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 Communication Reduces Cultural Barriers In LTC

An expert offers tips for overcoming cultural differences to improve caregiver-resident relationships.

 

Robert Kubacki, JD
Culture is one of many factors that affects how people communicate with each other. As diversity increases in long term care communities nationwide, culture plays an ever-increasing role in communicating.
 
As communication is filtered through a person’s culturally influenced expectations, aware care providers can look beyond differences to find common ground and reduce stress at the same time.
In most conversations, there is an unconscious expectation that communication preferences are the same as everyone else’s. Without cultural awareness, people are likely to criticize others for interrupting, speaking too loudly or too quietly, or attacking or ignoring.
In order to increase the likelihood that people understand to each other, communication should be viewed as an adventure of discovery.
In addition, care providers would benefit by recognizing the following five culturally influenced expectations:
  • How to display genuine concern;
  • How to establish trust;
  • How to determine acceptable speaking patterns;
  • How to identify problems; and
  • How to determine the degree of relationship connection.

Lost In Translation

Communication is an interaction between two or more people using verbal or nonverbal methods for the purpose of transmitting information necessary to satisfy personal or group needs. It begins with translating a thought, a feeling, or an idea into a message using words or physical gestures.
 
The message sender expects that the person receiving the message will recognize its meaning and respond appropriately. If the words or physical gestures mean something different to the listener, the sender might consider the response back to be inappropriate, nonresponsive, or nonsensical.
 
At its best, communication energizes, satisfies, and strengthens relationships. At its worst it is exhausting, induces stress, and undermines relationships.
 
A person’s culturally influenced social etiquette and communication preferences are acquired as a result of growing up in a particular social, socio-economic, or ethnic group. In any cultural context, the appropriate ways to be seen, heard, and have needs met are learned through social contact.
 
Once formed, these culturally influenced values and ways for socializing and communicating remain, to varying degrees, throughout one’s life. The stronger a person identifies with their culture, the more it serves as a comfort zone or provides a sense of belonging. Yet not everyone from the same culture or family behaves similarly.
 
It is important to avoid stereotyping (one person’s behavior reflected in an entire group). Within cultural or ethnic groups, individual styles and communication preferences vary due to many factors, such as personality, life experiences, socio-economic status, and physical or mental attributes.
 
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Communication Styles Vary

When two individuals share the same culturally influenced expectations, they will use and understand the same rules, meaning of words, gestures, silence, or pauses during their conversation. When the communication rules for one or the other are different, then their conversation becomes frustrating and stressful because both speaker and listener are sending and receiving messages whose meaning they do not understand.
 
The first culturally influenced expectation is how one displays genuine concern. Culture establishes rules for expressing emotions in an acceptable voice volume or the use, or nonuse, of hand and facial gestures while talking. With such rules, culture determines how to display genuine concern for another or an issue.
 Illustration by DrAfter123
At one end of this spectrum are cultures where speaking in a loud voice, displaying emotions like anger or joy in an obvious way, or using hands or facial expressions when talking are appropriate.
 
At the opposite end are cultures where displaying concern requires speaking in a low-volume voice that is calm and steady with no or minimal hand or facial gestures, and with restrained emotional expressiveness.
 
While both are appropriate in their respective cultural settings, when mismatched they clash. For example, if Robin Williams and Prince Charles were conversing, Williams would demonstrate his passion and concern openly with a variety of vocal variation and physical expression, while Prince Charles would keep an even tone of voice with little or no physical display or expression.

Establishing Trust

Establishing trust is the second culturally influenced expectation. Every culture has its own ways to ensure the survival of its members by providing guidance on how to determine if a person is trustworthy. Trust can be determined based on demonstrating relationship connectivity and establishing competency.
 
While both are important to establishing trust, culture advises which is most important. If a relationship is most important, trust building relies upon familiar appearances, customs and relationship connections. Once this relational information is established, then competency is considered.
 
If competence is most important, trust is established by a person’s knowledge or demonstrated skills, and relationship inquiries follow later. It is what one knows, not who someone is that counts.
 
Picture a conversation between Dolly Parton and Bill Gates, two savvy business people. Parton may begin talking about people they may know in common and then get down to business. On the other hand, Gates might begin wanting to know about Parton’s knowledge of the business deal on the table before talking about whom they both know.

Speaking Patterns

The third culturally influenced expectation encompasses acceptable speaking patterns. Who speaks when, and how often do they speak? Speaking patterns are similar to rules of the road. When two drivers come to a four-way stop or a rotary, which one has the right of way?
 
If speaker and listener know the four-way stop rules of talking, then the pace of their conversation has a clear beginning and end, and neither will interrupt the other.
 
If speaking is like a rotary, the speaker and listener know and expect that whoever wants to enter the conversation can do so at any time. They are comfortable with talking over and interrupting each other.
 
Frequently changing the subject gives life to the conversation. An imaginary on-screen exchange between Humphrey Bogart and Bob Hope might reveal that Bogart’s character would speak in succinct sentences with pauses, while Bob’s character would talk non-stop, interrupt Bogart’s character mid-sentence, and switch subjects.

Problem Identification

The fourth culturally influenced expectation is problem identification. Over the course of human development, people who lived in close proximity to each other developed elaborate processes for how to identify and talk about a problem without ever actually naming it.
 
This “don’t talk about the problem” approach allows people living close together to preserve relationships by using stories, allegories or indirect references while addressing the problem by not talking directly about it or enlisting the aid of a third party.
 
People who lived together, but not in such close proximity to each other, resolved disputes by distancing themselves and picking up the matter at another time or place. This allowed for the option to talk specifically and directly about the problem by “saying what they meant and meaning what they said.”  

Expectation

The fifth culturally influenced expectation, degree of relationship connection, concerns how individuals perceive themselves in relationship to their community. Is a person an individual whose sense of self and self-esteem is inextricably dependent upon their connection to their community, or an individual who belongs to, yet is independent of, their community?
 
Imagine if Mother Teresa were alive and she hosted “The Apprentice” instead of Donald Trump. Their respective perspectives would create two different shows. Communitarian cultures emphasize that without a community connection the individual will not survive. The group is owed the individual’s loyalty and assistance to ensure the group’s survival.
 
Individualistic culturally oriented groups, on the other hand, inform their members that each individual has the capacity to go out on their own, determine their own fate, and an ability to “pull themselves up by their bootstraps.” In doing so, the individual contributes to their group’s survival.
 
Tips, Resources, and Triggers
 
Robert Kubacki, JD, a part-time lecturer at Northeastern University in Boston, teaches classes on diversity and intercultural communications. He earned his JD from Western New England College School of Law and a Masters of Public Administration from Clark University. He can be reached at rwkubacki@gmail.com.
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