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Language and Culture Change: Are You Still Using the “F” Word at Work?

“The difference between the almost right word and the right word is really a large matter–’tis the difference between the lightning bug and the lightning.” - Mark Twain

To be honest, I didn’t realize how the power of my everyday words negatively impacted an institution where I worked. Now, on reflection, I’m actually embarrassed by my new-found knowledge, but I take heart from an Oprah quote: “When we know better, we do better.”

My challenge now to myself, and I hope my fellow colleagues working in Health Care Communities, is to constantly perform a language check-up.

Recently, there’s been a great deal of research done on how our choice of words impacts our work environment and directly influences our behavior. Other workplaces have had to change their language usage. For example, prisons are now Correctional Centers, stewardesses are now flight attendants, dietary is now culinary services. Likewise, our words in Residential Care need to be reflective of what we want to offer, which is a more normal and home-like atmosphere. Often traditional nursing homes represent a culture that needs changing, and changed language needs to be an integral part of it.

Nancy Fox wrote in her book, “The Journey of a Lifetime: Leadership Pathways to Culture Change in Long-Term Care,” that “our entire industry has developed a language that is demeaning and depersonalizing both of the Elders we serve and the hands-on staff who care for them. What we know is that language can and does influence us. Language is a powerful tool. When used in a positive way, it can inspire people. When used negatively, it can hurt. But when it becomes a part of a culture and is simply mindless, that is when we speak the words without understanding their impact, it is dangerous. When we awaken to the fact that this kind of language has seeped into our culture and is now actually driving our attitudes and beliefs, we can begin to change our language to shape a new culture." (p. 82)

“When we know better, we do better.” - Oprah Winfrey

There are also some excellent points made in the paper titled, “The Power of Language to Create Culture,” by Bowman, Ronch, and Madjaroff, (2016), which encourage us all to consider our choice of words.

Here's a quick summary of some of their topics that I found most helpful. To help us change our language, here are some practical suggestions:

•  Purchase laminated cards, the size of a business card from The Institute for Caregiver Education for staff team members. These cards say “Language is the key to the soul. Because of this, it is important to choose our words carefully. To help transform our “facility” into a true community, try using the following:

          1.  Use "Home" or "Community" instead of facility.
          2.  Address and refer to people by name, not diagnosis or job function.
          3.  Avoid excessive medical terminology when talking to residents or co-workers without a clinical background.
          4.  Don’t just bark orders. Try to explain the "why" of what you are asking for.
          5.  Think “Equalize Everyone."

•  Create a group of leaders to use examples of the new language – allow them to be the “teachers” who get it and can give feedback in a respectful way. Learning new beliefs and a new way of talking takes time. Be patient but clear.

•  The best way for a person to learn a new language is to speak it. Leaders need to encourage people to use the new language so it becomes automatic.

•  Instead of Director of Dietary, maybe change to Culinary Services Team Leader

•  Leaders and teachers need to keep reminding people that learning a new language requires three kinds of knowledge to take hold:

          1.  know it (facts/information)
          2.  know why (motivations and beliefs)
          3.  know how (the new words/concepts/language are spoken) to become dominant.

•  When you hear language that dishonors people in communities, be on the lookout for opportunities to reframe someone’s experience so that their beliefs and language can be changed. Reframing means to change the way we interpret or give meaning to an event, so when a person in a nursing home is called “resistant,” reframe it to “making a choice”

•  The best strategy of all: use it, use it and then use it some more. Changing language and culture take time and concerted effort so giving people a new vocabulary list is just one part of the job, but following through and accountability are critical. Empower the team to make it happen and that everyone is responsible for accountability. (Ronch, 2003)

healthcare language choice

Please do check in with yourself. Listen to the care partners at your workspace. Be an example. Make others accountable. Changing culture means changing our language. So, do you need to stop saying the “F word?”? Facility, that is.


Are you saying the right things in your community? Are you creating a home-like atmosphere? Take our quiz to find out where you can improve.


Be sure to sign up for Suzanne's webinar, "Bringing Back CHOICE to Residents" where you'll learn how to:

  • Reduce high food waste by 30-50%
  • Serve significantly hotter food to residents
  • Eliminate multiple food preference lists to track and maintain
  • Improve customer service to residents
  • Improve overall meal satisfaction
  • Exceed CMS regulations and align with best practices (Pioneer Network, Eden Alternative)
  • Implement methods that are working in 800+ healthcare communities at all levels of care in North America

Date:  Wed., October 9th, 2019
Time:  10 AM PDT / 11 AM MDT / Noon CDT / 1 PM EDT


About Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.