“English people are really bad at talking about feelings.”   “Eastern Europeans often talk in a very abrupt way.”  “Filipino staff are always kind and hard-working.” “Indian nurses are very reserved.”  “West Africans talk very loudly.” “Australians are very brash.” “Canadians are always lovely and polite.” “Gay men are so camp.”

How many of these comments have we heard or even thought ourselves?  Cultural generalisations and stereotypes are very much still out there.  We rightly challenge them as the notion that everyone from England can’t talk about their feelings, or people from all the Eastern European countries can be lumped together in one big group as ‘being abrupt’ is at best unhelpful, and at worst rude and rooted in prejudice.  Even the ‘positive’ stereotypes, for example about Filipinos or Canadians make huge assumptions and set high expectations!

However, stereotypes are often based on evidence or experience that there are certain qualities which are regularly associated with particular countries.  These are based on cultural norms that can be seen in many people from those places – even if there are many others who don’t conform to those norms.   Although I’m English, I consider myself as very open in talking about feelings, and my Nigerian brother-in-law isn’t ‘loud’ at all, for example.

I have recently had the privilege to witness amazing multi-cultural teams working in care homes in Canada, Ireland and the UK.  In one of our Butterfly Homes, there were over sixteen different nationalities and languages spoken.   This has generally brought a wonderfully vibrant energy to the homes, but has at times created some communication issues and a few cliques.

Do we talk enough about some of the challenges that integrating people of so many different ages, cultures, faiths and sexualities into one ‘big family’ as is the goal of a Butterfly Home?  Perhaps we are sometimes fearful of talking about these things for fear of being perceived as racist?

Reflecting on how others see us

I hadn’t considered much how I might come across to others, but in a recent visit to a care home in Toronto, my usual very chatty and bubbly style didn’t seem to go down as well as it often does. I felt an underlying mistrust and even hostility I hadn’t encountered before, which was unsettling.  In this home the staff team are predominantly black and Asian workers who have emigrated to Canada from all parts of the world.  A very open manager in the home said to me, “They are not used to an older, white, posh-speaking woman from England telling them what to do!” This gave me pause to reflect that being seen as ‘white’ and ‘English’ and ‘posh speaking’ gives me privilege which to some might be quite threatening or even alienating.  What could I do differently to earn this team’s trust? I didn’t feel I was ‘telling them what to do’, but that was how it felt to them and no wonder, with England’s colonial history?

Exploring common challenges in culturally diverse teams

These are some of the difficulties I have witnessed over the years, which I’m keen to put out there in the open, so we can talk about them more:

  • Groups of staff from the same country understandably will gravitate towards each other and talk in their own language.  This can make others feel excluded, even if this is not usually the intention of the people who are talking.
  • In some parts of the world, giving eye contact to an older person is considered disrespectful.   When training teams on best practice in communication, we can talk about this and stress that for many Caucasian adults living with dementia, eye contact can be very helpful.  This might be something that some workers will struggle with, but self-awareness and a willingness to adapt are important.
  • Team members do need to be aware of how abrupt or loud they might appear (whatever part of the world they come from) and be prepared to reflect honestly on how this might be experienced by those they support.  Peer feedback in a safe environment can support people to be more aware of their ‘style’.  We obviously don’t want people to change fundamentally who they are, but all of us need to be able to modify our approach in different contexts.   
  • Some team members from different parts of the world might find it harder to initiate conversations or be familiar with references relating to the history, music, food and other key topics linked to those of the ‘majority culture’ in the home. Curiosity to find out more and to listen and learn can be a helpful start to addressing this.
  • Lack of confident spoken English conversational skills can present a real barrier – especially when talking with people with cognitive impairments and/or hearing problems.  Are there ways of offering more English-speaking classes for people who would like them? (an in-house TEFL teacher, for example?)
  • A key part of the Butterfly philosophy is for team members to share photographs and stories about their own lives e.g. children, pets, weddings and holidays.   Nurses trained overseas might have learnt to behave in a much more formal and ‘professional’ way, so this won’t necessarily come naturally to them.  Interestingly, in a Butterfly care home in Devon in the UK, a nurse from India who is pregnant, is now sharing more of herself related to her pregnancy and gaining advice from people living in the home about childbirth, looking after babies etc.   This is a great example of how people can change and learn.
  • How well are we supporting those living in the care home who don’t have English as a first language?  What must it be like to never hear your own language spoken?
  • How emotionally safe do gay, lesbian, trans or bisexual people feel about being open about who they are? What happens if there are team members from cultural or faith backgrounds who are uncomfortable with LGBTQ people?

Why is it important to talk about some of these things?  By acknowledging the issues, we can start to put in place some support strategies to help address them.

Teaching teams about specific cultures and eras

Many years ago, a theatre company of older people called the Good Companions, led by Pam Schweitzer created a play for the turn of the new century in 2000 which told the everyday stories of older adults who had lived through the 1940s, 50s, 60s and beyond, based on the reminiscing of the older actors themselves.  It was a glorious insight into home life, wartime, raising children, entertainment and lots of other experiences from those years.   We used this play to train a diverse team in a care home in Kensington and Chelsea to give them greater understanding of the backgrounds and lives of the people who were living in the home at that time.   The teams who participated in these sessions were inspired and moved by the stories they heard.  What was particularly touching was that although they learnt a lot about the distinctive experiences of the white British Londoners in the stories, many of the staff from Ghana, the Caribbean and other parts of the world reflected on some of the themes which were actually very similar and relatable to their own families’ stories.

What unites us is so much more than what divides us.

Ultimately, this is perhaps the biggest goal when creating ‘family’ – to celebrate our differences, to let each other know what we need to feel a sense of safety and belonging, but also to remember that our shared humanity is the glue which will ultimately hold us all together.

What has your experience been of talking about these vital and sometimes personally confronting topics?

MCM Trainer & Consultant
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