There was at least one hundred years of caregiving experience among the ladies (and two gentlemen) who had invited me to speak to their church group. I always enjoy hearing from my audience and have learned a great deal from their experiences. 

“So, what is one thing a caregiver should never do?” I knew this was a broad topic and expected a variety of answers. The first one was illuminating.

“Never call incontinence briefs diapers or adult pull-ups. Just call them underwear or panties. It is embarrassing for the person and somewhat belittling.”

Such a simple act on the part of a caregiver – but one that can make a big difference to the recipient.

Her admonition reminded me of an issue that should always be considered in caregiving: dignity. This word is defined as “the state or quality of being worthy of honor or respect” and is closely connected with feelings of self-worth. It is always a caregiver’s responsibility to be mindful of and avoid words or actions that show a lack of respect toward the care recipient. 

When I was a charge nurse in long-term care, I frequently witnessed disrespectful actions toward patients by a few staff. Whether it was neglecting to close the curtain between roommates before providing personal care, talking to a resident as if he was a child, or exhibiting an “I’d rather not be here” attitude, many guidelines established to protect a person’s dignity were breeched. 

Of course, it should be a given that taking care of a loved one at home would always be carried out with respect. But caring family members are also human…and so a little reminder about the importance of guarding our words and actions to maintain an atmosphere where dignity is safeguarded is appropriate. 

According to Caregivers Board, dignity is the most cited quality-of-life issue in studies of care recipients’ attitudes and behaviors. Their website states that when a caregiver makes maintaining personal dignity a priority, “Elderly clients feel more content, and many show improvements in their emotional and physical health.” Following are three areas of personal dignity and suggestions for keeping each intact.

•         Physical dignity:  Assisting with bathing, toileting and dressing may be embarrassing to both of you. Bathing my dad, and later providing incontinence care, was difficult for me. My dad was always a modest man and I wanted to maintain his right to privacy. Provide as much cover as possible, such as placing a towel over the lap of a person during toileting. If it is safe, step just outside the door, and instruct the recipient to call you when he is finished. Imagine having someone watch you when you go to the bathroom.

When bathing or dressing, look at the person’s face and not the body. Never undress a recipient and leave him sitting or standing naked. It takes very little effort to discreetly position a robe, towel or sheet for cover-up. Close doors and pull window shades if needed to provide privacy. Avoid rendering personal care in the presence of visitors. 

• Emotional dignity: The desire for respect does not lessen when someone grows old or becomes ill or disabled. In some circumstances it may even intensify. Talk with your recipient, not to or about him. Avoid speaking in a condescending manner. Even those with dementia often sense when someone is talking down to them.

Depending on the relationship before caregiving, you may already know the likes and dislikes of your recipient. Act accordingly. If you are not aware of preferences, ask and learn what behavior on your part may trigger negative reactions in your recipient. Avoid actions you believe will annoy or frustrate. Watch your body language. Care recipients seem to have an uncanny ability to discern any negative attitudes displayed by their caregiver.

• Mental dignity: Unless a person is unable to make decisions due to cognitive decline, he or she should be able to make personal choices such as which clothes to wear or what television show to watch. It may be helpful to give them a choice between two outfits, instead of just opening the closet door and asking, “What do you want to wear today?” You may not always agree, but if their selection is reasonable and not harmful, try to accommodate their wishes. This may be especially important to someone who is aware he las lost certain physical or cognitive abilities and feels he no longer has control over his own life. Amiably discuss issues you do not agree about and be willing to see matters from your recipient’s point of view.

As in so many areas of life, a good question to guide our actions is, “How would I want to be treated?” Someday, you may have a caregiver safeguarding – or eroding – your dignity.

Caring Quote: Dementia doesn’t rob someone of their dignity, it’s our reaction to them that does. – Teepa Snow