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The Language of Culture Change in Long-term Care

When I was six years old, my mom decided to enroll me in a French school. Because we lived in Montreal at the time, she figured I better know how to speak the language of the “natives.” So, I went to my first day of school not speaking a word of French, only English. I couldn’t understand a word the teacher or other kids were saying. I basically copied whatever the other kids did. I stood up when they stood up, laughed when they laughed, and moved my mouth (as if I were really speaking) when the other kids repeated words from the chalk board after the teacher. Eventually, I did learn to speak French and managed to stay at that same school all the way through high school graduation.

When a new staff member joins a long-term care community, the experience is not unlike mine as a child. Each community has its very own language. The natives of long-term care communities impart both non-verbal and verbal communication which have been deemed acceptable and the norm for the environment. New staff members are to observe and copy the language in order to fit in. So, it is important that the language used when interacting with both residents and colleagues is based on respect, dignity, and accuracy.

Unfortunately, much of the language we use is in need of updating because it unintentionally demeans people, contributing to a hierarchical sense of “us” and “them” and a dehumanizing culture instead of a nurturing community with respect for its member. Part of transforming long-term care practice is finding new words to describe staff, parts of the building, and the industry itself. In essence, we need to adopt a person-centered language. The idea behind person-centered language is to acknowledge and respect long-term care residents as individuals. Sometimes, developing person-centered language is as simple as reversing common phrases to put the person first and the characteristic second. For instance, “a wheelchair-bound resident” becomes “a person who uses a wheelchair for mobility.” “A feeder” becomes “a person who needs assistance dining.” Again, caregivers need to be mindful of the dangers of using “separating” words: words that promote the separation between “us” and “them.” For example, look at the word “therapy.” Why is it that so many activities in a long-term care community need to be labeled as “therapy?” If a person who has always enjoyed painting now moves into a long-term care community and still enjoys painting, why is it now labeled “art therapy?”

We face an urgent task in adopting a new language and sharing it with our colleagues, the elders and others who require long-term care services, family members, and the public at large. Take time to consider the language being spoken where you work. Is this a language you are proud to teach others? Here are some examples of old words we should throw away from our long-term care language along with some new words that show mutual respect. Develop your own list of new words and share it with others.


Victim of… or Suffering from… Has….or With…

Wing, unit Household, street, neighborhood

Allow Encourage, welcome

Diaper Disposable brief, incontinence garment

The elderly, patient Elders, older adults, people, resident

A diabetic, a quad A person who has (whatever condition)

A feeder, feeder table Person who needs assistance with dining,

dining table

Nurse’s aide, CNA, nursing assistant Resident assistant

Front line staff (sounds like war) Certified resident assistant

Admit, place Move in

Discharge Move out

Lobby, common area Living room, parlor, foyer

Nurses’ station Work area, desk

Facility, institution, nursing home Home, life center, living center

100-bed facility 100 people live in this home/center

Housekeeping, housekeeper Environmental services, homemaker

Eloped, escaped Left the building, unescorted exiting

Dietary services, food service Dining services

Problem residents, behavior problems Person with behavioral symptoms

Agitated Active, communicating distress

Ambulation, wandering Walking

Wheelchairs, walkers People who use a wheelchair/walker

Hey you, Honey… The person’s preferred name

“That’s not my job.” “I’ll take care of that.”

“We tried that.” “Let’s try again.”

“You need to…” “Would you like to…”

Problem Challenge, opportunity

By Melissa Stefanski

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