The dignity of older individuals with Alzheimer’s disease and related dementias: A scoping review

Abstract

Background Supporting human dignity is the essence of delivery of care. Dignity is one’s sense of self-value that is influenced by the perceived value attributed to the individual from others. Individuals with Alzheimer’s disease and related dementias (ADRD) are at risk of violations of their dignity, due to their diminished autonomy, the alteration in their sense of self, the loss of meaningful social roles, and their limited interactions with peers and confirmation of identity. Objectives A scoping review was conducted to explore the state of art regarding the dignity of individuals with ADRD. Methods: A search was conducted using CINAHL, PubMed, Web of Science, and PsycINFO. Relevant articles were analyzed and organized based on the themes they addressed, and a narrative description of findings was presented. Results Twenty-six articles were included in the review. Findings highlighted characteristics of care that affected the dignity of these individuals. Researchers found that care was task-centered, depersonalized, and lacked a genuine connection. Individuals with ADRD experienced embarrassment, lack of freedom, and powerlessness, which contributed to feelings of being devalued, and threatened their dignity. Studies testing interventions to enhance dignity were either inconclusive, lacked rigor, or had no lasting effect. Conclusion: The dignity of individuals with ADRD may be violated during healthcare interactions. More research is needed to objectively measure the dignity of these individuals and examine the effectiveness of interventions aimed at promoting dignity.