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A National and European center of competence

logo-versighetsenteret-engelskThe Dignity Centre will work to make sure that the elderly, in their final, frail stage of life, are met with care, respect, social integration and the essential proficiency. This includes information, and training of medical staff, patients and their families, as well as research, networking and collaborative projects that promote similar goals. 

The aim  is to describe strategies that provide the elderly with the best possible opportunities to health, autonomy, care and quality of life – with a particular focus on the increasing group of patients suffering from dementia. One partial goal is that the elderly are able to receive outpatient care in their own homes for as long as possible, and that the quality of the care services are consistently good, regardless of the individual patient’s place of residence or physical or mental abilities.

From our archive: The international confernce Dignity for the Frail Old. From Dilemmas to Solutions was held in Bergen in 2010 (September 2-5): Conference Report, The conference information leaflet (pdf) and Programme (pdf)

bildeserie web eldre og yngreWhat does the term refer to?

Whatever has a price can be replaced by something else as its equivalent; on the other hand, whatever is above all price, and therefore admits of no equivalent, has a dignity  (Philosopher Immanuel Kant).
 
Kant, who was genuinely concerned with ideas of morals and values, emphasized that all humans, regardless of social status, age, or medical condition, do have dignity. However, such dignity can easily be violated by others. 

eldre handlepauseA person’s vulnerability increases as the elderly become ill and dependent on others’ help and understanding and have to let go of their self determination (autonomy). For many elders, especially patients suffering from dementia, the greatest challenge of old age will be the dependence on others to “read” and respect their thoughts, feelings, and needs – without violating their dignity. It can be everyday challenges, like proper nutrition, hydration, personal hygiene, exercise, fresh air, and social interaction – that the rest of us take for granted, but that are far from granted when we rely on others to provide us with them. It can be proficient medical treatment when one is in need, or someone taking his or her time to listen to important passages from the patients’ life stories. An old lady answered what the most important thing for her was: “That someone cares to sit down with me, and try to figure out who I am… – And also, I’d like to make my own sandwiches.”  

The challenge

The greatest social-political challenge facing the industrial countries throughout the next decades will be to make sure that the large and dramatically increasing group of elderly people receives a dignified fulfilment of their lives. By the year 2050, most European countries will experience that the number of citizens over the age of 65 increases with 70%, the number of 80 year-olds with 100%, and the number of 90 year-olds with more than 1000%. 
The life situation for elderly people aged 75 and over can be divided into four stages:

  1. In the first stage (“good health”), the elders will benefit from good health for an increasingly long period of time, and be table to take care of themselves with  proper social integration.
  2. The second stage (“developing medical and social challenges”) is marked by brief or longer periods in which medical challenges and social isolation will take place.  Many elders will require medical assistance and various health services in order to keep living in their own homes.
  3. In the third stage (“extensive medical and social challenges”), the medical problems and social challenges will be so extensive that the elderly patient will need supervision and care for several hours of the day. 60 % of elderly people over the age of 85 live by themselves. For generations, the family has been the elderly’s primary caregiver; however, due to social changes, family members of today and tomorrow will no longer be able to guarantee proper care for their elders. In Norway, 40 % of the population dies in nursing homes, and the number keeps increasing. Recent statistics from SINTEF reveal that patients in nursing homes have an average of 4 to 7 serious or chronic diagnoses.
  4. In the fourth stage (“care at the end of life”), the elderly will require care, support, and treatment around the clock. This final stage can last for days, weeks, or months.

dansThe first two stages – “good health” and “developing medical and social challenges” – are generally handled well in Norway. The great challenge is dealing with the elderly’s third and fourth stages of life, “irreversible medical and social challenges,” and “care at the end of life.”