Dignity in elderly care: meaning and legal protection

Abstract

We are living increasingly longer in a society that is struggling to define how to treat the very old, particularly those in care homes. The concept of dignity can guide how an older individual in care ought to be treated. In this dissertation I argue for an understanding of dignity that is built around the views of the persons cared for, and for the introduction of laws and policies aimed at creating conditions amenable to its realisation. Dignity must be viewed as rooted in our concrete autonomy, one that sees us embodied and embedded in the connections we make with others throughout our lives. Dignity, understood according to the views of the individual cared for, is aligned with this relational view of autonomy, one that prompts us to understand the individual through dialogical engagement. In order to realise the kind of dignity that matters to elderly individuals in care, it is essential to address a number of negative factors, including through law and policies. Addressing these factors means taking concrete steps towards converting potential dignity into actual dignity. One of these 'conversion factors' of dignity is vulnerability. In order for this personal conversion factor to be conducive to dignity, vulnerability ought to be conceptualised as inherent, universal and relational. Another conversion factor, this time environmental, is the regulatory system that controls care homes: for dignity to flourish, those affected by this system must be involved in its elaboration and monitoring. On a social level exists the conversion factor of ageism. Generational rapprochement is one way in which to help reduce it. This dissertation examines whether and how legal means responsive to these conversion factors help or hinder the creation of conditions amenable to dignity in long term aged care