Threats to dignified care for older people with mental illness: a qualitative analysis

Nasrin Rezaee; Mohammad Abbasi; Sally Pezaro; Rabea Mohsen Ali; Marjan Mardani-Hamooleh; Zahra Salehi

doi:10.1186/s12877-026-07160-z

Threats to dignified care for older people with mental illness: a qualitative analysis

Nasrin Rezaee
, Mohammad Abbasi
, Sally Pezaro
, Rabea Mohsen Ali
, Marjan Mardani-Hamooleh
, Zahra Salehi

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: The dual vulnerability inherent in advanced age and mental illness makes the provision of dignified care critical. However, current literature has given limited attention to identifying the specific threats and compromises to dignity experienced by older adults living with mental health conditions. The aim of this study was to investigate nurses’ perceptions of threats to dignified care for older people with mental illness. Methods: A qualitative interview study was conducted. Semi-structured and individual interviews with nurses (n = 27) were undertaken. Content analysis was used to make sense of the data collected. Results: Threats to dignified care for older people included unavoidable personal context, inadequate organizational infrastructure, and sociocultural traumatic wounds. The first category included the traumatic nature of the illness and being a victim of ageism. The second category included lack of necessary physical space and absence of integrated end-of-life care. The third category included the dominance of culturally rooted explanatory models of illness, lack of family support, and living in an ignorant society. The reports of, and threats of, violence and abuse directed towards older people are particularly concerning. Conclusions: Sociocultural dynamics pose a direct challenge to the dignity of older individuals, often culminating in the threat of undignified care. At the heart of this issue are several core influences: the effects of culturally rooted explanatory models of illness, the presence of insufficient family support, and the pervasive consequences of inhabiting a society marked by traumatic historical and cultural wounds. These components are critical determinants of the quality of dignified care received by older adults. Consequently, a focused combination of educational and sociocultural interventions is urgently needed to dismantle the cultural stigma and prejudice evident within this care context.

Original language	English
Article number	391
Number of pages	11
Journal	BMC Geriatrics
Volume	26
Issue number	1
Early online date	17 Feb 2026
DOIs	https://doi.org/10.1186/s12877-026-07160-z
Publication status	Published - 25 Mar 2026

Bibliographical note

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you
give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 16 Peace, Justice and Strong Institutions

Keywords

Mental illness
Older people
Dignity
Caring
Qualitative research

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10.1186/s12877-026-07160-zLicence: CC BY-NC-ND

s12877-026-07160-zFinal published version, 1,000 KBLicence: CC BY-NC-ND

Cite this

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abstract = "Background: The dual vulnerability inherent in advanced age and mental illness makes the provision of dignified care critical. However, current literature has given limited attention to identifying the specific threats and compromises to dignity experienced by older adults living with mental health conditions. The aim of this study was to investigate nurses{\textquoteright} perceptions of threats to dignified care for older people with mental illness. Methods: A qualitative interview study was conducted. Semi-structured and individual interviews with nurses (n = 27) were undertaken. Content analysis was used to make sense of the data collected. Results: Threats to dignified care for older people included unavoidable personal context, inadequate organizational infrastructure, and sociocultural traumatic wounds. The first category included the traumatic nature of the illness and being a victim of ageism. The second category included lack of necessary physical space and absence of integrated end-of-life care. The third category included the dominance of culturally rooted explanatory models of illness, lack of family support, and living in an ignorant society. The reports of, and threats of, violence and abuse directed towards older people are particularly concerning. Conclusions: Sociocultural dynamics pose a direct challenge to the dignity of older individuals, often culminating in the threat of undignified care. At the heart of this issue are several core influences: the effects of culturally rooted explanatory models of illness, the presence of insufficient family support, and the pervasive consequences of inhabiting a society marked by traumatic historical and cultural wounds. These components are critical determinants of the quality of dignified care received by older adults. Consequently, a focused combination of educational and sociocultural interventions is urgently needed to dismantle the cultural stigma and prejudice evident within this care context.",

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N2 - Background: The dual vulnerability inherent in advanced age and mental illness makes the provision of dignified care critical. However, current literature has given limited attention to identifying the specific threats and compromises to dignity experienced by older adults living with mental health conditions. The aim of this study was to investigate nurses’ perceptions of threats to dignified care for older people with mental illness. Methods: A qualitative interview study was conducted. Semi-structured and individual interviews with nurses (n = 27) were undertaken. Content analysis was used to make sense of the data collected. Results: Threats to dignified care for older people included unavoidable personal context, inadequate organizational infrastructure, and sociocultural traumatic wounds. The first category included the traumatic nature of the illness and being a victim of ageism. The second category included lack of necessary physical space and absence of integrated end-of-life care. The third category included the dominance of culturally rooted explanatory models of illness, lack of family support, and living in an ignorant society. The reports of, and threats of, violence and abuse directed towards older people are particularly concerning. Conclusions: Sociocultural dynamics pose a direct challenge to the dignity of older individuals, often culminating in the threat of undignified care. At the heart of this issue are several core influences: the effects of culturally rooted explanatory models of illness, the presence of insufficient family support, and the pervasive consequences of inhabiting a society marked by traumatic historical and cultural wounds. These components are critical determinants of the quality of dignified care received by older adults. Consequently, a focused combination of educational and sociocultural interventions is urgently needed to dismantle the cultural stigma and prejudice evident within this care context.

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KW - Older people

KW - Dignity

KW - Caring

KW - Qualitative research

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DO - 10.1186/s12877-026-07160-z

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JO - BMC Geriatrics

JF - BMC Geriatrics

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ER -

Threats to dignified care for older people with mental illness: a qualitative analysis

Abstract

Bibliographical note

UN SDGs

Keywords

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