Maintaining
Respect & Dignity

The elderly have a series of very important rights that are guaranteed by both state and federal law. Those rights include such things as:

• To have a high quality of life.

• To be treated like anyone, regardless of age, should be treated; in other words, the Golden Rule.

• To have meals of their choosing.

• To be protected from abuse.

• To have adequate management of their pain.

• To have personalized activities of their own choosing.

• To have privacy.

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Actually, their rights are just about what most anyone would want in order to live a happy, satisfying, quality life. One of the most significant of those rights for elders in any kind of care facility or situation – because of its great impact on their quality of life – is the right to dignity and respect. That’s an important one, and it’s one that every caregiver can have considerable impact on every elder with, every day.

Have you ever thought about what treating your elders with dignity and respect actually means? And how you should be conducting yourself in order to comply with this federally-guaranteed right? And have you thought about how very significant the actions and activities of frontline caregivers are in ensuring this right, and in making our elders feel like they are treated with dignity and respect?

The fact is, it can be as important as medical care with many elders. It only makes sense that frontline caregivers are a key factor in this because of the great amount of time they spend with the elderly each day – in some cases more than any other person.

The problem is that many elders feel like second-class citizens. After all, this is a society that emphasizes youth, physical perfection and good looks.

FEELING LIKE A BURDEN
As elders get older and lose many of the attributes of their younger days, many begin feeling like they don’t really fit in anymore, and that no one really wants to associate with them anymore. All you need to do is notice the huge emphasis on young, good-looking, people in the movies, on television and in advertisements, to begin to understand how they may be feeling.

Their bodies are slowing down, sometimes they have major health problems, they may not think they look attractive anymore, and so on. But even more than that, they often feel like they’re simply in the way.

With the fast pace of family life and activities, their family members, unfortunately, often don’t feel that they have time to give to their elders anymore. And as a result, the elders can feel that they’re a burden, and that no one wants to socialize with them any more than they have to. You can see this in many nursing homes ... some elders get very few visitors. Even nearby relatives don’t drop in nearly as much as they should and some rarely get invited out to do things with friends and relatives anymore.

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In today's society, patience sometimes runs thin and tempers can flare. Some people don’t like to deal with the problems that many elders have, and so they talk crossly to them when things go wrong, or even completely lose their temper. An elder's problems such as a sudden bout of incontinence, the need to be helped into a store, help with their pain, or just simply an understanding, compassionate conversation once in a while can be things that no one feels that they have time for anymore.

And one of the most unfortunate situations of all is that this second-class treatment often occurs with the very people who are supposed to be helping these elders – caregivers! Caregiver negligence and abuse of an elder are all-too-frequent occurrences. One of the most important jobs of all caregivers is to treat their clients with the utmost in dignity and respect, to make them feel appreciated, respected and valued at all times.

If you don’t think this is a problem, take a look at some of the ways that elders are often treated completely differently than younger people, and with much less respect. You may even see signs of it around you, and possibly never even realized that some of these things were disrespectful. But they are.

This list comes from the book, Gerontological Nursing, written by Charlotte Eliopoulos, RNC, PhD, a holistic nurse who has authored
several books on elder care.

• Dressing men and women residents in similar asexual clothing.

• Denying a woman’s request for a female aide to bathe her.

• Forgetting to button, zip or fasten clothing when dressing the elderly.

• Unnecessarily exposing older individuals during an examination or personal care duties.

• Discussing incontinence episodes when the involved elder is present.

• Ignoring a man’s desire to be cleaned and shaved before his female friend visits.

• Not recognizing an attempt by older adults to look attractive.

• Joking about their interest in and flirtation with each other.

"Chances are that no care provider would walk into the room of a 25-year-old in traction and undress and bathe him in full view of others in the room," Eliopoulos writes. "Older adults are entitled to the same dignity and respect that is afforded to persons of other ages."

There are a couple of reasons why this is such an important topic for caregivers. First, there is the "medical" reason. Treating elders with dignity and respect makes them feel better about themselves and keeps them from getting depressed. And elders who are not depressed – who feel good about themselves – recover faster from diseases and surgery and can live longer.

The second reason is simply to promote a good quality of life for your elders in their later years. Providing a good quality of life is part of the required environment for all elders and you are responsible to provide that!

