Friday, February 22, 2008

What's in a Name

Recently a news story ran on one of the cable networks about the correlation between street names and the value of the houses on those streets. It seems that houses on streets with names like Massacre Lane or Poison Avenue don't sell well. Houses on such named streets go down in value. And who is surprised. I don't know how streets acquire such names except that perhaps 'Massacre' or 'Poison" were names of leading pioneer families. Over time that connection is lost and people only see the word in its most ordinary meaning.

Retirement centers – Nursing Homes – come up against the same issue. If you had to move from your home because you need more help day-to-day, and you had a choice of where to live, would you choose Brown's Nursing and Rehabilitation Center or Theresian House? Southfield Convalescent Center or Meadowlark Hills? The infirmary or St. Mary's Convent Community?

The first name in each of the three pairs defines those who live there by their physical frailties and limitations. The latter name is more normative of a residential complex or, in the case of Sisters, just another convent. There is no implication in the name that those who live there are in the least bit deficient.

Because words reflect and shape our concepts, names that point to a limited, negative defining of the people in that place, both the individuals who live there and those who care for them are subject to negative concepts about themselves or those they are there to serve. Given that truth, what are the consequences for the residents who receive care in such a frailty-defining environment?

Conversely, as words reflect and shape concepts, so do concepts reflect and shape the words we use. That's what's in a name.

Wednesday, February 13, 2008

Dancing with Rose

That is the title of a book that was recommended to me by a colleague and friend. I just started reading it late last night. More about the book later.

The title reminds me of an event I experienced as a volunteer ombudsman here in the San Francisco Bay Area several years ago. I was working full time but I also volunteered with the San Mateo Ombudsman Program to visit a nursing home in my neighborhood once a week.

The scene that I recall now is seeing a resident in this "typical" nursing home, a man, with some type of dementia go up to the Activities Director and ask if she would dance with him. Her response was one of duty. Of tasks to be completed as her primary goal and focus. She said, "I'm too busy." End of conversation. It was obvious to me then that she did not see responding to this request as a part of her job description.

What an opportunity lost! Here is a person with cognitive impairment TELLING the Activities Director what is important and meaningful to him. A gold mine for an individual who is attuned to person-centered care, who is attuned to the dignity and individuality of each resident. 'Oh, yes, Mr. Johnson, I will dance with joy with you now and I will see that there are always many opportunities for you to dance with others!'

The big question here is Who Are We Working For. Are we working for the administrator who wants to see tasks completed, who wants to see an activity room neat and clean, who wants to see 'big numbers' for all scheduled activities? Or, are we working for the resident and trying to discern what are his/her routines, his/her interests, his/her life-long patterns. Only when responses are made to these issues can we be enablers of life-long development, of quality of life, of individualized person-centered care. Only then are we actualizing the reality that this long-term care ministry is, in the words of Joanne Rader, "sacred."