On a daily basis I hear people use the word facility, and it’s almost always modified by the adjectives such as assisted living, nursing, and care. I’ll stand in the supermarket line and overhear a conversation between two people about moving a frail relative into a nursing facility. I’ll read an article or watch a television program, and sure enough, if an elder who needs care is involved, they go to a facility. I’ll listen to a social worker (who should know better) in a hospital tell a friend that her parent needs to be moved from the hospital into a rehab facility (and my friend has two days to pull off the move).
Frankly, I can’t stand the word, and I would not want any member of my family to live, or stay for that matter, in a place that refers to itself as a facility. The word always reminds me of the situation described by Ann Fadiman in her book, The Spirit Catches You and You Fall Down, which tells the story of a medical system that was unprepared to understand the types of relationships in an ethnic community and the kinds of support to help a Hmong family with a sick daughter. I wrote a post about the book.
The dictionary defines facility as a space or equipment necessary for doing something. No where in the definition is there any mention of community, relationships, friendships, empathy, or support, the qualities that define a place where people live and receive care. We need to be careful when it comes to how an elder or caregiving community looks. The most beautiful places for elders can turn out to be facilities — without many of the above qualities. Others that are less than perfectly groomed may be wonderful and caring communities.
My family is lucky. The places where our elder parents have lived or receive car think of themselves as communities. The communities happen to occupy space. But the building or buildings — the facilities — are not the essence of where they live. Virginia Mennonite Retirement Community (VMRC), a place that I happen to know quite well, believes in the values promoted by the Eden Alternative organization, a group that is “dedicated to creating quality of life for Elders and their care partners, wherever they may live.” You won’t hear people use that word at VMRC!
Left to me, I’d never use the word facility — unless I am referring to equipment in a lab or hospital, for instance. Even when patients visit that lab or hospital, they are visiting people and not equipment. I have to believe that most of the people in nursing homes and assisted living pride themselves in the communities that they create and the empathy and care that they provide.
So let’s give up using facility, cross it out, and try hard not to ever modify it with adjectives such as elder, senior, senior care, nursing, and respite. Let’s respect places that define themselves by their values, relationships, and the communities they create and let’s encourage the other places to become more than spaces and equipment necessary for assisting older people.