I.
Personal experience and program planning reading converged for me this week when I spotted in a local newspaper a publicity photo masquerading as news in which staff of a very large nonprofit long term and community health care services corporation with a local presence are pictured awarding themselves for their rapid expansion, in particular, of home health care services (to the tune of a 532% increase in Medicare claims).
From Kettner, Moroney, and Martin’s Designing and Managing Programs: An Effectiveness-Based Approach (2008): “The emphasis on planning is too often on organizational survival or program maintenance and expansion” (italics mine). In such nonprofit programs, KM&M go on to say, priorities “often drift from their initial focus and are adjusted to meet the demands of the agency and staff.” In plain terms, such agencies may lose touch with the needs of those they serve. A consequence of this type of agency culture is, according to KM&M, that “staff tend to view potential clients in terms of those services the staff are in a position to offer.”
I can testify to that! but I’ll spare you the narrative, for now, and move on to comment how language reflects agency culture (drawing on experience with the same agency).
II.
Language reflects culture and of course, strengthens it, too. Rather than fostering program effectiveness, language that objectifies people who are recipients of human services leads into the revolving door of de-humanization.
It is common at the local nursing home to hear staff refer to “doing” the disabled and elderly people, by which they refer to assisting them with dressing, undressing, getting up, or going to bed, and so on; “feeding” rather than assisting the disabled adult or elderly people with eating; and “toileting” people, rather than assisting people to go to the toilet.
I have, in two and one-half years immersion in a nursing home's culture, been a stalwart supporter of nursing assistants, and remain so to this day. Good nursing assistants persist in their work against all odds and in challenging conditions, i.e. they can offer only the most basic care given staff person to person-served ratio and they often appear hurried, stressed, and exhausted doing so.
However, learning to refer to assisting people in terms that do not objectify those people can only benefit everyone involved because it is the first step to restoring respect and equality between the helper and the helped.
The “do to” language disregards the autonomy and integrity of disabled and elderly persons and conveys an underlying attitude that staff are managing, and even also controlling, the physical needs of the people they are assisting.
When programs and staff serve themselves, not the people they are supposed to be serving... when programs and staff administer, manage, and deliver services according to their own needs, not those of the people they are supposed to be serving... and when program and staff deliver services using language that objectifies those people they are supposed to be serving... those programs and staff have lost track of their missions, if ever they had them in plain view.
And is mission not that which distinguishes nonprofit organizations from profit making ones? It surely is not expansion, for that, if anything, likens the two.
