Addressing Dignity Related Concerns
| Dignity-conserving trait: | Continuity of self |
| What it means: | The person’s belief that the essence of who they are is still intact, despite the illness |
| Questions to ask: | “Are there things about you that this disease does not affect?” |
| Interventions: | Talk to the person about the facets of life not affected by the illness Learn about the person’s biography, attending to those aspects of life that he/she values most See and relate to the patient as someone worthy of honour, respect and esteem |
| Dignity-conserving trait: | Role preservation |
| What it means: | Ability to engage in the person’s usual roles |
| Questions to ask: | “What things did you do before you were sick that were most important to you?” |
| Interventions: | Learn about the patient’s biography, and understand the roles that are most important to him or her Facilitate enactment of these roles within the limitations of the person’s illness See and relate to the person as someone worthy of honour, respect and esteem |
| Dignity-conserving trait: | Maintenance of pride |
| What it means: | The person’s ability to maintain positive self-regard and self-respect in the face of diminishing independence |
| Questions to ask: | “What about yourself and your life are you most proud of?” |
| Interventions: | Talk to the person about the aspects of his/her life that instil pride See and relate to the person as someone worthy of honour, respect and esteem Maintain a professional demeanour when providing care |
| Dignity-conserving trait: | Hopefulness |
| What it means: | The person’s belief that activities and events in life are still possible and meaningful, despite the current situation |
| Questions to ask: | “What is still possible?” |
| Interventions: | Talk to the person about what is still possible, despite illness limitations Encourage the person to redefine goals and expectations Encourage and enable the person to participate in activities he/she feels are meaningful and purposeful |
| Dignity-conserving trait: | Autonomy/control |
| What it means: | The person’s perception that they have autonomy and control over life circumstances, regardless of functional limitations |
| Questions to ask: | “How in control do you feel?” |
| Interventions: | Assess the person’s perceived level of control Involve patients in care, treatment and planning decisions, as desired by patient Where possible, provide choices |
| Dignity-conserving trait: | Generativity/legacy |
| What it means: | Taking comfort in feeling that something of value will be left behind that transcends death |
| Questions to ask: | “How do you feel your life has affected and benefited others?” |
| Interventions: | Facilitate life review or support the patient in other projects that foster the sharing of memories that are meaningful to the person (for example, making audio/video tapes, writing letters, journaling) Suggest Dignity Therapy |
| Dignity-conserving trait: | Acceptance |
| What it means: | Accepting the unavoidable course of illness so energy can be focused on appropriate and meaningful activities |
| Questions to ask: | “How at peace are you with what is happening to you?” |
| Interventions: | Explore the impact of the illness for the patient Appreciate the dynamism of the process of responding to a life-threatening illness Support the person in his/her outlook Encourage doing things that enhance his/her sense of well-being (such as meditation, light exercise, listening to music, prayer) |
| Dignity-conserving trait: | Resilience/fighting spirit |
| What it means: | The person’s ability to rally against his/her illness-related concerns |
| Questions to ask: | “What part of you is strongest right now?” |
| Interventions: | Support the person in his/her outlook Encourage doing things that are meaningful and enhance his/her sense of well-being (such as meditation, light exercise, listening to music, prayer) |
| Dignity-conserving trait: | Living in the moment |
| What it means: | Focusing on the here and now, rather than worrying about the future |
| Questions to ask: | “Are there things that take your mind away from illness, and offer you comfort?” |
| Interventions: | Support the patient’s efforts to participate in normal routines, or to take comfort in momentary distractions (such as daily outings, light exercise, listening to music) Make appropriate use of humour, and discuss issues that are non-illness related |
| Dignity-conserving trait: | Maintaining normalcy |
| What it means: | Maintaining some sense of normality while coping with the challenges of illness |
| Questions to ask: | “Are there things you still enjoy doing on a regular basis?” |
| Interventions: | Support the person’s efforts to participate in normal routines, or to take comfort in momentary distractions (such as daily outings, light exercise, listening to music) Support and enhance independence using appropriate resources, assistive devices and personnel |
| Dignity-conserving trait: | Finding spiritual comfort |
| What it means: | Finding solace within a spiritual belief system, which may include rituals and practice of organized religion, being in touch with nature and/or connecting with a uniquely defined creative life force |
| Questions to ask: | “Is there a religious or spiritual community that you are, or would like to be, connected with?” |
| Interventions: | Sensitively assess the ways in which the person best expresses his/her sense of spirituality Respect individual belief systems Enable the person to participate in particular spiritual and/or culturally based practices Enlist support of spiritual care leaders identified as being important to the person |
The Person’s Perspectives and
Interactions with Others
Privacy
boundaries
Social
support
Care
tenor
Burden to
others
Aftermath
concerns