We have all, at some point in our lives, needed to rely on other people to help us meet our basic needs. For some of us, the last time that happened was when we were children. For many of us, we’ve faced this in adulthood too, during debilitating illness or following surgery. It can be difficult to accept help in these moments, especially if we find ourselves struggling to perform the most basic tasks like feeding ourselves or even getting out of bed. Frustration at our own reduced ability can cause us to lash out at the very people trying to help us, or to refuse aid even though it would lessen our own struggle.

It should be no surprise, then, that aging people who find themselves needing care may be resistant to asking for or accepting help from other people. Family members and friends may struggle to understand why a loved one lashes out in anger at the prospect of receiving care, or cheerfully ignores any attempt to broach the subject. Their rejection can seem foolish, stubborn, or even malicious, until one realizes that they are afraid- afraid of seeming weak or pitiful, afraid of losing their freedom and agency, and most fundamentally, afraid of losing their dignity.

The concept of dignity is at the core of my practice as a caretaker. When people are struggling with loss of bodily and sometimes mental functions, temporarily or permanently, it is crucial to help them feel that they still have agency in their life, that their wisdom and experiences are still valuable and valued, and that their needs are neither shameful nor burdensome. Helping my clients feel that they are still whole and worthwhile people regardless of their need for care helps them to keep joy and fulfillment in their lives. This in turn provides mental and physical health benefits, and the motivation to continue to make an effort in their own care of themselves.

One of the tools I use to help make sure I’m meeting my clients’ need for dignity is the Patient Dignity Inventory, or PDI. Since every patient’s experience of their dignity needs is different, the inventory helps me assess what I can do to most help them. For some people, needing assistance using the bathroom might be causing them shame and distress that I can help calm. For others, not feeling heard may be depressing their spirits, and I can help them by listening to their stories and feelings.

The PDI is one of several tools I use to address patient dignity concerns. I’ll address some others in another post soon, including Dignity Therapy and what I like to call the Patient Dignity Question.