Let's stop calling ourselves an "industry.".

Is long-term care really an "industry?"

One might ask, "Why all the fuss?" It seems that long-term care (LTC) has always taken for granted that it is an industry. Pick up any leading LTC publication, or listen to leaders of nursing homes, assisted living facilities or the organizations that represent them; and one will see that "industry" is the word they use. So, what's the big deal?

Reference the popular movie Titanic - simple, seemingly inconsequential mistakes led to the death of hundreds. I'm suggesting that a similar scenario might lie in wait for long-term care.

You have heard, no doubt, of the alleged promises mothers and fathers have asked their children to make: "Please, never place me in a nursing home!" This is a mindset with, no doubt, many apprehensions. Surely, some of this negativity has been rightfully earned by us who, as nursing home operators, endeavor to take nickels and dimes to run multimillion-dollar operations, sometimes through shortcuts that are unacceptable when caring for human life. From a global perspective, the service we have provided might not have been all that bad, but as with "rotten apples in the barrel," the good get tainted with the rest.

The baggage of the past will continue to haunt LTC, with the principal challenge coming from the government and its pledge to clean up delivery systems through rules, fines and threats - all made on the heels of further cutbacks in funding to provide care.

And what are we doing to address the matter? In the minds of some, perhaps little more than rearranging the deck chairs on the Titanic. Millions of dollars are being spent by provider organizations on media campaigns saying how good nursing homes and the care they provide really are. We are marketing our "industry" as one the American public can believe in because we have changed from the cold, uncaring people of the past to the warm, concerned caregivers of today and tomorrow.

We must understand the words we use and their implications - in this case, the perceptions that arise from them. Regardless of how often we say "we care," when we call ourselves something that is innately uncaring, an industry, we only waste precious resources that could be used in a much wiser way.

Think about it. When and if your time comes, do you want "personal care" provided by an industry or by a person who exhibits characteristics of a professional grounded on a specific discipline? For each of us who, as providers, professionals or other relevant caregivers, choose to respond to this rhetorical question, the answer will be clear, if we're honest with ourselves. We must change how we refer to ourselves, and we must do it now.

Depending on the type of organization we are, terms like field or profession - or perhaps even ministry, in some quarters - might work to convey a more consistent and welcome message to the society we serve. Diehards who are convinced that all said in this article is nonsense and little more than a play on words might wish to keep the word "industry," but perhaps we can reserve it for in-house use. Great thought must be given, in any event, to appropriate use of this word to avoid backsliding.

And before we trivialize this by referring to "political correctness," let's think about the potential scope of this change. We serve (directly and indirectly) residents and families; the public at-large; governmental entities, including regulators and payers; caregivers and managers in other fields; and, by reflecting a good example, provider groups and associations and vendors. We are attempting to enable residents, families, colleagues and the public to see long-term care from a different perspective.

It can't hurt. It just might help us assume our proper role much sooner, as the new millennium begins.

Daniel W. Farley, PhD, CNHA, is president/chief executive officer of GlenWood Park Retirement Village, Princeton, West Virginia.