Dignified language in a healthcare environment
By Crystal Shelley, LCSW
As editors, we consider how messaging will affect readers. Is it clear? Is it biased? Is it harmful? These questions are no different in healthcare environments, where it’s vital for care providers to intentionally choose language that values the dignity and humanity of those receiving services.
One area of healthcare that is known for the use of devaluing language is long-term care. Industry lingo is usually clinical at best—and dehumanizing at worst.
Walk down the hall of a nursing home and you’ll hear patients referred to by a room number, a generic epithet like “the guy with Parkinson’s,” or a nickname like “honey” or “grandma.”
You’ll also come across instances where patients are treated like children or talked down to, such as when they’re asked if they need to “go potty” or are admonished for their incontinence.
My most powerful reminder of the importance of language choices in healthcare came when I worked for a company that challenged those industry norms as part of its culture. On my first day as the social services director of a long-term memory care community, I was handed a list of terms and phrases we were and were not supposed to use.
The point was not to censor but to shape how the staff viewed the people we served. Almost all of our residents had some form of dementia, and emphasis was placed on using language that preserved their dignity and humanity.
Here are some examples of intentional language that was used:
- The environment: Our residents weren’t admitted to a lockdown facility, they moved into a community that was secure (to prevent elopement, or the wandering out of a safe space, that sometimes occurs with memory loss).
- The care: We didn’t have aides who fed and toileted residents, we had caregivers who assisted residents with their meals and with using the bathroom.
- The relationships: We didn’t call residents by anything but their preferred names or nicknames, such as “Bill” or “Dr. Wang” or “Coach.”
These shifts in language fostered an environment where our residents were seen as individuals. Our word choices reminded us that each person we served had a history prior to their disease, including hobbies and life stories and unique personalities.
Because I was new to working in long-term care and because of my natural appreciation for choosing intentional language, I was able to easily adapt to the terminology. But I saw how my coworkers—many of whom had worked in healthcare settings before—struggled to change what had been ingrained in them.
Language also affected how residents’ families viewed their personal experiences. A common phrase used to describe anyone with challenging behaviors is that they’re “being difficult.”
Part of my role was to provide support and education to family members. Reminding them that their loved one was “having a difficult time” helped families reframe the experiences. It also reinforced that their loved one’s resistance or agitation was the result of a brain-deteriorating disease instead of a conscious choice to be frustrating.
Not only did this affect how families saw their own loved ones, it also helped them view other residents with empathy and compassion.
Shifting from value judgments to neutral, factual language made a difference too. Rather than saying that someone was “afflicted by” or “suffered from” their illness, the preferred language was that a person “had,” “was diagnosed with,” or “lived with” their illness.
While the dementia was ultimately devastating for our residents and their families, there were also profound moments of joy and love, moments that would be minimized by phrases that painted everything as despair.
Although I don’t work in healthcare anymore, the lessons I learned about language in that setting will always stay with me, especially because they apply outside of long-term care and healthcare even.
Now I’m an editor who helps writers convey their messages effectively to readers, and that means going beyond clear, error-free communication. It means helping writers make intentional choices to affirm the dignity and humanity of everyone.
Dignified language in a healthcare environment was originally published in Tracking Changes (Summer 2021 edition). Members receive a PDF of the quarterly Tracking Changes newsletter by email.
