The institutional “dragon” is too big to swallow in one mouthful. If we really commit to understanding the depth associated with institutional creep (sliding back into medical model practices), it’s important to start small with dragons that are manageable. One such deeply rooted institutional practice includes language; what we say and how we say it makes a significant impact on those with whom we work, and those for whom we hope to create a life worth living. Since words have the power to make or break someone’s day, it’s imperative to explore their impact on transformational success.
The Green House Project is certainly not the first, nor will it be the last, to challenge the language of long-term care. In her article entitled, “Mayday: The Language of Culture Change,” Karen Schoeneman, Deputy Director at Center for Medicare and Medicaid’s Division of Nursing Homes, explored the barriers hidden in words commonly used in nursing homes. “Part of transforming long-term care practice is finding new words to describe staff, programs, parts of the building, and the ‘industry’ itself.” Person-centered language allows us to do just that, as its goal is to acknowledge and respect residents (elders) as individuals. Sometimes, as Karen states, it’s “as simple as reversing common phrases to put the person first and the characteristic second.” In one such example, “a feeder” becomes “someone who needs assistance with dining.”
So, what can you do today in your organization to combat traditional language? First, work as a team to discuss and understand the power of language. There’s magic in synergy, and teamwork produces an overall better result than if each person was working to the same goal individually. Next, continue sharing ideas and tools to help direct conversation. (One decision making tool we embrace is the learning circle, as it provides everyone with an equal voice.) Lastly, ask yourselves questions to really challenge the reasoning behind the words we use. Examples include, but are not limited to, “What do the elders say they want?” and “How does this drive the standard forward?”
Although policy and regulation are often the most referenced barriers to true culture change implementation, one of the real obstructions is closer than we think. I, you, our colleagues – the language each of us uses creates a barricade that separates us from them. Whether it is staff v. elders, leadership v. care givers, or yet another division of people with and without power, we need to sharpen our awareness of what we say and how we say it, or words will continue to separate worlds. And that’s no world where we would choose to be.
This article is based upon a presentation by Melissa Honig, Project Guide, at The Green House Project’s 2009 Annual Meeting and Celebration in Kansas City, Missouri.