairment, because Australia's
aged care system is in crisis. Individuals with dementia and the larger community with stakes
in high-quality elderly care must be educated about their rights and what ought to be
anticipated from the service to be effective activists for both themselves and society. The
article that follows presents empirical research that helps to comprehend how hospitalised
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2ESSAY
older individuals perceive their sense of dignity and how receiving dignified nursing care
while in the hospital is a critical component of Australia's medical system assessment.
Discussion:
Due to their increased sensitivity as a consequence of deteriorating cognitive and
behavioural functionality, older persons in healthcare settings are more vulnerable to
interpersonal violence (Filipska et al., 2020). (Hubbard et al., 2017). According to estimates,
38% of older individuals in Poland encountered psychological abuse of some kind while
receiving medical care in hospitals (Filipska et al., 2020). Interpretive descriptive research by
Naderi et al. (2019) found some unpleasant experiences for hospitalised older individuals in
acute hospital environments in Iran, including the needless use of physical restraint and
improper treatment by "Health care practitioners (HCP)". It's conceivable that Africa as well
as other continents have distinct social perceptions. Recent research, however, indicates that
older Australian persons are not particularly happy with the standard of nursing care provided
during severe hospitalisation (Fuseini et al., 2021), which might indirectly affect their sense
of dignity. One of the most crucial nursing care aspects and among the most significant
factors influencing wellness is preserving the dignity of elderly patients being treated in
hospitals (" Nursing & Midwifery Board Australia (NMBA)", 2018). Numerous worldwide
professional ethical guidelines for nurses have highlighted the need of maintaining patients'
dignity and treating them respectfully.
A rising corpus of scientific data on patients' respect and the nursing treatment of
senior citizens in the last two decades (Kerr et al., 2020). While the value of dignity is
generally acknowledged, no consensus exists on how to define this crucial idea (Allard et al.,
2018). The idea of providing elderly patients in hospitals with dignified care has been
clarified to spur advancements in geriatric care. The bulk of interpretations of compassionate
care was put out in editorials written by subject-matter experts or as part of literature reviews.
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Tauber-Gilmore et al., (2018) defined dignity treatment for older patients as a treatment that
encourages and reinforces a person's self-respect and does not compromise it, regardless of
any differences, based on a study of the literature. According to Fuseini et al. (2022),
providing older folks with dignified care entails respecting their dignity and recognising them
as unique people. To ensure the delivery of dignified care to geriatric persons, they
highlighted four care-related topics that caregivers must concentrate on: a secure environment
of care; optimistic actions and attitudes; mindset of treatment; and particular care activities.
According to Hillman et al. (2013), the interpersonal communication, sociocultural, and
contextual components of care should indeed be taken into account when determining what
constitutes respectful care for hospitalised older individuals.
The results of a recent needs assessment demonstrated that care for older patients in
medical configurations is primarily focused on routine work, while person-centred care is
frequently neglected (Bláhová et al., 2020). Despite attempts to define what creates
honourable care for elderly persons, and despite calls for a comprehensive view of dignified
care. Routine treatment raises the possibility that hospitalised senior citizens may not be
getting the sort of individualised care required to maintain and enhance their dignity. To
improve gerontological practice and health care plans, researchers have already attempted to
investigate the topic of dignified nursing home care for hospitalised senior citizens (Bláhová
et al., 2020). Poor HCP-patient relationships and mixed-sex departments with unisex
restrooms are two issues that Hillman et al. (2013) identified as limiting the respect of
hospitalised older individuals in the UK. Another qualitative study conducted in the UK
found that elderly patients admitted to hospitals often struggle with shared decision-making
and a loss of privacy (Tauber-Gilmore et al., 2018). Using an interpretive descriptive method,
Kerr et al. (2020) investigated elder patients' and family members' opinions of decency in
acute care environments in Victoria, Australia. Lack of collaborative decision-making,
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treating patients with respect as unique persons, and patient safety concerns were found to be
the three key themes. Parallel to this, a recent comprehensive assessment found inadequate
privacy as well as seclusion, losing control, callous treatment, and a feeling of being
disregarded by Pharmacists as the variables that impede older people's dignity in acute care
hospitals (Bláhová et al., 2020).