GOOD OLD-FASHIONED MANNERS
Just what’s involved in treating your elders with the dignity and respect that the law guarantees them ... and that they are also entitled to?

Incorporating good, old-fashioned manners in everything you do is a good start. What does this mean? It means doing things like this:

• Be polite and pleasant at all times. This means having a smile on your face and a very pleasant demeanor when relating to your elders. Treat them like you would your friends or your family members.

• Always say "please" and "thank you" whenever appropriate.

• Look them straight in the eye when talking to them. Nothing shows rudeness or disinterest more than not looking at a person when you’re talking to them.

• Use "Mr." and "Mrs." when addressing elders until they tell you to use their first names. It’s the polite and respectful thing to do, and many elders will appreciate it.

• Learn the names of your elders and use them when visiting with them. If you have trouble memorizing names, write them down on a piece of paper and check them ahead of time. Using a person’s name is a sign of interest and respect for anyone.

• Offer to help them whenever they seem to need it. This includes offering to help for big things and even very little things every day. Always do it in a cheerful manner and with a smile.

• Frequently check on them, no matter where they’re at or what they’re doing, and ask if there’s anything they need or anything you can do for them.

• Sit down with them often, with a smile on your face, and ask them how they are, what’s new, what’s going on in their lives, and so on. In other words, carry on a little interested conversation with them, looking them in the eye and showing that you’re interested. Also, if they seem interested, give them a little news about yourself as well. Many of your elders will be very interested in your life, your children, your interests and so on, but DO NOT BURDEN THEM WITH ANYTHING NEGATIVE IN YOUR LIFE. Very often, you are one of their main contacts with what’s going on in the outside world.

• Ask them about their lives. Find out about their past, the jobs they’ve had, their hobbies, their families, where they’ve been and what they’ve done in their lives. Most elders love to reminisce and it can actually be therapeutic for them in addition to showing that you’re interested in them. For those with dementia, reminiscing like this can actually help improve their cognitive abilities.

• Ask for their opinion on things from time to time. This could involve anything – today's fashion, what’s happening in the news or even personal advice for you. Remember, they have lived long lives, have had many interesting experiences, have learned many lessons and can be full of wisdom for you to ponder as you make your own decisions in life. Who knows what valuable advice and information you can get from them, just by taking some time to sit down and listen to them? It could be priceless.

HELPFUL TIPS
The author Eliopoulos also has some suggestions in her book on how you can make your elders feel more important and more involved:

• Include your elders in their own care planning as much as possible.

• Provide a variety of options to your elders on minor items and give them freedom to choose among them. Discuss these options with them.

• Equip your elders for maximum self-care by educating, relating, coaching, sharing and supporting them.

• Become an advocate for your elders as they seek information and make decisions.

• Offer plenty of feedback, positive reinforcement, encouragement and support.

• Give them lots of loving and compassionate touch. Hold their hand as you talk to them, and put your arms around them whenever appropriate, as often as possible.

• Watch over them very attentively in your caregiving job.

• Make sure they’re not in pain, need medical help or are otherwise suffering. If they have a sudden problem with incontinence, for example, take care of them immediately and cheerfully.

• Let them have as much privacy as possible for potentially embarrassing situations. Visualize how you would like to be treated in those circumstances and do the same for your elders.

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In fact, guidelines from the Centers for Medicare and Medicaid Services (CMS) actually require that you handle potentially embarrassing, or humiliating, situations like you would like to be treated in those situations yourself. The CMS calls this the "reasonable person concept" and it’s a part of the guidelines that their surveyors look for when inspecting facilities. And note that this even includes elders who suffer from dementia who you may think don’t know the difference.

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The CMS would also like you to take special care of elders when they are eating and not do anything that embarrasses or humiliates them in any way. Their guidelines say that staff should be "attentive and responsive to the resident’s requests and to provide assistance to eat in a manner that respects the resident’s dignity, and minimizes potential feelings of embarrassment, humiliation and/or isolation related to an inability to assist themselves with food or fluid intake.

Bottomline: It’s up to you, as a compassionate caregiver, to help the elderly live their lives with as much respect and dignity as possible. In the end, much of this boils down to something as simple as the Golden Rule – treat others how you’d like to be treated.