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Introduction
It is increasingly evident that dignity matters to older people, and that dignity is a key factor in the delivery of good-quality health and social care. A number of literature reviews and concept analyses of "dignity", and of "care with dignity", have been published in recent years ([18] Fenton and Mitchell, 2002; [23] Jacelon et al. , 2004; [36] Nordenfelt, 2004; [14] Coventry, 2006; [1] Anderberg et al. , 2007; [24] Jacobson, 2007; [20] Gallagher et al. , 2008; [25] Jacobson, 2009). From these, dignity can be understood to be a fundamental right, subjectively experienced and rooted in a person's perception of being treated and regarded as important and valuable in relation to others. Dignity is understood to be ascribed based on role, position or achievement, on moral integrity, on personal identity, or on the innate, inalienable value as a human being, with these dimensions shaped by the wider social and cultural contexts in which care-related social interaction takes place and in which dignity is enhanced or diminished.
A number of empirical studies have explored the salience of dignity from the perspective of older people ([50] Woolhead et al. , 2004; [4] Bayer et al. , 2005; [28] Levenson and Joule, 2005; [9] Calnan et al. , 2006) and from the perspective of health professionals ([2] Arino-Blasco et al. , 2005) as well as in a range of care settings, including hospitals ([22] Jacelon, 2003; [8] Bridges et al. , 2009; [46] Webster and Bryan, 2009; [44], [45] Tadd et al. , 2011a, b) and nursing homes ([19] Franklin et al. , 2006; [38] Pleschberger, 2007; [48] Westin and Danielson, 2007). This body of evidence underpins national and international policies and health standards (for example, National Service Framework for Older People in Wales - [47] Welsh Assembly Government, 2006). Such evidence also underpins practice, with domains and indicators of dignity - such as recognition and acknowledgement of autonomy, personal identity, participation and control, choice, effective communication, personal care, privacy and independence ([16] Faulkner, 2006; [30] Matiti and Cotrel-Gibbons, 2006; [37] Picker Institute, 2008; [11] Clark, 2010) - used in monitoring and assessing care and service delivery within a range of health and social care settings.
The research described above has helped significantly to refine...