Skip to main content Accessibility help

Preserving Dignity in Later Life

  • José Manuel São José (a1)


This article examines how elders who receive social care in the community experience loss of dignity and how they preserve their dignity. Qualitative research revealed that loss of dignity is a major concern for these elders and that they preserve their dignity differently, ranging from actively engaging with life to detaching themselves from life. We conclude that, in later life, preserving dignity while receiving social care differs from preserving dignity in the context of health care, especially health care provided in institutional settings. Furthermore, preserving dignity in later life, while receiving social care, is a complex process, depending not only on performing activities and individual action and responsibility, but also on other actions, some of them involving a certain inactivity/passivity, and interactions with others, especially caregivers. This article offers some insights to developing better policies and care practices for promoting dignity in the context of community-based social care.

Cet article examine comment les personnes âgées qui recoivent l’aide sociale dans la communauté subissent une perte de la dignité et comment ils conservent leur dignité. La recherche qualitative a révélé que la perte de dignité est une préoccupation majeure pour ces aînés, et qu’ils conservent leur dignité de differentes manières, variant de s’engager activement à la vie jusqu’à s’en détacher. Nous concluons que, dans la vie plus tard, la préservation de la dignité tout en recevant des soins sociaux diffère de conserver la dignité dans le contexte des soins de sante, en particulier les soins de santé fournis dans un cadre institutionnel. En outre, conserver la dignité en fin de vie, tout en recevant des soins sociaux, est un processus complexe, qui dépend non seulement de l’exécution des activités et la prise des actions individuelles et de leurs responsabilités, mais aussi d’autres actions, dont certaines impliquent une certaine inactivité/passivité, ainsi qu’interagir avec les autres, surtout les soignants. Cet article propose meilleures politiques et pratiques pour la promotion de la dignité des personnes âgeés dans le contexte de la protection sociale à base communautaire.


Corresponding author

La correspondance et les demandes de tire-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: José Manuel de São José, Ph.D. Faculty of Economics Campus de Gambelas Edifício 9 8005-139 Faro (Portugal) (


