Highlights the importance of dignity within the care of the elderly, focusing on the importance of theoretical concepts International in focus, it provides a contemporary discussion of the care of older people Of use to qualified nurses and social care practitioners working with older people, as well as those on ethics and gerontology courses.

Preface viii Contributors x An Outline of the Book xii Preamble: the Case of David and Rebecca xviii Part I Theoretical and Conceptual Considerations 1 1. Health, Autonomy and Quality of Life: Some Basic Concepts in the Theory of Health Care and the Care of Older People 3 Lennart Nordenfelt Introduction 3 1.1 Health 3 1.2 Quality of life 8 1.3 Autonomy 18 1.4 Integrity 23 1.5 Final remarks on the basic values 24 References 24 2. The Concept of Dignity 26 Lennart Nordenfelt Introduction 26 2.1 The definition of dignity 27 2.2 Dignity: towards an analysis 30 2.3 Relationships between the notions of dignity 40 2.4 Further explorations on dignity. A commentary on some other authors 42 2.5 Dignity and older people 46 References 52 3. Being Body: The Dignity of Human Embodiment 54 Jennifer Bullington Introduction 54 3.1 The objective body and the lived body 56 3.2 The dignity of the human body 64 3.3 Implications for health care 74 References 75 Part II Dignity and Older People: Some Empirical Findings 77 4. Dignity and Dementia: An Analysis of Dignity of Identity and Dignity Work in a Small Residential Home 79 Magnus Öhlander Introduction 79 4.1 Living together in a residential home 81 4.2 The homelike nature of the residential home 84 4.3 Activities and routines 87 4.4 Identity 89 4.5 Home, sweet home 91 4.6 Dignity, normality and culture 93 4.7 Summary and concluding remarks on dignity work, normality and power 94 References 97 5. Dignity and Older Spouses with Dementia 99 Ingrid Hellström Introduction 99 5.1 Dignity in spousal relationships 105 5.2 Conclusions 115 Acknowledgements 116 References 116 6. Caring for Older People: Why Dignity Matters – the European Experience 119 Win Tadd and Michael Calnan Introduction 119 6.1 The Dignity and Older Europeans study 121 6.2 Findings 126 6.3 Discussion 138 6.4 Conclusion 142 Acknowledgements 142 References 142 7. A Dignified Death and Identity-Promoting Care 146 Britt-Marie Ternestedt Introduction 146 7.1 A dignified or good death 148 7.2 Being allowed to be the person one is and to decide for oneself 149 7.3 Death as a religious, medical and private event 151 7.4 Extended identity close to death 155 7.5 Threats to identity close to death 157 7.6 Identity-promoting care 159 7.7 Conclusion and reflections 164 References 165 8. Dignity and the Dead 168 Göran Lantz Introduction 168 8.1 The view of the dead person 168 8.2 The dead as persons 172 8.3 Change and continuity 173 8.4 The necessary psychological change 174 8.5 Brain death as a special category 175 8.6 Fear of the dead person 175 8.7 The rights of the dead 177 8.8 Who owns the dead? 181 8.9 Religious aspects 181 8.10 The dignity of the dead 186 References 188 9. Dignity as an Object of Empirical Study: Experiences from Two Research Programmes 190 Lennart Nordenfelt 9.1 General considerations 190 9.2 Basic ethical concepts: a comparison between the DOE project and the Home project 193 9.3 Salient aspects of the care of seriously ill older people in the Swedish context 200 9.4 Conclusions 204 References 205 Index 207

The notion of quality of life has, for several decades, been well established in ethical debate about health care and the care of older people.   Dignity in Care for Older People highlights the notion of dignity within the care of the elderly, focusing on the importance of theoretical concepts. Primarily based on the research project, Dignity and Older Europeans, funded by the European Commission, this book provides a thorough investigation of the concept of dignity and related concepts such as quality of life and autonomy. It includes a chapter devoted to the dignity of human embodiment, emphasising the importance of the notion of the lived body in the context of elderly care. As a result of the conceptual study, a model of dignity emerges in which four variants of dignity stand out: dignity of merit, dignity as moral status, dignity of identity and Menschenwürde (the specifically human value). From this follows a discussion of how these variants of dignity can be used in characterising the care of the elderly. The notions of dignity and dignified care are discussed, particularly in relation to demented persons and dying persons. The book also contains a chapter on the dignity of the dead person. International in focus, Dignity in Care for Older People provides a contemporary discussion of the care of older people, and will be of use to qualified nurses and social care practitioners working with older people, as well as those on ethics and gerontology courses.

Chapter 1. Health, autonomy and quality of life: some basic concepts in the theory of health care and the care of the elderly. Chapter 2. The concept of dignity. Chapter 3. Being body: the dignity of human embodiment. Chapter 4. Dignity and dementia: An analysis of dignity of identity and dignity work in a group dwelling. Chapter 5. Dignity and elderly spouses with dementia. Chapter 6. Decent care for older people: why dignity matters ? the European experience. Chapter 7. A dignified death and identity-promoting care. Chapter 8. Dignity and the dead. Chapter 9. Dignity as an object of empirical study: Experiences from two research programmes