Communicating Dignity

Communicating Dignity

Good communication is an important part of respecting dignity in care. How you make yourself understood and how you demonstrate that you understand what others are trying to tell you requires knowledge and verbal and non-verbal skills.

According to Skills for Care:

“The way people communicate is central to upholding the dignity of individuals and forming and maintaining positive relationships to enable person-centred care. It is a two way process, where individuals must be appropriately supported to communicate their needs, wishes and preferences to enable choice and control in decision making. Body language, words and tone are all indicators of communicating with respect, courtesy and integrity. The complexity of communication requires care and support workers to build effective relationships with individuals in order to identify barriers and facilitate meaningful interaction that upholds dignity.”

[From: ‘Common Core Principles: Dignity’, Principle 3 – see http://www.ccpdignity.com/the-common-core-principles/ ]

In this section you will be asked to think about how you communicate and how you help your team to communicate in ways that demonstrate respect for dignity. A number of different activities are suggested to assist you to develop the communication skills of your team.

Empathy plays a part in respectful and dignified communication. Empathy helps us to communicate well and improving our communication skills helps us to be more empathic. We all have the ability to empathise. We are born able to pick up the emotions our parents are feeling. We feel their emotions as if they are ours. Then as we develop and realise we are separate from our parents, although we can still feel what they feel we know it is their feeling not ours.

As well as an understanding of how others feel, empathy requires connecting to the person. It involves allowing yourself to remember or imagine how it feels to be in the place they are in, and being willing to stay with them, not disconnect, and to try if possible to give them what they need. Empathy means acknowledging and being a witness and fellow human being who listens well and responds appropriately.


Activity 3 – Discussion questions

This activity will help you to think about and understand the different ways in which we communicate using discussion questions. It will also help improve your own communication skills and help others in your team to communicate more effectively with residents, families and colleagues. Discuss the following – in a group or with individual care givers:

  • Think of a time when you felt understood by another person. What was it that helped you to feel understood?
  • Think of a time when you didn’t feel understood, or you felt that your needs were not recognised by another person. What was it that made you feel this way?
  • What helps you to understand how another person is feeling, and what their needs are?
  • What makes it difficult for you to understand what another person is experiencing or feeling, or what their needs are?
  • Think of a time when you found it difficult to understand another person’s feelings or needs. What might you have done differently to make it less difficult?

Activity 4 – Communication Role Play

This will require more time and setting up and involves role play in groups of 3. You will need to agree a challenging dignity-related situation you or one of your team has experienced and then each person takes one of the following roles:

  1. Care worker - to respond with empathy to see what impact it has on you and the person you are communicating with.
  2. Resident/Relative -To play the role of the person the HCW is talking to. To give feedback on your experience of how the conversation felt: what impact did it have, did you feel you had dignity, what went well, what would you have liked to be done differently?
  3. Observer-to give feedback on your experience of watching the conversation, did it feel like dignity was maintained, what skills and strategies were used or might have been used? Comment on: behaviour; feeling; and what was said.

Activity 5 – Hand Massage

This activity focuses on non-verbal communication and is intended to help care workers get closer to residents. It involves hand massage. To practise this skill, it is suggested you invite care givers to carry this out on each other – so long as they are comfortable with this.

This activity is to help people think about the different ways they communicate, including non-verbally. It will assist care givers to reflect on the impact that touch can have on the way people connect and the way that they feel. There are a series of steps to follow:

  1. First, gain the agreement of the person that you can massage their hand.
  2. When you have consent, using your thumb, massage the centre of the other person’s palm, press firmly
  3. Whilst maintaining the pressure in the palm, use your other hand to pull from the palm towards and along the ring finger, repeat this about 7 times
  4. Place both your thumbs on the muscles at the base of the thumb, gently press and pull them apart, repeat 7 times
  5. Gently squeeze either side of the nail on each finger.
  6. Gently squeeze top and bottom of the end of each finger
  7. Pull each finger down the sides
  8. Pull each finger top and bottom
  9. Gently but firmly massage the web area between each finger
  10. Rub firmly over the whole hand.
  11. Once one hand is done, get the person to notice how different that hand feels to the other hand.

Activity 6 – Non-verbal communication – Say what I see

This next activity also focuses on non-verbal communication and is called ‘Say what you see’. You will need to develop some feeling/emotion cards with one word each e.g. sad, happy, angry, disappointed, frustrated etc.

  1. Working in pairs decide who is Person A & who is Person B
  2. Without showing Person B, Person A takes a card with a feeling/emotion
  3. Person A tries to communicate the feeling on the card without speaking – i.e. using body language and facial expressions
  4. Person B observes closely to try to work out what Person A is expressing
  5. Person B acknowledges the feeling by saying ‘You look …’
  6. Person A and Person B swap roles

The pairs discuss as a group how it felt to be Person A and Person


Activity 7 - Top Tips for Communicating Dignity

We asked each of the groups to identify ‘Top Tips for Communicating Dignity’. These were some of the tips staff, residents and relatives in the care homes suggested:

Top Tip 1 – Refer to resident and relative by preferred name.

Top Tip 2 – Speak to people with ‘one voice’ not many people giving instructions.

Top Tip 3 – Give people time to respond.

Top Tip 4 – Be aware of body language.

Top Tip 5 – Apologise when appropriate.

Top Tip 6 – Assume the right amount of responsibility.

Top Tip 7 – Listen carefully.

Top Tip 8 – Use touch appropriately.

Top Tip 9 – Get to know the person.

Top Tip 10 – Smiling and humour are very important.

Top Tip 11 – Give the person your whole, undivided attention when you are talking with them

Top Tip 12 – Arrange times in advance for conversations about care planning and activities so that the times are convenient for the residents and family members

© 2015 University of Surrey     +44 (0)1483 300800     Email: nursing-ethics@surrey.ac.uk