Dignity and the capabilities approach in long-term care for
older people
Jari Pirhonen MSSc
Researcher, PhD Student, School of Health Sciences and Gerontology Research Center, University ofTampere, Tampere, Finland
Abstract The ageing populations of the Western world present a wide range of
economic, social, and cultural implications, and given the challenges
posed by deteriorating maintenance ratios, the scenario is somewhat
worrying. In this paper, I investigate whether Martha C. Nussbaum’s
capabilities approach could secure dignity for older people in long-term
care, despite the per capita decreases in resources. My key research
question asks, ‘What implications does Nussbaum’s list of central human
capabilities have for practical social care?’ My methodology combines
Nussbaum’s list with ethnographic data gathered from a Finnish shel-
tered home for older people. On the basis of this study, it seems that the
capabilities approach is a plausible framework for the ethics of care
because it highlights differences in the ability to function and thus dif-
ferences in opportunities to pursue a good life. The ideas presented in
this article could assist social policy planners and executives in creating
policies and practices that help old people to maintain their dignity until
the end of their days.
Keywords: capabilities approach, long-term care for older people, eudai-
monia, dignity, Martha C. Nussbaum.
Introduction
To get back my youth I would do anything in the world,
except take exercise, get up early, or be respectable. Oscar
Wilde
It is a well-known fact that western societies are ageing
rapidly, and Finland is ageing fastest (Giannakouris,
2008; Christensen et al., 2009; Official Statistics
Finland, 2012; Eurostat, 2013). Finnish baby boomers,
i.e. the generation born 1945–1954, are now entering
retirement and will increase the demand on health and
social services in the near future (Statistics Finland,
2007). There has been a widespread public discussion
and political debate on the topic, and a new law con-
cerning older people’s rights to health care and social
services came into effect in Finland on 1 July 2013.
1
Correspondence: Mr Jari Pirhonen, Researcher, PhD Student,
School of Health Sciences, University of Tampere, Tampere
33014, Finland. Tel.: +358 41 788 5478; fax: +358 3 3641 511;
e-mail: jari.pirhonen@uta.fi
1
The new law delineates obligations for municipalities to deliver
specific services in order to maintain health and functional
ability of older people. Evaluation of need for services and secur-
ing the quality of services are the key elements of the law.
Original article
doi: 10.1111/nup.12057
29 © 2014 John Wiley & Sons Ltd
Nursing Philosophy (2015), 16, pp. 29–39