Claire McBrien

Mrs Jones should be taken to the Christening without her pearls and wig if that is what she chooses to do.

Dignity in care is not about the expectations that we or others may have about a person’s appearance, it is about the freedom of choice and control that a person has with regards to their self and how they live their life. Mrs Jones is not the person she was yesterday or the person she may be tomorrow, she is the person she is today. Today she does not want to wear her pearls and wig. The scenario implies that she is clean, dressed appropriately for the occasion and the weather, wearing her make up (and her smile!) and she wants to go to the church. To not facilitate her attendance at this special occasion simply because she does not wish to wear her pearls and wig is a deprivation of her liberty.

Mrs Jones has a diagnosis of dementia but that diagnosis alone does not mean that she lacks the capacity to make this choice. The Mental Capacity Act (MCA) specifies that people should be supported to make their own choices even if those choices may seem unwise or unusual. Intervention is usually not needed unless there is a risk of harm or the choice made is not in that person’s best interests.

Mrs Jones daughter could be contacted and informed of the situation so that she and others at the Christening could be prepared for seeing her mother without her pearls and wig. This preparation could give them the opportunity to not expresses any shock or negativity towards Mrs Jones when she arrives at the church. This simple act of making a phone call is one that serves to protect and promote her dignity.

It is often necessary for nursing and care staff working throughout all settings in health and social care to advocate for patients and people in receipt of care support. The voices of health and social care staff are sometimes the only voices that speak out for people like Mrs Jones to have their active participation and decisions respected by others. Care should be provided within the boundaries set out in policies, guidelines and legislation to ensure that best practice is utilised to provide the least restrictive way of caring that also offers empowerment to people like Mrs Jones.