Safeguarding the Dignity of Patients in Homecare Nursing

Although Singapore still has a generally young population, the proportion of elderly is expected to grow significantly. In 1970, there were about 118,300 persons aged sixty and above. Ten years later, this rose by 47%, to 173,600. By 2030, up to 835,000 person will be sixty or older1Kong, L., Yeoh, B., & Teo, P. (1996). Singapore and the experience of place in old age. Geographical Review, 86(4), 529-549.. People are living longer, and the younger generation isn’t producing enough babies to replenish the population. This silver tsunami is expected to have an impact on how healthcare is being delivered.

Homecare nursing remains a viable and compelling solution that can alleviate many of the common struggles that the elderly face in their day-to-day living. These include social disconnection, embarrassment at burdening family and friends and disabilities due to physiological and mental deterioration. Alarming statistics point to increased suicide rates amongst the elderly because of these struggles.

Homecare nursing cannot therefore just be a business. It must be rooted in the fundamental idea that the elderly is first and foremost a person. As such, practitioners of homecare nursing need to recognise the right of the elderly to2Holmberg, M., Valmari, G., Lundgren, S. M., Sahlgrenska akademin, Göteborgs universitet, Gothenburg University, . . . Sahlgrenska Academy. (2012). Patients’ experiences of homecare nursing: Balancing the duality between obtaining care and to maintain dignity and self‐determination. Scandinavian Journal of Caring Sciences, 26(4), 705-712. doi:10.1111/j.1471-6712.2012.00983.x.:

Defend privacy: This means that the patient has a right to defend himself or herself from a nurse’s unprofessional conduct. Undesired behaviour from nurses may include:

  • Rushing through the regime of activities and complaining that he or she has no time.
  • Complaining about the job stress, as this gives the patient the impression that he or she is the source of this stress.
  • Surveying the home layout and making comments on its size or neatness.
  • Making or accepting calls, as well as chatting on their mobile devices.

Make choices: To receive homecare nursing is a choice that either individuals or families make to facilitate Activities of Daily Living, especially if the patients are not able to visit health care centres on their own. As a result, homecare nursing must be designed around the patients’ psychological need to make their own decision on whether they need the nurse to come on any particular day or time. In Sweden- where homecare nursing is a growing trend– some patients express satisfaction that they are able to avoid a homecare visit, even on days when their strength was reduced.

Participation: Receiving aid can be quite an overwhelming experience for some elderly patients, especially if they had been productive members of society. It is therefore important for patients to retain a sense of control over their care. They appreciate taking part in nursing activities as it gives them a sense of control. On days when they are able, some patients make the effort to bathe before the arrival of the nurse, or even help out in dressing their own wounds.

Social engagement: In Singapore, the elderly are often lonely because their primary social structure- the family– is either out schooling or working. Patients benefit when homecare nurses are social and are able to interact on an equal social conversation. For many patients, the nurses’ visit might become a welcome social routine, where talk need not focus on illness, but on other matters. In this, the homecare nurse also provides a much-needed therapy to alleviate the elderly’s loneliness. Some patients particularly appreciate when nurses shared something about their own personal lives, as it connects them to a world beyond the walls of their own home.

References   [ + ]

1. Kong, L., Yeoh, B., & Teo, P. (1996). Singapore and the experience of place in old age. Geographical Review, 86(4), 529-549.
2. Holmberg, M., Valmari, G., Lundgren, S. M., Sahlgrenska akademin, Göteborgs universitet, Gothenburg University, . . . Sahlgrenska Academy. (2012). Patients’ experiences of homecare nursing: Balancing the duality between obtaining care and to maintain dignity and self‐determination. Scandinavian Journal of Caring Sciences, 26(4), 705-712. doi:10.1111/j.1471-6712.2012.00983.x.

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