"The Dirty Words of PACE" is a phrase I've coined to help us remember what NOT to say out loud.
If you were at the (very fun) pre-conference workshop presentation at the NPA Conference in San Diego, you had a deep dive into The Dirty Dozen -- the 12 dirtiest words we use. These are all words we inherited from CMS. In each case, these words create barriers with the person we are speaking to.
Why "Nursing Home" Is the Dirtiest Word of PACE
The term "nursing home" triggers strong reactions. People associate it with losing independence, feeling judged, or being forced into a situation they don’t want. At its worst, it is associated with neglect and abuse.
Nobody is Going to a Nursing Home, Ever
PACE marketing often says "Alternative to a nursing home." This is wrong on 3 counts:
- PACE is factually NOT an alternative to a nursing home. PACE does not and has never offered 24/7 supervision of people with skilled nursing needs. PACE does not provide 24/7 home care or standby care. If someone needs a nursing home, truly, then they are likely not PACE eligible.
- PACE is not "intercepting" people on their way to the nursing home. We can't enroll people that quickly (except one PACE in the Pacific NW, kudos to your 24 hour enrollment process).
- NOBODY is going to a nursing home. Nobody believes that they will ever go to a nursing home. And if they don't believe that they are going to a nursing home, and if they would never go to a nursing home unless forced to, why would we *advertise* that PACE is an alternative to... to this thing nobody wants.
PACE is for People with "a Nursing Home Level of Care"
A PACE enrollment representative is meeting a potential participant. They are meeting INSIDE a nursing home. PACE-man says, "it's for people who need a nursing home level of care." Potential participant says, "Well, that's not me, I don't need nursing home care, I don't need to be here."
PACE is an "Alternative to a Nursing Home"
A PACE Director of Marketing has filled the PACE center for an evening of a four-course dinner and "get to know PACE" to potential participants in the community. (FYI, we did not recommend nor arrange this but an outside "senior living marketing" firm sold her on this... and on paper, it looked very good. This was an experiment. Not all experiments work.)
I am seated at a table with a woman in a wheelchair and her county caregiver.
Director of Marketing tells a beautiful heartwarming story about how PACE changed one man's life through personal care and attention. And she wraps it up by saying, "PACE is an alternative to a nursing home."
And... at that moment, the woman in the wheelchair loudly says, "Well, I don't need a nursing home so I don't need this PACE. Let's get out of here." She pushes her wheelchair back from the table and she is already down the ramp before we can even process what just happened.
What is a Nursing Home Level of Care?
In North Carolina, a NHLOC is a person requiring assistance with 3 activities of daily living. This is about the only state where this is codified. But no PACE organization can define it, publicly and in writing. If we can't define it, why use it? If it can't be defined, does it have meaning? Or is it jargon that let's PACE imply, "we decide."
How Messaging Changes Across Different Channels
The right words depend on where your message is shared. Here’s how to adapt your approach for digital ads, face-to-face talks, and brochures.
Face-to-Face: Building Trust
In conversations, the term "nursing home" creates immediate resistance. You’ve probably seen it happen—someone stiffens, looks away, or says they aren’t interested. That’s because the phrase can feel like a label or a loss of control.
Instead, use softer, more positive language:
- Instead of "nursing home level of care," say: "a little extra help to stay safe at home."
- Instead of "alternative to a nursing home," say: "help to keep living the way you want, at home."
Focus on their goals and needs, using open-ended questions like:
- "What’s been on your mind about getting extra help?"
- "What would make it easier for you to stay independent?"
Brochures: Positive and Easy to Share
Brochures are often shared with others, like family members or caregivers. Because they last longer than an ad, words like "alternative to a nursing home" can feel stigmatizing or too direct. Instead, focus on what PACE offers.
For example, instead of focusing on what PACE isn’t, try phrases like:
- "Helping you stay safe and comfortable at home."
- "Support to live well, wherever you call home."
Facebook Ads are in a "Private" Feed, They're not "Digital Ads" on news sites
In digital ads, like those on Facebook, people are often scrolling alone. Phrases like "stay out of the hospital and nursing home" work well here (we've tested it) because they’re direct, easy to understand, and tap into common fears. Plus, privacy allows people to engage with the message without judgment.
- Keep it clear: Use language that immediately explains the benefit.
- Address fears: Offer solutions to things people worry about, like losing independence.
- Be concise: Grab attention quickly and deliver the message.
Tailoring the Message
Here’s how the phrase “nursing home” can be adapted across channels:
| Channel | Suggested Language |
|---|---|
| Digital Ads | "Stay safe at home and out of the hospital or nursing home." |
| Face-to-Face | "We help people stay independent and get the support they need, right at home." |
| Brochures | "All the care you need, while living at home." |
Meet People Where They Are
The words you choose can either connect or create barriers. In digital ads, direct phrases can resonate because they’re private and clear. In conversations, softer, more personal language builds trust. In brochures, focus on benefits and empowerment.