The Necessity to Preserve Dignity and Autonomy Among The Residents for The Health Service Provider

Introduction

Dignity is always a chief concern in Hong Kong health services. In Hong Kong, residential Care Services for the elderly can be divided into homes for the aged, Care and Attention Home for the Elderly, and Nursing Home. The total number of places under these residential care services is 33134, and around 20% of residents are in nursing homes. It is important and necessary for the health service provider to preserve dignity and autonomy among the residents. Dignity is an ethical imperative in the setting of health care. However, the fact is, in most of situations, these aims cannot be reached. Dignity can be compromised during healthcare. Most of the elderly are being treated disrespectfully and unacceptably by their health service provider. Accordingly, those older service users are suffering indignity. All human being has the right to be respectful in the world.

Definition of Dignity

Dignity is the state or quality of being worthy of honor or respect. Dignity can be influenced by people’s health conditions and the attitude of others. It is proved that poor body image or body function experienced by health conditions would decrease their sense of control and confidence, so as dignity. Besides, dignity can also be influenced by the behavior in the care environment. Treating patients as valued individuals is the key variable that promoted dignity. The attitude from the staff which affects patients' dignity can be divided into three aspects: “Interactions and Communication”; “Providing Privacy”; and “Essential Care”.

Interaction and communication

All humans want to communicate and need a response and confirmation so that they may feel that they are individuals, and human beings. In general, the caregivers were often busy in Hong Kong nursing homes. The staff is more concerned with completing the tasks as fast as possible and ignoring the patient's emotional and relational needs. Even with how busy they are, the care provider should also interact elderly. If it no time to sit and talk, as least talk during providing care by starting from “How's your day?” Expressing friendliness, such as “Would you say a little more about that....” in communication could help people feel comfortable. The care provider should not make any assumptions with the patients' needs. Always ask and confirm their preferences and offer choices to service users feeling they are in control. For example, Today is a bit cold, do you want to wear a jacket? Besides, simply listening and responding to patients could make them feel valued. It is reminded that respectful language should be used, treat with courteous and speak slowly with the elderly during communication is important. Patients would feel being respected and valued and their dignity will be increased.

Privacy and Confidentiality

Before any physical examination, treatment, or personal care, valid consent from the patients must be obtained. Consent is voluntary and free permission or agreement for something to happen. People have the right to determine whether to receive treatment and care to their bodies. The areas of privacy for people accessing healthcare is divided into three part: “Personal Space Privacy”,” Physical Privacy”, and “Personal Information privacy”. The staff behavior is closely related to patients' privacy.

Personal Space Privacy

The patient's personal space has been disrupted when staff enter their room or move their belongings without getting permission. In the nursing home setting, getting permission to rearrange patients' items is important. Besides, the staff should knock on the resident’s door and wait for a reply before entering the room. If they are not able to reply, they should also know the door and announce the patients before entering the room. Getting Rearranging personal items with the resident’s permission.

Privacy of the body

Some of the patients would not wish to explore bodies to different-sex staff. The health care provider should be sensitive to the patient's wishes and respect them. Exploring patients' bodies over adequately or removing their clothing without agreement or discussion would harm the privacy and feeling not being respected by the patients. In the nursing home, if patients need to undergo examinations and need personal care, make sure only minimum clothing is removed.

Privacy of information

Information on patients is given in confidence. They can believe the staff would keep the information confidential and only share to those necessarily They can believe the staff would keep the information confidential and only share to those necessarily. According to the confidentiality model confidentiality is composed with four requirements: “Protect”, “Inform”, 'Provide Choice” and “Improvement”.

Protect means looking after the information. Inform is to ensure patients know where their information would be used. Providing choice is to allow patients to decide to disclose their information or not. Finally, always makes improvements for better maintain patient confidentially.

In the nursing home setting, staff should keep their voice low if an intimate procedure needs to be done, such as changing napkins. Auditory privacy is also important as visual privacy. Staff needs to be aware and sensitive to protect patients' information all the time.

Essential care

Essential care means personal care such as maintaining good personal hygiene, dressing, toileting, and dining. The comfort and satisfaction bring from these essential cares provided by careers are highly related to their dignity and self-esteem. In the nursing home, if patients spill food when dining, make sure to ensure they have enough intake for food by providing additional food. If food is spilled on clothing, Staff should also assist the patient to change clean clothes after dining.

Conclusion

Although dignity is divided into internal and external factors, the staff in the nursing home could help the elderly maintain good dignity in external factors by showing their good attitude. Having a good practice in providing good interactions and communication, providing privacy and essential care to patients in the correct manner could make the patients feel they are in control, valued, confident, comfortable, and able to make decisions for themselves. Therefore, dignity can be presented to them. Besides, it is proved that some positive outcomes such as high satisfaction can be presented when the patient is being treated with dignity.