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The power of language - nursing home resident vs aged care consumer

OPINION - A few years ago, when the Royal Commission into aged care began, so too did the aged care reforms which brought about legislative changes, as well as a new set of industry standards.

Older adults should have a say in how they want their care and services delivered to them (Source: iStock)
Older adults should have a say in how they want their care and services delivered to them (Source: iStock)

Along with these changes came a new way of describing nursing home residents. Previously, in all formal descriptions, nursing home residents were called care recipients. Informally, care recipients were known as residents.

Then all of a sudden, the language changed and formally and informally, care recipients and residents respectively, became known as aged care consumers.

Since then there has been quite a bit of backlash towards the title change, not only from aged care providers, but care staff, the general public, and aged care consumers themselves who still preferred to be called residents.  

But this is because the Government didn’t really explain why there was a change, and why the change was important. 

In addition to this failing, the Government only changed some of the literature. For example, the most current version of the Aged Care Act, still uses the terms care recipients and residents. Even members of Government refer to aged care consumers as “residents” in their speeches and general announcements to the public. 

So why are we bothering with making the change? Well, to really understand this, we must go back to 2010 when the mental health reforms were underway. 

During this time, mental health patients were fighting for more say into their healthcare, more individual support, more advocacy. 

There was a high incidence of seclusion and restraint, at time for punitive reasons than a clinical need. 

There was a huge power imbalance. The mental health reforms rose to balance the power and empower patients to be a driver of their own “recovery”. Healthcare started to become more of a collaborative process. 

To achieve that, language was used to empower patients. The word patient already placed people seeking mental health treatment in a position under the authority and power of the clinician. 

Patients do what the doctors tell them, end of story. So, changing the label from mental health patient, to mental health consumer, endeavoured to bring about some power to the patients, as they were “consumers” of a service, a customer if you will. 

Subsequently, they pushed for rights like those any consumer, customer or patron of a service may have, and may often expect. 

Imagine going to a restaurant and being told that you couldn’t have the porterhouse, they were only doing salmon, and you had to eat that because that was your meal. Imagine the outrage! 

In a restaurant, the consumer or patron has choice, has waitstaff who care for their needs, and there is often mutual respect and a balance of power. The consumer gets what they want, and the service provider gets paid and delivers the appropriate service.

Jump forwards now to 2018, when the Aged Care Royal Commission formed, and the aged care reforms started to make changes. There were and still are, many similarities between mental health patients and nursing home residents. 

Power imbalance, lack of choice, impersonal care and treatment. We needed to change this from the ground up, and that started with empowering older adults to have a voice, to have choices, to have a say in how they wanted their care and services delivered to them. 

And so, the language changed to label nursing home residents as consumers of an aged care service. 

To empower these older adults into speaking up, to acknowledge that they are in fact paying for a service, and therefore should be treated like a customer, a patron, an “aged care consumer”.  

They are no longer a resident of a service, like a tenant with a landlord overseeing their care. They are now on an equal and balanced platform.

In summary, language and how we define and label people is an incredibly important part of aged care reform. Just like how it was with mental health reforms a decade ago. The label of patient and resident creates an imbalance of power. 

Using language such as “consumer”, enables people to feel empowered so that they can be involved in their own healthcare needs and decisions.

​Nishan Saparamadu (Photo: supplied)

Nishan Saparamadu is the Director and Director of Nursing at Della dale Aged Care in Victoria. He has a science degree from Melbourne University with a double major in Psychology and Neuroscience. He went back to university in 2008/09 to complete a Masters of Nursing Science and became a nurse after he finished his masters. He also has a Graduate Diploma in Mental Health Nursing. In Victoria, he worked for seven years at Austin Hospital as a psychiatric nurse while also working as the Deputy Director of Nursing at Della dale Aged Care. Since 2018, he has taken on the full-time role of Director of Nursing at Della dale. Nishan is currently in the process of getting a Master of Business Administration (MBA) from the Melbourne Business School.

Della dale Aged Care has been Nishan's family business, starting in 2002. His mother dreamed of owning her own nursing home and Della dale was named after her, translating to Della's House. Nishan says her mother wanted the nursing home to be like a big home with every occupant feeling like a member of the family.

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