Wednesday, 4 October 2017

Care Partner Wednesday--Words Matter


"I just changed his diaper. You grab a bib for me, and I will feed him."

Is this a conversation between two parents holding their newborn infant? Or perhaps two Early Childhood educators in a daycare situation?

No, it's a conversation held between two care partners over the head of a non-verbal elder in a wheelchair.

Is your skin crawling? It should be.

We who are passionate about changing the culture of eldercare need to examine our words and ensure that they are keeping up with our passion. The elder in that chair may have been cognitively impaired and non-verbal, but it's likely he can hear. If he can understand even a small portion of what was said, can you imagine the shame? Not only were the words completely inappropriate, but they were spoken about the elder as if he were a task to be performed and not a person. He might have been one of the wheels on his chair for how person-centered the conversation sounded.

Words matter. We need to examine our language and listen to what is being said. Are the words and phrases ones that we would like to be used about us if the tables were turned?

If you have followed my journey, you know that I fought and lost a battle to remove bibs from our dining rooms. At the very least, let's call them "clothing protectors" and not bibs. Let's offer cloth napkins to those who want them. Let's treat our elders with respect.

When I approach someone who needs to be covered when they are eating, I will say, "Can I put this on to protect your clothes?" This gives them choice and protects their dignity as well as their clothes.

We refer to incontinence products as "briefs." Babies wear diapers. Adults wear pads, pull-ups or briefs.

Rather than referring to what occurs in the dining room with people who need help as "feeding," which is what I do to my dog before I leave for work each day, we call it "assistance with the meal." I put Teddy's dish down and leave the room. That's feeding. In the dining room, I interact with residents and staff. Even if they aren't able to talk, I tell them what kind of food they are eating. "Here's a spoonful of chicken, George." I watch for cues--a look or sound of pleasure, a grimace, or lack of enthusiasm for what is being offered. If they don't like it, we try something else. I smile and we interact. It's a happy, community time. Food gets consumed, but it's only part of the process.

Another word we need to drop from our vocabulary is "refused." "She refused her medication." "He refused his dinner." The word refused makes the elder sound like a cranky person with an attitude. The truth may be they weren't hungry, or didn't feel the need for their pain medication at that time, or didn't understand and no one explained. How much better to say they "chose not to."

Those of us who work in eldercare are familiar with the expression "behaviours." It always refers to something negative, such as aggression, calling out or wandering. Dr. Bill Thomas, the founder of the Eden Alternative, talks about these "behaviours" as being related to an unmet need. We are learning to ask the question, "What is the unmet need?" This moves the responsibility from the elder to us. It also moves the solution from an immediate medical answer "what medication does he need to control the behaviour?" to a social one "what is the unmet need and how can we meet it?"

Why do words matter? Because our words show who we are and what we believe. If we are passionate about caring for our elders in a way that respects their person-hood, let's ensure our words do the same.

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Care Partner Wednesday--Words Matter

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