Direct Care Worker Special: Maintain the Dignity of Those You Serve

PIC - ELDERLY WOMAN IN WHEELCHAIRMerriam Webster’s Dictionary defines dignity as: “the quality or state of being worthy, honored or esteemed.” And all of us want to feel worthy or honored. This is especially true in our old-age.

However, the feeling of being worthy may be seriously diminished when a person can no longer perform some of the regular activities of daily living that so many of us take for granted. These activities include:
 Feeding ourselves
 Toileting ourselves
 Cleaning our home
 Dialing a telephone number
 Remembering key dates in our lives
And so much more.

And as a result of not being able to carry on these items themselves, many have to rely upon you as a Direct Care worker to help them. As a result they likely feel, at least on occasion, less than dignified. I can recall a “home help” client for whom I arranged 24 hour services. She had suffered a heart attack and several strokes. When she finally came home she was in a wheelchair. Every time she left her home with assistance from me or my staff either to have her hair done or just to go out for groceries, she felt bad about her neighbors seeing her in a wheelchair. This limitation affected her feeling of worthiness.


So almost every time I took her out of the home in a wheelchair I would tell her, “your neighbors are going to be jealous about this first class chauffeuring you are getting.”  Certainly my comments did not remove her physical limitations that necessitated her use of a wheelchair, but for the moment I would like to think that I shifted her focus to my colorful comments rather than on her neighbors seeing her in a wheelchair. So one of the most successful ways we can help a person to maintain or restore their dignity is by: MINIMIZING ATTENTION ON PERSONAL LIMITATIONS. But there is more we can do. And it all has to do with our demeanor and decorum.

There are a variety of unpleasantries associated with rendering physical care to a limited adult. Some of these relate directly to care delivery and the associated odors and sites that are tough to endure. It is not easy for someone to be constantly reminded that their odors make someone else unpleasant. To get around this we can:

1. To the extent possible, clean a soiled area with our client out of eye shot. In this way they are not being constantly reminded that they need us for something they wish they could do themselves.
2. Never make comments such as: “you really made a mess today”, or “I need a mask to clean this up”, or “let’s open all the windows so I can do my job”. While it is true that you may have to open some windows, making the client feel they have created this great environment of unpleasantness for you would demean them and cause great embarrassment.
3. Keep the entire home environment as odor and germ free as possible throughout the day. This will minimize the occasion when a visitor will come in and notice an unpleasant odor and remark about it in the presence of the client.

We can also help a person maintain their dignity by making an honest evaluation of what their limitations are. This does not mean we conduct ourselves like licensed professionals and make medical assessments we are not qualified to make. However, we want our client to do as much as they can for themselves. Dignity and independence [“that feeling of worthiness”] are closely related.

Therefore, we must allow them to feed themselves if they are able, clean themselves after toileting if they are able, dial the telephone if they are able. We promote and maintain independence by allowing people to function at the highest level they can. Even if some might enjoy having you do some things for them that they could do for themselves, they would experience greater dignity when they can do as much as possible without you. In these situations we must be a realist. A person’s abilities and limitations must be honestly evaluated.

At the end of the day it is truly about getting to know the person and dealing with them accordingly.  Sign-in and share your thoughts.



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