As stated by Ostaszkiewicz et al. (2020), complaints raised by patients and medical
personnel call attention to instances in which people felt that they had been treated fairly and
with regard for their dignity, or that they had not. The way individuals choose to illustrate the
types of therapy that, in their eyes, do or do not qualify as dignified depends on why a
comprehensive investigation of patients' constructions of their identities and descriptions of
their experiences is interesting. These can include outright abuse, like as leaving a patient in
an unclean bed, or suitable possibilities for involvement and active engagement in treatment
choices. It is not unexpected that a large portion of what is referred to as promoting dignity in
care might be categorised as patient assessment. Nursing professionals should concentrate on
the four elements mentioned in this paper to operationalize dignity in daily practice
(environment of care; staff attitudes and behaviour; culture of care; and specific care
activities). The use of practical knowledge by managers, practitioners, and policymakers is
something else that is necessary. They will be able to accept ambiguity and uncertainty in
people's views as a result. For instance, the concepts of dignity and autonomy may clash. The
tension between a French Dwarf's purported right to be tossed around a nightclub and the
idea that such behaviour is against the public good, even when it is voluntarily selected, is
possibly the most severe example (Ostaszkiewicz et al., 2020). Nevertheless, if an older
relative chooses to defy accepted hygiene practices and refuses to take a bath, his strategic
interests must be taken into account, weighing the importance of his autonomy and freedom
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against the risks of self-neglect, the anguish or offence caused to everyone else, and his
rights.
Conclusion:
The study revealed several variables that support or hinder providing elderly patients
with dignified nursing care. Patients’ dignity is maintained when they get respectful and
compassionate treatment, their privacy is protected, and family members participate in their
physical care. Inadequate knowledge of their medical condition, poor nurse communication, a
lack of privacy, and lack of participation in care choices are all obstacles to dignity. Family
members' participation in physical care, which was impacted by cultural and religious beliefs,
environmental obstacles to confidentiality and dignity, and a lack of participation in decision-
making was the distinctive characteristics found in the Australian setting.
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References:
Aged Care Quality Standards (ACQS).
https://www.agedcarequality.gov.au/providers/standards. (2019). Retrieved 11 August
2022, from https://www.agedcarequality.gov.au/providers/standards.
Allard, E., Legault, A., & Genest, C. (2018). Dignity or dignities? When a concept has
multiple meanings. Journal of Pain and Symptom Management, 56(2), e1–e2.
https://doi.org/10.1016/j.jpainsymman.2018.0
Amegbor, P. M., & Rosenberg, M. W. (2020). Health and socioeconomic risk factors for
overnight admission among older adults in Ghana. Journal of Population Ageing. 1–
19. https://doi.org/10.1007/s12062-020-09294-3
Bláhová, H., Bártová, A., Dostálová, V., & Holmerová, I. (2020). The needs of older patients
in hospital care: A scoping review. Aging Clinical and Experimental Research,
(Bláhová H., hana.blahova@bulovka.cz; Bártová A.; Dostálová V.; Holmerová I.)
Department of Longevity Studies, Faculty of Humanities, Charles University, Prague,
Czech Republic. Embase. https://doi.org/10.1007/s40520-020-01734-6
Filipska, K., Biercewicz, M., Wiśniewski, A., Kędziora-Kornatowska, K., & Ślusarz, R.
(2020). Prevalence and associated factors of elder psychological abuse- a cross-
sectional screening study, based on a hospitalized community from Poland. Archives
of Gerontology and Geriatrics, 90, 104152.
https://doi.org/10.1016/j.archger.2020.104152
Filipska, K., Biercewicz, M., Wiśniewski, A., Kędziora-Kornatowska, K., & Ślusarz, R.
(2020). Prevalence and associated factors of elder psychological abuse- a cross-
sectional screening study, based on a hospitalized community from Poland. Archives
of Gerontology and Geriatrics, 90, 104152.
https://doi.org/10.1016/j.archger.2020.104152
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Fuseini, A. G., Rawson, H., Ley, L., & Kerr, D. (2022). Patient dignity and dignified care: A
qualitative description of hospitalised older adults perspectives. Journal of Clinical
Nursing. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.16286
Fuseini, A., Bayi, R., Alhassan, A., & Atomlana, J. A. (2021). Satisfaction with the quality of
nursing care among older adults during acute hospitalization in Ghana. Nursing Open,
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Nursing and Midwifery Board, Australia. (2018). Nursing and Midwifery Board of Australia
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https://www.un.org/en/development/desa/population/publications/pdf/ageing/
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