Tuesday, 3 February 2009

The challenge of assessing dignity in care

It should be compulsory for health and care providers to be monitored, assessed and held to account over the level of care and respect given to their patients, according to leading older people’s charity Help the Aged. The Charity is calling for “Standards for Better Health Framework” to be extended to include 9 measures of dignity, identified by older people as essential to delivering decent quality healthcare.

A new Help the Aged report, “On our Own Terms: The challenge of assessing dignity in care”, explains that all too often for older people, use of health and social care services comes hand in hand with a lack of dignity. The research carried out by the Picker Institute on behalf of the Charity, argues that current measures do not give a clear reflection of the overwhelming lack of dignity in care.

To effectively monitor and assess the dignity of older people using health and social services, Help the Aged wants the following 9 criteria including in the “Standards for Better Health Framework”: read on

This timely report as the Care Quality Commission, the new regulator for health and social care in England prepares to assume its responsibilities from April 2009. I think it is also timely for kidney care – a lot of people with kidney disease are elderly. The report singles end of life care out as a particularly challenging domain to measure. It does however identify a number of toolkits and guidelines for healthcare professionals that have been developed and which provide a good basis for the development of dignity indicators in conservative kidney care. Stephanie Gomm (Consultant Palliative Care Physician, Salford Royal) and Ken Farrington (Consultant Renal Physician, Stevenage) who are leading on the production of a conservative kidney care chapter to complement the national End of Life Strategy, will be examining this aspect of the report in detail and I know that they and the group will be open to other suggestions for indicators and would like to know of work that is going on in this area. We do need more research but we also need to have dignity centre stage in our conservative care planning from the beginning.

Four cross-cutting things were identified within the indicators:

– support to make choices
– personalisation and tailoring care
– respect for individual lifestyle
- preferences and involvement in decision making
- staff attitudes
– respect of all attitudes in relation to all aspects of care
- courtesy and sensitivity in all forms of communication
- availability of and access to appropriate facilities and equipment
- cleanliness of facilities