Although there are many psychological stresses in senior living and care, I’d like to focus on one: cross-cultural issues. I’ll describe the situation and then offer some tips for making diversity of culture a positive force in the workplace, not a detriment.
If the system for long-term care in your community is anything like the one that my parents and other family members were part of, a lot of the providers and staff members I’ve encountered hail from a wide variety of places, and many, perhaps a majority, are not US-born. For example, my mother’s providers were a mix of folks from Caribbean, Hispanic, Indian and other cultures. Providers and staff from Trinidad were not the same as providers and staff from Barbados, so even the broader Caribbean group was diverse.
Wherever we see cultures intersect, we encounter both benefits and challenges. The benefits of diversity are well-documented: Different perspectives and backgrounds lead to stronger decisions and a greater likelihood that a client will see someone they can relate to. The challenges are many. Different background expectations lead to different norms, and communication and attitudes about conflict may vary as well.
Noted Dutch anthropologist Geert Hofstede documented categories of differences, among the most important of which is the contrast between people from cultures with “high power distance” (maximal deference to authority) and those from cultures with “low power distance” (tendency to be more informal with authority). Many other factors come into play when people born in different places work together (for example, individualism versus collectivism, linear versus circular notions of time and other concepts).
Let’s explore further the theme of power distance. In a well-known study conducted in the early 2000s, it was documented that Korean co-pilots were so deferential to the pilots that even when they knew that the pilot was committing an error, they didn’t speak up. As a result, in the 1990s, Korean Air had a spate of very significant and avoidable mishaps. Some observers believe this same cultural norm may have contributed to the 2013 Asiana Airlines crash in San Francisco.
How might this manifest in a senior living and care setting? A nurse or other caregiver from a “high power distance” culture may see an error being committed by a peer or a supervisor and be reluctant to raise the issue. The outcome of that omission could range from insignificant to catastrophic.
A supervisor from the same kind of culture may be aware of the tendency but not know how to break the pattern (or may not want to, feeling that deference equals respect). A supervisor from a “low power distance” culture may not realize that anyone would refrain from speaking up. We all fall prey to the fundamental attribution error and assume others think like we do.
What can leadership do to help make sure that a blend of cultures is 100% positive? We suggest a few things.
- Leaders should learn more about the cultural backgrounds and expectations of their employees. Some of this learning can be reading or watching videos, perhaps even taking courses. And some of it needs to be person-to-person, but not with the employees. It’s stressful enough to be working in a senior care setting without feeling the need to be a cultural ambassador and a culture coach.
- Groups should be allowed time to train together in settings lead by a competent and experienced facilitator. Those trainings should focus on things such as the Hofstede factors and may go further and deeper. The focus of the training should be on how cultural expectations and norms may lead to different ways of approaching fundamental tasks at work, as well as how people perceive and approach difficult conversations and conflict.
- The cultures of all the employees should be recognized and honored. In many respects, this is a legal requirement (especially with regard to religious expression and nondiscrimination), but in others, it’s purely a matter of creating a welcoming and psychologically safe workplace where people feel comfortable, in their own way, offering suggestions for improvement and giving and receiving feedback.
When handled appropriately by leadership, the diversification of the workforce in senior living and care settings is an absolute joy to witness. My mother, who was born in Poland and spent her whole life in the United States speaking with an accent and analyzing the world with exquisite folk sayings unique to the culture of her youth, formed amazing relationships with providers from around the world. Long after she was unable to travel, my mother continued to expand her horizons through the fabulous people who provided exemplary care through her final years.
She’s just one example of countless others who benefited immensely from the diversity among caregivers. In her institutions, whatever conflicts may have lain beneath the surface were handled by leadership in ways that never manifested visibly — and my siblings and I were at her side a lot, so if there were significant cracks, we would have likely seen them.
Managing a diverse workforce in the challenging environment of long-term care requires a high degree of leadership skill. Residents’ and patients’ lives, and the quality of their lives, depend on it.
Richard Birke is the chief architect of JAMS Pathways and is experienced at resolving complex, multiparty disputes. With more than 35 years of hands-on dispute resolution, he draws on experience in a wide range of disciplines — including mediation, psychology, economics, law, communications, negotiation theory, strategic behavior, and diversity, equity and inclusion — to apply the right tools to every client situation. He can be reached at [email protected].
More information about JAMS Pathways can be found at www.jamspathways.com.
The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.
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