The basic principle of human right is the ability to safeguard dignity at all times. However, in some cases, longevity of care linked with poor health and disabilities mean older people as well as other vulnerable groups’ have had their dignity compromised to some extent during care giving. This is because some of these groups are unable to maintain their dignity and rely on others such as informal or formal carers to assist them. This situation is likely to become a challenge or degrading to some people in future as the population is becoming older with complex needs as well as increasing demand for care in their own homes or in an institutional care homes. In reality, this would mean that in some instances their dignity and basic human rights might be overlooked.
In this endeavour, maintaining human dignity is a basic principle. As a result one should have the values to cherish and respect people irrespective of gender, colour, age and disabilities. These principles and values are enshrined in both the Humans Right Act (1998) and Equality Act (2010) yet; politicians of different persuasions have shielded away positive actions to address the issues regarding: poor quality of care; demographic change, the growth of older people and their increasing demand for care and significant support for carers. Most times, when you read headlines and comments by leading politicians (law makers, executives etc) you will find that they suggest ways of helping older people as well as other vulnerable groups and their families to come to terms with their current needs.
Nonetheless, changes within health and social care have created a market where demand has superseded supply. This has affected the supply of quality workers who probably have the right skills and experiences to assist older people to observe their dignity. Practice observations have uncovered worrying cases of neglects, abuse, deprivations and institutional abuse of different kinds. This typifies examples of lacking respect for older people's privacy and dignity. Social worker’s caseload on “Safeguarding of Vulnerable Adults” is on the increase as they are trying to address issues emanating from poor quality and lack of experience to deliver care. Neglecting service user’s dignity is a disturbing experience that has to be tackled but can only be achieved through comprehensive funding supported by all political parties. Otherwise there is uncertain future facing mostly the poorer in society who cannot afford private carers to support them at the greatest time of need in their lives.
Promoting dignity and privacy of older people and other vulnerable groups during care giving is paramount. But as evidence has shown there has been a shortage of both formal and informal carers as well as the lack of experience by a high proportion of carers are major problems in the home care system. Some of the complaints from both families and users of service are for example, people being left in filthy nightwear and bedding after a home care visit or without a wash or hair wash for several weeks. Home care visits are sometimes so brief (fifteen minutes) and people have to choose between having a cooked meal or a wash. The short visits also mean that carers have to rush tasks like washing and dressing, which frustrates the users of health and social care and care staff as well as family members.
Apparently, high staff turnover both in home care and residential care settings have a profound impact on the cared for persons and to some extent their relatives. Both the cared for persons and their relatives have described the emotional impact of being washed and dressed by a large number of different people, and having to repeatedly disclose personal information every time a new care worker comes around to assist them with personal care. In addition, some older people find it difficult in engaging with younger carers who have no experience of care giving. Some feel that their privacy and dignity are not respected when they are undressed by some care workers in front of family members or in front of their bungalow window.
The problems or the difficulties come from two dimensions - when organisations lose sight of the person they are caring for and it becomes about a task, and – How do we get older people (in particular) to be well-informed as powerful consumers? They are very passive about complaining. Hence social services’ budgets are under a lot of pressure because of: the growing older people population and their increasing demand for care; the comprehensive spending review and the government policy on spending. Nonetheless, service users need to be more assertive in getting the right care they need, at the time they need it.
Despite government commitments made by both the previous and current government, basic rights to dignity, respect and autonomy are still being breached. The biggest threat to the human rights of older people as well as other vulnerable groups who are receiving care at home is from cuts to adult social care budgets, and it is very unclear whether tightening eligibility criteria to care will allow local authorities to continue to meet their human rights obligations. It should be recognised that there is no place for poor quality care in care services, either in the home care system or in residential homes (Ugwumadu 2011).
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