Dignity of older adults among nursing homes: A scoping review

BackgroundDignity is a core concept in geriatric care. However, current attention to dignity-related care issues faced by older adults in nursing homes remains insufficient. There is a notable lack of systematic and proactive support measures in both theoretical research and practical interventions.AimsThe aim of this scoping review was to describe literature focussing on older adults' dignity in the context of nursing homes, in order to identify research gaps in this field and provide evidence for developing interventions to preserve dignity.MethodsA scoping review was conducted following the Arksey and O'Malley framework. Medline (via PubMed), Web of Science Core Collection (WoSCC), Embase, CINAHL Ultimate (via EBSCOhost) and PsycINFO (via EBSCOhost) were searched up to 1 August 2026. Two reviewers independently screened, extracted and synthesised the data.ResultsIn total, 25 articles were selected from a pool of 1362 documents. The aspects addressed in the included literature covered the level of dignity, influencing factors, the adverse impact of dignity loss, assessment tools and intervention measures for older adults in nursing homes. Results showed that older adults in nursing homes were at a significantly higher risk of dignity loss than their community-dwelling counterparts. The influencing factors mainly included demographic characteristics, disease-related factors, psychological and cognitive factors, care service and environmental factors, and sociocultural factors. Dignity loss significantly increased the risk of emotional problems such as depression and despair. The assessment tools identified included patient dignity inventory (PDI), dignity in dying questionnaire-14 (DD-14) and measurement instrument for dignity Amsterdam-for long-term care facilities (MIDAM-LTC). Dignity care interventions can be divided into three major categories: psychological and communicative tools, daily humanistic care strategies, and self-initiated dignity-preserving strategies.ConclusionsNursing home residents often experience compromised dignity, influenced by multifaceted factors. Currently, there is a lack of universally applicable assessment tools, as well as a systematic framework for comprehensive interventions. Future research should standardise assessment tools and develop evidence-based, effective coping strategies.