Background: Many older people in Swedish nursing homes have physical and/or mental conditions that may convey the violation of dignity. Dignity is a common caring science concept, however complex and multivalent. Thus, the aim was to explore aspects of dignity in older persons’ everyday lives. 

Design: Focused ethnography. 

Methods: Data consisted of 170 h of fieldwork, comprising observations (n=39) with residents (n=19), assistant nurses (n=22), and repeated interviews with residents (n=35). To study dignity-related concerns, the Chochinov model of dignity was used to direct a deductive analysis. 

Results: The residents suffered from illness-related concerns that inhibited a dignified life. Their failing bodies were the most significant threat to their dignity. This caused fear of extended dependency, agony, loneliness, and meaninglessness. The most dignity-conserving repertoire came from within themselves: their self-knowledge had provided them with self-esteem and tools to distinguish what was still possible from what had to be accepted. Socially, residents’ dignity depended on assistant nurses’ routines and behavior. Dignity-conserving interventions were observed, such as emphatic listening and care performed according to residents’ preferences. However, dignity was violated by long waiting times, lack of integrity, deteriorating routines, and harsh encounters with assistant nurses. 

Conclusions: Important dignity-conserving abilities came from within residents themselves. To protect residents’ dignity, all nursing home professions must provide holistic care that comprises attention to personal, bodily, social, spiritual, and psychological needs.

Ethical issues and approvals: The study followed ethical standards stated by the Declaration of Helsinki, approved by The Regional Ethics Board of Stockholm (Dnr 2017/8-31/1).