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What’s in a Word? Language and the Direct Care Workforce

June 4, 2018

Words have power.

Whether we’re talking about strategically-selected words in a poem, or the words said in anger that “cut to the quick,” the power of words is undeniable.

I remember something a co-worker once shared with me. She was from the Deep South and claimed that you could say anything to anyone, no matter how egregious or offensive, as long as you followed it with: “bless her heart.” (“She’s as big as a barn… bless her heart!”)

I don’t know if my former colleague’s observation is true. But I do know that words can lift a person up or tear them down. They can support and respect, or they can disregard and minimize.

Words can shift how we see and think of another individual–and how they come to think of themselves.

The terms used in eldercare services are rich with examples of the power of language. With the growth of the “culture change” movement over the past 30 years, more attention has been placed on overcoming language that doesn’t support dignified, person-centered care.

For example, we are less likely today to refer to the person receiving services as “the patient” or “the hip in room three”—terms and designations that inadvertently reinforce weakness and disease, and might render that person anonymous.

We are more likely to refer to this individual as “an elder” or “older person,” or by their name—personal terms that honor the individual.

As awareness increases about the impact of our words, the status of the person receiving services will be elevated and seen in a different light.

That awareness should also extend to how we refer to the person providing the care. The goal should be to consistently use language that respects the knowledge and value of the direct care worker.

Here are some examples:


Term: “Low-skilled/unskilled” worker

Why change it? There is a definite set of skills and specialized training required of people in the caregiving profession.

Instead use: “Care professional, skilled professional, Personal Care Assistant (or other specific occupational titles)”


Term: My “helper”

Why change it? This term belittles the role of caregiving, making the job seem inconsequential. Proper caregiving for many is a matter of life and death.

Instead use: Their name


Term: A “stepping stone” to a real job (nurse, CNA, etc.)

Why change it? To refer to the direct care worker role as a “stepping stone” diminishes the validity of the role and belittles those who choose to remain in this profession without becoming a nurse or CNA.

Instead use: “A chosen profession, a valid career choice”


We can all use language that recognizes the value of caregivers. People who deliver care, and the people who receive it, deserve empowering descriptions. And it can start with only a few words.

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