Why Are We Still Dropping The F-Bomb?

September 08, 2015
Jill Vitale-Aussem, Guestblogger

Facility - fəˈsilədē

I recently reviewed the proposed CMS regulations and what struck me right away is that while the proposed changes were created to “reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety,” one thing hasn’t changed a bit.  And that one thing is the word that is used to describe the homes and communities where older adults live. FACILITY. ‘The facility shall do this and the facility shall not do this.’ Facility is the coldest, most institutional word possible. And it’s sprinkled generously throughout those hundreds of pages of CMS regulations.

If you’ve seen the movie A Christmas Story, you likely remember the scene in which 9-year-old Ralphie is helping his dad change a tire on the car on a dark snowy night. Ralphie is so excited to help and then he drops all of the lug nuts and loses them in the snow. In frustration, he yells out “Fuuuuudggge!” Ralphie then explains through narration, “…only I didn’t say fudge. I said THE word. The queen mother of all dirty words – the F-dash-dash-dash word!” Ralphie ends up being punished with a bar of soap in his mouth.

That’s how we should view the word ‘facility’. As the queen mother of all dirty words. The F-bomb. Pay attention and you’ll notice it’s still spoken by people in our field constantly. And used by our regulatory agencies. It’s time to eradicate “facility” from our vocabulary.

Is a ‘facility’ a place where older adults should live? How can we expect to change the way we behave if we don’t change the words that describe what we do? Dr. Thomas says that “words make worlds” and he’s right. Call a building a facility and people will act like they live and work in a facility. Call it a community and the seeds of change are planted.

So, bust out the soap, implement a “swear jar” if you want. I don’t give a facility what you do. Let’s start changing our world through the words we use.

8 Comments. Leave new

This article is awesome! Great reminder of Words Make Worlds! What world are we creating when using the F-word?!

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Thank you Jill! So, just how far are we willing to extend ourselves as Elder advocates for changing the culture of care? Are we willing to stop using the word “facility” in the name of the home? Are we willing to stand up and say that the name of the Elder’s home does not need to include the services offered, e.g. nursing or rehabilitation center? Are we willing to dig even deeper in the very documents that describe what should be done in order to be paid for services by the government and challenge other language, like “behaviors, feeding assistants, admission, discharge, patient, etc.? What is out there besides the f-bomb that needs to be changed?

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Jill Vitale-Aussem
September 9, 2015 11:13 am

Denise – I love how you always push us further! 🙂

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Jill, You are soooo right! Everyone submitting comments on the new proposed regulations should lead with this one…the f-word must go.

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Jill Vitale-Aussem
September 9, 2015 11:16 am

Chris, maybe if CMS hears it from enough people, it will make a difference. I also submitted this suggestion through LeadingAge.

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This is an excellent excellent article. Words mean so much. How do we retired folks out here, effect this change in the government language? I worked at a Thrift store that gave free clothes and household items to folks who needed them. They were given a “GIFT CERTIFICATE”. Store staff persisted in asking folks “do you have your VOUCHER?” I made so much noise about the indignity of this, that the idea finally caught on. Shoppers had Gift certificates. Made a big difference to them when they went up to check out
I agree the F-word must go, and so too, all those other words that denigrate the people receiving the service.

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Jill Vitale-Aussem
September 9, 2015 11:14 am

Nancy – the voucher vs gift certificate is a great example of how words can either empower or disempower people!

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Or we could all just start referring to our own houses as facilities

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