Ensuring that older people are cared for with dignity and respect in hospital

Alone we can do so little; together we achieve so much!

Older people deserve better care. A Dignified Revolution is a group of individuals, the majority of whom are nurses, who want to improve the care of older people in hospital. It was launched in January 2008. The impetus to establish the initiative was driven by:

• The distress that these individuals had experienced because of the poor care that their elderly relatives had received whilst in hospital, and their concern that other might find themselves in the same situation;
• The realisation that the lack of dignity and respect that older people tolerate when in hospital is not a recent phenomenon. The issue was first publicised in 1997. Ten years on, despite extensive media attention and numerous reports and guidance from government, little has changed.

Many nurses provide outstanding care. However, the attitude and behaviour of other nurses when caring for vulnerable older people does not reflect the duty of care that they have towards their patients

The experience of many of us involved in A Dignified Revolution is that:

• Many nurses do not consider that basic nursing care is part of their role. Instead, they consider it is the role of the healthcare assistant. However, whilst these workers may be able to make a bed and feed a stroke patient, they are unable to assess skin condition or the effects of facial paralysis, nor assess the effects of the person's illness on the family. This is information that a qualified nurse would gather from patient contact in order to be able to draw up the nursing care plan
• The public do not appear to be aware that registered nurses are responsible for the supervision and care actions of support workers. They have a duty of care to the patient regardless of who provides the basic nursing care and this duty of care makes them accountable in law.
• Doctors are seen to be more supportive and caring than nurses.
• Many of the poor experiences being shared are being reported by health professionals who work in various parts of the NHS. The system seems to inhibit them challenging practices which are demeaning their professions.

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