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Culture Clash: Opportunity or Conflict?

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Culture clash: Opportunity or conflict?

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.

2
CONFLICTING CULTURES

The culture of many healthcare environments, including residential care for elders, often follows traditionally hierarchic models in which the patient's schedule is determined by the schedules of the workday and shifts, task lists and power structure. In contrast to this, many families follow a more collaborative style of care, where family members consult with each other about how best to meet the needs of the elder. When the family member comes in and, because of a prior caregiving relationship or simply because they know and are concerned about the elder, assumes he or she is part of the care team in the community, we sometimes find ourselves with a problem. Perhaps we bristle at having a professional opinion questioned; perhaps we assume the family member is an adversary, taking time from our day with difficult questions or a different opinion of what a loved one may need.

In many cases, family members who want to be involved in informing care are viewed by the professional caregivers and managers as interlopers, or worse, nuisances. A conflict can naturally arise from this attitude because, of course, the family member simply sees involvement as a natural part of continuing to

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