Nursing home patients or nursing home residents?
By Rick Machemer, Ph. D.
Words matter. They have power. Words generate an image — in the person using them as well as in the person receiving them.
Does the word and its image accurately reflect reality? What if the word and the image cause harm, not physical, but cognitive or emotional? Do we change this word to be more fashionable, more correct? Or do we change the word to more accurately describe the situation?
Now put this word, with its image, into the context of a person living in a nursing home for the remainder of their life.
We often refer to a person living in a nursing home as a patient. The image of a patient is of a person who is ill or has a disease or has been injured, who needs treatment, and then leaves. The person accepts the treatment passively. It’s unusual for other than the person’s medical history to be known. Anything else may seem irrelevant to the treatment. While appropriate in an acute medical setting, this one-dimensional view of the person is inappropriate in a long-term care setting. Nursing home is after all, two words, nursing and home. Nursing to focus on the on-going medical needs of the person. Home, a place to live in which all the many dimensions of the individual — family, friends, education, work, memories, dreams, concerns, fears, the things of a complete life — are known, are important. The word patient used in a nursing home “reduces” this complex individual to “only” a chronic illness or disability. Everything else about the person becomes secondary.
Remember, this is now their home. The individual may continue to actively participate in daily life activities and in their care. They didn’t check their history, their memories, their dreams, their fears, the rest of their non-medically-related life at the door.
What image do we want to convey when we speak about an individual living in a nursing home? Is it a one-dimensional view — to focus on only the medical needs? Is this person to no longer have a say about their life? Are they to lose their history, dreams, fears, memories? Do they exist only to receive care? If so, use patient. If we want to see them as a unique human being with a past, looking toward a future, filled with memories, encouraged as able to participate in their care, sharing all the human emotions, then use resident.
It’s critical to focus on the person first as a resident in their home, and the medical and other care needs second. It’s a decision. That decision affects the person and how they see themselves. It affects how others see and interact with this person.
There is a choice — make the individual into a one-dimensional caricature who needs only care. Or acknowledge and celebrate all that makes this individual a complete human being – a resident who needs care – in their home.
Rick Machemer, PhD, is the cofounder of the Lifespan Gerontology Program in 1981 and a former biology and gerontology professor at St. John Fisher University.