Harry Lewis

I want to take a short break from what at least one of my readers has called “depressing” reflections on nursing home conditions to dwell briefly on the suggestion that Harry Lewis made in response to my introduction many weeks ago:

Sometime you can parse the relation of respect to dignity. There is actually rather a lot of talk about DISrespect these days, so much so that the word has been turned into a verb. This thought is rather fuzzy in my mind, but it seems that people would be more likely to be treated with respect if they acted with dignity, and dignity is today considered inauthentic, like using the dessert spoon while eating the entree.

After some reading and reflection, I have come to consider dignity as an inherent quality of all human beings, what I will call “inherent dignity.”  Respect, on the other hand, is a sentiment demonstrated through certain behaviors offered in response to perceived inherent dignity.  Respect may also be earned by “worthy”, or as Harry would perhaps say, “dignified” behavior.

The notion of inherent dignity is, I think at root, a religious one.  For example, Daniel Groody writes in “Globalization, Spirituality and Justice”, p.109:

Catholic social teaching believes that human beings, created in the image and likeness of God (Genesis 1:26-27), have by their very existence an inherent value, worth, and distinction. This means that God is present in every person, regardless of his or her race, nation, sex, origin, orientation, culture, or economic standing. Catholic Social Teaching asserts that all human beings must see within every person both a reflection of God and a mirror of themselves, and must honour  and respect this dignity as a divine gift.

Apart from a creationist or religious belief, the notion that, as human beings, we share the same “essence” encourages us to believe in the worth and value of others as we believe in our own worth and value.

There is little about an elderly man or woman in a nursing home that would elicit a natural response of respect. Most are physically ravaged by age and illness, possibly scarred or handicapped, stooped, and weak; many are angry or resentful about their condition, tired, lonely, and hungry. Under these circumstances, some are incapable of acting with dignity. Whether we recognize these individuals as children of God or simply as fellow human beings, determines whether we acknowledge their inherent dignity and respond with respect.

As a society, I think we have come to value “productivity” in all its forms as the highest possible good, the most valued human quality.  Those who are not “productive” for whatever reason—age, mental or physical disability, social or financial disadvantage—are considered of less value and are regarded as less deserving of respect. This, I believe, is why we allow the oldest members of our communities to live in conditions that, when we come face to face with them, appall us and make us afraid of our own end-of-life circumstances.

If you were to ask an elderly person, faced with entering a nursing home what he or she fears most, I believe (and research has shown) that the answer would amount to the inability to make one’s own decisions or the loss of control – control of one’s body, of one’s surroundings, of one’s schedule.  It is extremely difficult to maintain a sense of personal dignity, and therefore an expectation that one deserves respect under these conditions.  Some elders do so.  They are the ones we consider dignified; the ones we admire and hope to emulate.  The ones we may respect.  But the others?

The way we treat the elderly, indeed, the way we treat all those who are more vulnerable than we imagine ourselves to be, says a great deal about who we are as a society.

For this reason, I am writing about the “depressing” conditions in nursing homes.