By - Judah L. Ronch, PhD
We talk a lot about culture change, but what is it about the culture that needs to be changed, and which culture are we talking about? In all community care settings, there are actually a few cultures that come together and, sometimes, collide. We have examined culture before and used Edgar Schein's definition, which we have loosely summarized as “the way we do things around here.”
1 This definition applies to both the culture in the community where we are giving care and to the culture of the family from which this person has come, and sometimes these are the cultures that clash.
The culture of many healthcare environments, including …show more content…
Everyone wants to be informed as completely as possible about the situation: ignorance breeds anxiety, fear and anger, which fuels the conflict cycle.3
Keep these principles in mind in order to involve all parties on the solution team. Those working on the professional side would do well to remember that when families push back it may be because they are viewing the same situation through the lens of their cultural values. The family might not feel that the providers are wrong or bad, but that they see the situation another way. By marginalizing the family's viewpoint, we create the anger that we then blame them for. They become, in our view, difficult to deal with and an impediment to good care for the elder. But because we have not been able to honor their viewpoint, we have left them out of the solution process, creating a difficult situation.
On the family side, it may be that they are discounting the expertise that professionals have been trained to, and are proud to, bring to the problem-solving phase of care. Family members being dismissive of professional opinions further widen the gap in cultures of care. The truth is that both perspectives are needed to present the fullest information about the person and the illness or challenge. The more data points brought for consideration to the solution team, the better. Each culture brings something valuable.
If we remember the second principle, we will have compassion for those on the family side