RNNarrative ReviewScandinavian journal of caring sciences2020

Dignifying and undignifying aspects of care for people with dementia: a narrative review.

Wendy van der Geugten, Anne Goossensen

PMID 31750569

WHAT IT FOUND

Dignity in dementia care depended on staff seeing each resident as a unique person, adjusting to changing abilities, and using respectful touch, speech, and routines.

Hastiness, task-focused care, locked environments, and talking over residents made care feel undignifying.

Key findings

01Dignifying care required staff to adjust and attune to changing abilities, personality, preferences, and care needs.

02Undignifying care arose from ignoring or failing to adapt to the changing person with dementia.

03Scarcity of time and resources made care task-centred and left residents feeling neglected, overlooked, or alone.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This is a narrative review of qualitative studies, so it describes experiences and themes rather than proving that any specific care practice improves dementia outcomes. The search was limited to four databases and the terms dementia and dignity, so relevant papers on indignity or related concepts may have been missed. The first author performed the initial screening alone, which may have led to relevant articles being excluded before full-text review. The review included only qualitative studies and excluded grey literature and books, so practical experience and other relevant sources were not captured. Some included studies were rated poor on methodological quality but were kept because few relevant studies were found. The included studies did not consistently use a formal scale to describe dementia stage, so findings may not apply equally across mild, moderate, and advanced dementia.

The easy way to misread this

Do not read these themes as evidence that a named dignity intervention improves dementia care. The paper synthesises qualitative experiences and does not test whether any practice changes outcomes.

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