The Menu Is Not The Meal

June 10, 2015
Jean Mesendick

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There is a transformative power to language, to the words we choose, to the verbal expression of our thoughts and ideas. Word choices make such a deep impact on both the speaker and the listener. I see this every day. I bet you do too.

Each time I substitute the world elder for resident or patient it moves me forward just a tiny bit. I like to think that I am not guilty of ever having referred to someone by his or her diagnosis, “the diabetic”, “the renal failure” or “the CVA”. But I do know I have been guilty of referring to a fellow human being as a room number, “310 A needs a pain med”.

The use of the term care partner has completely captured me. This particular phrase is backed by such empowerment. When we use care partner to refer to an elder it implies collaboration instead of subservience. When we use care partner to refer to a member of the staff it suggests a level playing field instead of authority. Wherever we use this term, with family or volunteers, administrators or physicians it sets the table for cooperation and mutual respect. That is the transformative power of language.

However, as Alan A. Watts said, “The menu is not the meal”.   The use of the words alone will never be enough. It will never suffice to use the word napkin instead of bib, if we do nothing else to bring convivium to a meal. It is not enough to substitute the word home for unit if it does not feel, look or smell like a home. The menu is not the meal. The menu is merely words on a page, the meal is nourishing and sustaining and it is the meal that we want when we read the menu.

How can get from menu to meal? In the beginning we can make small changes in behaviors and practices that will lead to small rewards. I am a follower of a personal trainer whose formula is Big Change=Small Actions+Time. I know that we are all growing impatient for Big Change, right now. I certainly am. It is already too late for my parents but it may not be too late for yours. You are hungry for person-centered care right here, right now.

What is the next step for culture change? I propose that it circles right back to that transformative power of language, to our ability to communicate our vision to our friends, neighbors and family members. But how do we also drive home our message to community leaders, to the economists, to the legislators and regulators? Which words are the most powerful? What medium is most effective?

I am looking for suggestions, or success stories, from the readers of this blog on what works. I hope that you will post comments that will help me, and others like me, to move this campaign forward at a faster clip.

I am hungry and no longer satisfied with reading the menu!

7 Comments. Leave new

Mary Kim Smith
June 10, 2015 3:25 pm

Go Jean!
Thank you for your leadership. The first step to changing a culture is to change language and behavior. Your post is right on target. Language or behavior is reshaped one word or one action at a time. Our families enjoy having time together over a meal in our individual homes. We share relationships, celebrations, concerns, and loving connections during this time together without menus on the table or posted on the wall. Creating this environment for our Elder, Staff, Family, or Community Care partners to enjoy can be accomplished by creating the simplicity and security of home and family regardless of where “HOME” is found. MK

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Jean Mensendick
June 10, 2015 4:28 pm

Absolutely, Mary Kim. The language is powerful but the scene you described of people gathered in a supportive environment, sharing a meal certainly does feel like home. How can we get this in place for all the care partners?

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Jean,

Thank you for sharing! Timely article for me! The community where I am a care partner is always working on words! We moved from employee to care partner two years ago. The CNA Care Partners understood the power of these word changes quickly! We have a very diverse work environment and no matter the culture of the care partner, they understood what the word changes meant! ” I am a care partner, my boss is a care partner and the Execuive Director is a care
Partner too!’ We squashed the hierarchy with 24 hours!

The frustrating part of the journey is some family members think culture change is like turning on light switch. We have so much more education to do! We need families to work with us not against us and that is a big part of our strategic plan over the next year.

I completely agree with your trainer! Big change is taking small steps and time. Thank you for sharing this for I will be using this comment when helping families understand what is meant by the term journey!

Thank you for sharing!

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Jean Mensendick
June 11, 2015 11:21 am

Mark Lowell, I would love to have an off-line conversation with your about the way you have built diversity in your staff. It is a subject of great interest to me. (You can find my contact information on the listing of Eden Educators).I am glad that this blog post resonated with you. Words are powerful, in the same way that diving boards are powerful, they can move you farther than you could go without them, but they are only launching points.

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Just some comments about practical everyday words and actions. Instead of a bib when eating, a serviette (word used in South Africa) or napkin with a buttonhole worked in one corner, especially for a man, can be fixed over the top button of a shirt and will provide adequate protection against spillage of food. Men must find it very hard to have to wear a bib. Also, the words padded underpants would be better than diaper or nappy (word used in South Africa where I am)

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Thank you for this article- While I personally have been aware of and engaged in the “culture change” movement for years, I have just last week joined an organization that does a fabulous job at providing PERSON FOCUSED care (meaning the team is individualized, thoughtful and creative in how they accommodate personal preferences), but it is not PERSON CENTERED, in that the elder is not actively involved in the the care development process. Part of this is due to the very tradition based culture of this faith based community- they embrace individuality within the system. Tradition is SO important here, that I am reluctant to introduce anything that refers to “change” because of the implications of that word (change implies a beginning point and an end point- from A to B, change isn’t always better…etc). I am tasked with leading the current into a journey that will result in a new cutting edge dementia program, and have already decided to emphasize this a journey of growth- not a system of change. My first meeting with the dining team and residents will be “A Menu is not a Meal”- I look forward to hearing what that statement means to people as we develop our vision! Thank you!

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Thank you so much. How many of you are offering buffet style dining? We are, and getting tagged because our servers (not dietary)
are not wearing hair nets? Anyone else experiencing this? If so, how are you addressing?

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