Unaccommodatingness

Our search covered all the dates from 1951 to April Week 02, 2007.We used the following key words: dignity, older, geriatric, gerontology, aging/ageing, senior citizen, OAP/OAPs, pensioner, old or elderly or elder or elders.

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In addition to increasing attention to indignity and policy responses, particularly in relation to the care of older people, there is a growing body of empirical and theoretical literature relating to dignity [].

However, in spite of the wide-ranging body of literature relating to dignity, the common usage of the term seems more likely to confuse and confound than to clarify the meaning of dignity.

If nurses are to be "personally accountable for actions and omissions", respecting the dignity of patients [], clarification is an essential first step.

To this end we critically examine three key questions relating to dignity: What does it mean? How should it be operationalised in relation to the care of older people?

Dignity has become a central concern in UK health policy in relation to older and vulnerable people.

The empirical and theoretical literature relating to dignity is extensive and as likely to confound and confuse as to clarify the meaning of dignity for nurses in practice.

Nevertheless, the emphasis placed on dignity means that it cannot be ignored as an issue for health care professionals.

Dignity in care is for example one of three themes in the report "A New Ambition for Old Age" [], which outlines the next steps in implementing the National Service Framework for Older People and which should therefore be an influential document in the future planning and management of service for older people. Philosophically it can be traced at least as far back as the writings of Aristotle.

In relation to dignity, a concept discussed and applied in relation to the everyday complexities of nursing practice, such a dialectic is necessary.

Theory without empirical data is likely to be esoteric and disconnected from the reality of practice.

Philosophers engage in critical reflection and offer typologies and accounts of dignity generally without reference to empirical data (other than from hypothetical examples, anecdote and personal experience).

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