Not too long ago, I attended an event for eldercare professionals, and I heard a friend of mine chiding another attendee for using “the f-word.” Lest you think that we are anything less than polite here in Kansas City, I must tell you that this particular “f-word” was not the four-letter variety. Rather, this person used the word “facility.”
The word “community” is gradually replacing “facility” as the preferred designation for the places where our seniors live.
I must admit that having “grown up” with the f-word in my clinical training, it has been rather challenging to shift my vocabulary. I am willing to make the effort, though, because I recognize that “community” is a much nicer term. It’s better for marketing, of course (who wants to move to a “facility?”), but it is also congruent with culture change in nursing homes, particularly the idea that the places where our seniors live long-term are their homes, not just places to provide medical care after someone leaves the hospital.
“Culture change” is one of those buzz words in eldercare that can mean many different things, some of which may seem contradictory. Primarily, culture change really emphasizes meeting residents’ needs on an individual level rather than trying to fit them into some kind of mold. For example, it used to be that we’d try to get everyone to show up to group activities, even if they didn’t really want to. Or, we’d make everyone sit down to eat at the very same time, with the very same menu, like it or not. Now, we have open dining and alternative meals, and we respect residents’ decisions not to attend activities rather than dragging them to bingo every Tuesday at 2:00, and we spend time arranging for individual activities instead.
At the same time that we focus on individual needs, though, we still need to cultivate community in these places where seniors live together. This is why we have “neighborhoods” instead of “units” now and “residents” instead of “patients.” No, we can’t force community by making residents do things on our schedule, but we can plan spaces and experiences to encourage socialization and facilitate community building. Then, we observe, listen closely, and participate as members of the community to figure out what is working and what is not in terms of meeting individual needs AND cultivating community.
I’ll stop there, but I do want to hear from you. What has worked best in your community? Which areas need improvement? Please leave a comment below!