Hide All
Améry, J. (1994). On aging: Revolt and resignation. Bloomington, IN: Indiana University Press.
Baggott, R. (2008). Healthcare. In Alcock, P., May, M., & Rowlingson, K. (Eds.), The student’s companion to social policy (pp. 318325). Malden, MA: Blackwell.
Baillie, L. (2007). The impact of staff behaviour on patient dignity in acute hospitals. Nursing Times, 103(34), 3031.
Bauman, Z. (2000). The individualized society. Cambridge, ENG: Polity Press.
Bayer, T., Tadd, W., & Krajcik, S. (2005). Dignity: The voice of older people. Quality in Ageing: Policy Practice and Research, 6(1), 2229.
Beck, U., & Beck-Gernsheim, E. (2002). Individualization: Institutionalized individualism and its social and political consequences. London, ENG: Sage.
Bettio, F., Verashchagina, A., & EU Expert Group on Gender and Employment. (2010). Long-term care for the elderly: Provisions and providers in 33 European countries. Rome, ITA: Fondazione G. Brodolini.
Black, K., & Dobbs, D. (2014). Community-dwelling older adults’ perceptions of dignity: Core meanings, challenges, supports and opportunities. Ageing and Society, 34(8), 12921313.
Bradshaw, S. A., Playford, E. D., & Riazi, A. (2012). Living well in care homes: A systematic review of qualitative studies. Age and Ageing, 41(4), 429440.
Carstensen, L. L., & Hartel, C. R. (Eds.). (2006). When I’m 64. Committee on Aging Frontiers in Social Psychology, Personality, and Adult Developmental Psychology. Board on Behavioral, Cognitive, and Sensory Sciences, Division of Behavioral and Social Sciences and Education. Washington, DC: National Research Council/The National Academies Press.
Chochinov, H. M., Hack, T., McClement, S., Kristjanson, L. J., & Harlos, M. (2002). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54(3), 433443.
Colombo, F., Llena-Nozal, A., Mercier, J., & Tjadens, F. (2011). Help wanted? Providing and paying for long-term care. Paris, FRA: OECD.
Coventry, M. L. (2006). Care with dignity: A concept analysis. Journal of Gerontological Nursing, 32(5), 4248.
Dahlin-Ivanoff, S., Haaqk, M., Fänge, A., & Iwarsson, S. (2007). The multiple meaning of home as experienced by very old Swedish people. Scandinavian Journal of Occupational Therapy, 14(1), 2532.
Fujisawa, R., & Colombo, F. (2009). The long-term care workforce: Overview and strategies to adapt supply to a growing demand. Paris, FRA: OECD.
Gallagher, A., Li, S., Wainwright, P., Jones, I., & Lee, D. (2008). Dignity in the care of older people – A review of the theoretical and empirical literature. BMC Nursing, 7(11), 112.
Gennip, I. E., Pasman, H. R. W., Oosterveld-Vlug, M. G., Willems, D. L., & Onwuteaka-Philipsen, B. D. (2013). The development of a model of dignity in illness based on qualitative interviews with seriously ill patients. International Journal of Nursing Studies, 50(8), 10801089.
Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Cambridge, ENG: Polity Press.
Glasby, J. (2012). Understanding health and social care (2nd ed.). Bristol, ENG: Policy Press.
Glaser, B. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. San Francisco, CA: University of California.
Glaser, B. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA: Sociology Press.
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago, IL: Aldine.
Godfrey, M., Randall, T., Long, A., & Grant, M. (2000). Home care: Review of effectiveness and outcomes. Exeter, ENG: Centre for Evidence-Based Social Services.
Goffman, E. (1971). Relations in public: Microstudies of the public order. New York, NY: Basic Books.
Gorman, M. (2000). Development and the rights of older people. In Randel, J., German, T., & Ewing, D. (Eds.), The ageing and development report: Poverty, independence and the world’s older people (pp. 321). London, ENG: Earthscan Publications Ltd.
Grenier, A. (2005). The contextual and social locations of older women’s experiences of disability and decline. Journal of Aging Studies, 19(2), 131146.
Grenier, A. (2008). Recognizing and responding to loss and ‘rupture’ in older women’s accounts. Journal of Social Work Practice: Psychotherapeutic Approaches in Health, Welfare and the Community, 22(2), 195209.
Grenier, A. (2012). Transitions and the lifecourse, challenging the constructions of ‘growing old’. Bristol, ENG: Policy Press.
Griffin-Heslin, V. L. (2005). An analysis of the concept dignity. Accident and Emergency Nursing, 13(4), 251–227.
Hall, S., Longhurst, S., & Higginson, I. (2009). Living and dying with dignity: A qualitative study of the views of older people in nursing homes. Age and Ageing, 38(4), 411416.
Hammarström, G., & Torres, S. (2010). Being, feeling and acting: A qualitative study of Swedish home-help care recipients’ understandings of dependence and independence. Journal of Aging Studies, 24(2), 7587.
Hermus, G., Stonebridge, C., Thériault, L., & Bounajm, F. (2012). Home and community care in Canada: An economic footprint. Guelph, ON: Victorian Order of Nurses.
Hickman, S. E. (2004). Honoring resident autonomy in long-term care: Special considerations. Journal of Psychosocial Nursing and Mental Health Services, 42(1), 1216.
Hilário, P. (2015). Making sense of a changed physical body: Why gender matters at end of life. Journal of Aging Studies, 33, 5866.
Hillman, A., Tadd, W., Calnan, S., Calnan, M., Bayer, A., & Read, S. (2013). Risk, governance and the experience of care. Sociology of Health & Illness, 35(6), 939955.
Hofmarcher, M. M., Oxley, H., & Rusticelli, E. (2007). Improved health system performance through better care coordination. Paris, FRA: OECD.
Huber, M., Rodrigues, R., Hoffmann, R., Gasior, K., & Marin, B. (2009). Facts and figures on long-term care: Europe and North America. Vienna, AUT: European Centre.
