The welfare of older people who live in care homes has raised concern for decades in many countries.1 Scandals surface on a depressingly regular basis, and although these enter the public consciousness, none provokes the outcry caused by reports of abuse of vulnerable people at the opposite end of the age range—children.

Two recent campaigns by the charity Age Concern England and partners focused on lack of respect for the dignity of older people. “Hungry to be heard” examined the problem of malnutrition in older people in hospital,2 and it called for more help for those needing assistance with eating and drinking. But protecting patients' meal times from interruption will prove a difficult goal for frazzled staff in many acute hospital units. “Behind closed doors” campaigned for people to be able to use the toilet in private in all care settings and argued that this was a general marker of …