An Institutional Mindset




In my last post, I shared my initial impression of the physical aspects of the Green House Project based on a workshop group tour of a local Green House Home. While the design of the home is a key element in the Green House “revolution,” it is only one piece of the puzzle. There is also a set of core values and a philosophy behind the Green House approach. For a Green House Project home to succeed, staff and administrators must totally embrace these values. In future posts, I’ll outline what these values are, explore what they mean from the caregiver’s perspective and talk about the philosophy that makes the Green House model truly revolutionary. In this post, I would like to share a simple personal epiphany.

Embracing the Green House core values means shedding the institutional mindset that comes from working in a traditional long-term care setting for any length of time. During the workshop, I noted a kind of “born again” theme running through the presentations. One speaker actually used the phrase “in my former life in long-term care,” more than once. I got the sense that in order to accept the principles of the Green House model and practice them effectively, one must first go through a process of internal psychological change. My epiphany: as much as the Green House model appeals to me, I have not gone through that process and as a caregiver, I am still very much a product of my institutional work culture.

The institutional environment is task orientated. For a caregiver, this means going full steam through the shift, efficiently organizing your activity so that you can get as much done as possible in the time you’ve been given. That is how a good worker responds to heavy workloads. It is a necessary approach, because the alternative is allow the sheer volume of tasks to overwhelm you and ultimately you simply leave things undone. When it comes to residents, “things undone” is actually another way of saying “neglect.”

But residents aren’t “tasks” or “things to be done,” and to approach them this way is another form of neglect. So within this flurry of activity, a good caregiver will seek to engage residents on an emotional level. The posts on CNA Edge deal with this aspect of caregiving almost every single week. I’ve always thought of the Art of Caregiving involved the ability to go full tilt until the point of physical and emotional contact with the resident, then decelerate as if time was standing still. But the art is imperfect and we don’t always make that shift.

For a caregiver, shedding the institutional mindset means to liberate yourself from that anxious “gotta get it done” mentality with which we have been conditioned. There are tasks to perform in a Green House Home, but the work environment is such that they are performed within the context of the emotional and social relationship with the Elder and not the other way around. In other words, there is no reason to “decelerate,” because you don’t “accelerate” in the first place.

I think that with the proper support and appropriate training, most good caregivers would be both capable and highly motivated to make this psychological adjustment. But if the change is to be real and sustained, one must first be aware of his or her starting point.

For me, such a psychological shift would require me to reshape my definition of The Art of Caregiving. Perhaps the first step has been taken with my growing awareness of how much the institutional influence is still with me.

One thought on “An Institutional Mindset

  1. aortigara

    Yang, thank you for your insights and reframing of what ‘caregiving’ is. I believe it is that partnership and relationship that elevates the work for both staff and elder.


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