Jacelon, C. S., Connelly, T. W., Brown, R., Proulx, K., & Vo, T. (2004). A concept analysis of dignity for older adults. Journal of Advanced Nursing, 48(1), 7683.
Janlöv, A., Hallberg, I., & Petersson, K. (2006). Older persons’ experience of being assessed for and receiving public home help: Do they have any influence over it? Health and Social Care in the Community, 14(1), 2636.
Konecki, K. T. (2008). Grounded theory and serendipity: Natural history of a research. Qualitative Sociology Review, IV(1), 171188.
Lawton, J. (1998). Contemporary hospice care: The sequestration of the unbounded body and ‘dirty dying’. Sociology of Health & Illness, 20(2), 121–43.
Leichsenring, R. (2004). Developing integrated health and social care services for older persons in Europe. International Journal of Integrated Care, 4(3), 115.
Lin, Y., Watson, R., & Tsai, Y. (2012). Dignity in care in the clinical setting: A narrative review. Nursing Ethics, 20(2), 168177.
Lloyd, L., Calnan, M., Cameron, A., Seymour, J., & Smith, R. (2014). Identity in the fourth age: Perseverance, adaptation and maintaining dignity. Ageing and Society, 34(1), 119.
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 6165.
Malderen, L. V., Mets, T., De Vriendt, P., & Gorus, E. (2013). The active ageing – Concept translated to the residential long-term care. Quality of Life Research, 22(5), 929937.
Marin, B., Leichsenring, K., Rodrigues, R., & Huber, M. (2009). Who cares? Care coordination and cooperation to enhance quality in elderly care in the European Union. Stockholm, SWE: European Centre for Social Welfare Policy and Research.
Martinson, M., & Berridge, C. (2015). Successful aging and its discontents: A systematic review of the social gerontology literature. The Gerontologist, 55(1), 5869.
Matiti, M. R., & Trorey, G. M. (2008). Patients’ expectations of the maintenance of their dignity. Journal of Clinical Nursing, 17(20), 27092717.
Nicholson, C., Meyer, J., Flatley, M., Holman, C., & Lowton, K. (2012). Living on the margin: Understanding the experience of living and dying with frailty in old age. Social Science & Medicine, 75(8), 14261432.
Nordenfelt, L. (2004). The varieties of dignity. Health Care Analysis, 12(2), 6989.
Nordenfelt, L. (2009). The concept of dignity. In Nordenfelt, L. (Ed.), Dignity in care for older people (pp. 2653). Oxford, ENG: Wiley-Blackwell.
North, M. S., & Fiske, S. T. (2012). An inconvenienced youth? Ageism and its potential intergenerational roots. Psychological Bulletin, 138(5), 982997.
Plankey-Videla, N. (2012). Informed consent as process: Problematizing informed consent in organizational ethnographies. Qualitative Sociology, 35(1), 121.
Randers, I., & Mattiasson, A. C. (2004). Autonomy and integrity: Upholding older adult patients’ dignity. Journal of Advanced Nursing, 45, 6371.
Rodrigues, R., Hofmarcher, M. M., Leichsenring, K., & Winkelmann, J. (2013). Active and healthy ageing for better long-term care: A fresh look at innovative practice examples. Vienna, AUT: European Commission.
São José, J., Barros, R., Samitca, S., & Teixeira, A. (2016). Older persons’ experiences and perspectives of receiving social care: A systematic review of the literature. Health and Social Care in the Community, 24(1), 111.
Scott, P. A., Valimaki, M., Leino-Kilpi, H., Dassen, T., Gasull, M., Lemonidou, C., & Arndt, M. (2003). Autonomy, privacy and informed consent 3: Elderly care perspective. British Journal of Nursing, 12(3), 158168.
Sipilä, J., & Kröger, T. (2005). Editorial introduction: European families stretched between the demands of work and care. In Kröger, T. & Sipilä, J. (Eds.), Overstretched European families up against the demands of work and care (pp. 18). Malden, MA: Blackwell.
Street, A. F., & Kissane, D. W. (2001). Constructions of dignity in end-of-life care. Journal of Palliative Care, 17(2), 93101.
Tadd, W., & Calnan, M. (2009). Caring for older people: Why dignity matters – The European experience. In Nordenfelt, L. (Ed.), Dignity in care for older people (pp. 119145). Oxford, ENG: Wiley-Blackwell.
Tadd, W., Hillman, A., Calnan, M., Calnan, S., Read, S., & Bayer, A. (2012). From right place – wrong person, to right place – right person: Dignified care for older people. Journal of Health Services & Policy, 17(2), 3036.
Tanner, D. (2010). Managing the ageing experience: Learning from older people. Bristol, ENG: Policy Press.
Timonen, V., Conlon, C., Scharf, T., & Carney, G. (2013). Family, state, class and solidarity: Re-conceptualising intergenerational solidarity through the grounded theory approach. European Journal of Ageing, 10(3), 171179.
Turnock, C., & Kelleher, M. (2001). Maintaining patient dignity in intensive care settings. Intensive and Critical Care Nursing, 17(3), 144154.
Twigg, J. (2000). Bathing, washing and the management of personal care. In Twigg, J. (Ed.), Bathing, the body and community care (pp. 4576). London, ENG: Routledge.
Wainwright, P., & Gallagher, A. (2008). On different types of dignity in nursing care: A critique of Nordenfelt. Nursing Philosophy, 9(1), 4654.
Wiles, J. L., Wild, K., Kerse, N., & Allen, R. E. S. (2012). Resilience from the point of view of older people: ‘There’s still life beyond a funny knee’. Social Science & Medicine, 74(3), 416424.
Woogara, J. (2005). Patients’ rights to privacy and dignity in the NHS. Nursing Standard, 19(8), 3337.
Woolhead, G., Calnan, M., Dieppe, P., & Tadd, W. (2004). Dignity in older age – What do older people in the United Kingdom think? Age and Ageing, 33(2), 165170.


Preserving Dignity in Later Life

  • José Manuel São José (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed