Green House Blog

Fighting the Dragon: How clothing supports cultural change

THE GREEN HOUSE® model strives to de-institutionalize care settings while supporting elders to live in homes within intentional communities. To live the life they want to live on their own terms. Every aspect of what we do and how we do it either supports or detracts from this vision.

What we wear is germane to the overall challenge of Fighting the Dragon – stopping institutional creep. Our clothing reflects, for each of us, so many things. We choose our dress to communicate who we are, where we are going and what we are going to do. Clothing sends a message. Staff that belong to Green House communities are in the unique position of working in the home of elders. The mission of these homes is to support normal, active, engaged lives. And so the question of dress for staff (Shahbazim, nurses, and guides) becomes an issue for thoughtful consideration when The Green House homes are in development.

The leadership and staff of each organization needs to consider guidelines for staff dress based on the goals of The Green House philosophy. They need to engage staff and elders around Green House® principles to create policies and guidelines about dress.

Things to consider when developing guidelines

1. It is important for Shahbazim to determine their dress code while considering the wishes and preferences of Elders.

2. Uniforms like ‘scrubs’ and traditional healthcare uniforms send several messages like,

• this is a setting for sick people

• this is an institution

• we are here to work

• they separate us and mark us as “in charge”

• we are fundamentally different than the people we serve

3. Clothing has different norms and standards as it reflects the organizational culture. It can reflect regional differences, cultural heritage, and socio-economic values, too. The Green House homes already represent a wide range of geographic, cultural and socio-economic communities. And dress standards will necessarily impact the overall cultural fabric.

Many staff identify that scrubs and uniforms are convenient and economical for what is still very clinical work. Showers, personal care and cooking lend themselves to work dress that is flexible and durable. And, there is a need for clothing that is clean and sanitary. However, these needs should be balanced with the goal of creating and supporting home.

Whether The Green House home is open or still in planning stages, the issue of dress and its impact on culture is a very important decision to consider.

**Fighting the Dragon is a repeating topic addressing issues of Institutional Creep. Please let us know of issues you have encountered or opportunities you have had in combating institutional behaviors or ideas that are often lurking. aortigara@ncbcapitalimpact.org

Navigating Difficult Conversations

We’ve all had difficult conversations in the past and we all know how much stress and anxiety they can cause. Such conversations often lead to arguing, hurt feelings and sometimes even physical violence. They may strain and ruin the most long-standing relationships. In the Green House home, relationships matter. They are the heart of the model and critical to the health of the home. We cannot afford to let misunderstandings and conflict undercut our mission, and ultimately, the Elders. Yet, we cannot always avoid these discussions, nor should we. What do we do? We turn a difficult conversation into a learning conversation.

Elements of a Difficult Conversation

Despite the specifics, most difficult conversations have a similar structure and understanding that structure is key to improving the way you deal with the conversation. Much is left unsaid on both sides and this is often what makes the conversation difficult.

  • The Facts – Disagreement over the facts of what happened, what should happen, who said what, who’s right, who’s wrong.
  • Feelings – Are my feelings appropriate? Should I acknowledge them, express them or keep them hidden? What about the other person’s feelings? Are they hurt or angry?
  • Self-Image – This is an internal conversation each party has with themselves to try to determine what the situation means to them. Are they good, bad, trustworthy, untrustworthy? How this conversation turns out determines one’s self-image and self-esteem and whether they are balanced and comfortable in the difficult conversation or defensive and anxious.

 Each of these three elements, or conversations-within-the-conversation, contain challenges that we must struggle to manage and understand, and while we can’t change everything within them, we can change how we respond to them. Let’s look at each of these in a little more detail.

The Facts 

  • I’m right, You’re Not – What’s true, what’s false, who’s right, who’s wrong occupies much of a difficult conversation. Both parties are sure they are right and argue vehemently for their side. The thing is, the conversation is not about the facts, but what they mean. It’s not about what’s true but what is important. It is about interpretation, values and perceptions. Moving away from assuming you are right to understanding the values and perceptions of both sides allows us to stop delivering messages and to start asking questions about how both sides see the situation.
  • Intentions – We try to determine the other’s intentions from their behavior or maybe from past experience. We assume we know them, but such assumptions are little more than inventions and rarely accurate. We often do not know our own true intentions. Intentions are complex and often mixed. Jumping to assumptions about the other’s intentions ratchets up the difficulty of our conversation.
  • It’s Your Fault – Much effort is spent in a difficult conversation about who is to blame. The problem is that talking about blame is like talking about truth – it produces denial and disagreement but little learning. Not wanting to be blamed, we spend much of our energy defending ourselves. The point here is that things went wrong because of what both parties did and how they reacted to each other, so the blame is shared. Exploring what went wrong and how to correct it going forward gets you much farther along in the conversation towards defusing the conflict and difficulty.

 Feelings and Emotion

Difficult conversations often involve strong emotion. How should you deal with that when it arises? Many people try to stay rational and avoid the emotion. The source of emotion, even in ourselves, is hard to understand, let alone talk about. Emotion clouds judgment and can make us feel vulnerable. In the context of work, talking about them may also seem inappropriate.

The problem is that difficult conversations are usually about emotions and feelings. That’s what makes them difficult, after all. Ignoring them may save time or reduce anxiety, but in the end, you will accomplish less if you do not address your feelings. Unfortunately, there is nothing that will make doing so easy or risk-free, but with practice, we can all do a better job at it.

Self-Image

This element is subtle and may be the most challenging, yet it offers much leverage in managing anxiety and improving our skills in handling the other two. This is a look inward about who we are and how we see ourselves within the context of the difficult conversation. This is the deeper ‘something’ beyond the apparent substance of the conversation that is at stake for us.

As we examine our self-image, we may lose our balance, feel anxiety, perhaps lose confidence in ourselves and our position. In extreme situations, we may forget what we were going to say and just want out.

As with emotion and feelings, there is no magic bullet that makes this conversation easy, but our skills do improve with practice. And the better we get, the more we’ll find that the Self-Image element becomes a source of strength, rather than anxiety.

A Learning Conversation

Even though we may not admit it, our initial purpose for having a difficult conversation is often to prove our point or to get them to do or be what we want. We are there to deliver a message.  As we have explored, this rarely results in a positive outcome.  If you try to understand the other’s point of view, understand and share feelings and work together, rather than try to persuade and get your way, you will move toward a learning conversation.  The chart below displays the differences between a head-butting battle of messages and a thoughtful learning conversation. Which one would you rather be party to?

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Adapted from Difficult Conversations – How To Discuss What Matters Most. Douglas Stone, Bruce Patton, Sheila Heen of the Harvard Negotiations Project. 1999, Penguin Books, Ltd.

The Green House Project Featured in USA Today, Plus Our Consumer Toolkit

The Green House Project was happy to lend its support to a new USA Today piece published today, entitled The Supplement on Alzheimer’s Disease. The story talks to Green House Project Director Robert Jenkens as part of an “expert panel” (on page 10 of the print version).

Click here for the web version of The Supplement on Alzheimer’s Disease.

The Green House model embodies principles that support elders living with dementia to have full and supported lives. To learn more about the model and to follow us please become a fan of The Green House Project on Facebook today. Find Green House homes in your state.

Finally, learn how to bring Green House homes to your community by downloading the The Green House Project Consumer Toolkit here.