Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings

Abstract

Linguistic and ethnocultural diversity in long-term residential care is a growing trend in many urban settings. When long-term care staff and residents do not share the same language or ethnocultural background, the quality of their communication and care are jeopardized. There is very little research addressing how staff and residents communicate when they experience a mismatch in their language and ethnocultural backgrounds. Thus, the goals of the present study were to 1) document the verbal and nonverbal behaviours used by staff and residents in diverse interactions, and 2) identify and account for behaviours that either promoted or detracted from positive communication by drawing on principles from 'Communication Accommodation Theory'. Two long-term care facilities in British Columbia Canada were selected due to the diverse linguistic and ethnocultural backgrounds of their staff and residents. Twenty-seven staff and 27 residents consented to being video-recorded during routine activities (e.g., mealtimes, recreational activities). The recorded observations were transcribed, translated, and coded using qualitative descriptive and interpretive analyses. A number of verbal and nonverbal behaviours were identified and interpreted in relation to whether they promoted or detracted from positive communication. The findings point to considering a variety of proactive strategies that staff and administrators could employ to effectively accommodate to language and ethnocultural diversity in long-term care practice.

Resident and family member perceptions of cultural diversity in aged care homes

“…The caring attitudes and behavior they observed in staff enhanced their positive experience. Despite these positive findings, similar to previous studies, cross‐cultural communication was perceived as a challenge and compounded by residents' sensory impairments (Kim et al, ; Small et al, ). However, residents demonstrated an ability to facilitate communication and ensure their care needs were met.…”

“…Thirty‐five percent of the aged care workforce were born overseas and 24% are from non‐English speaking countries, with the majority coming from Asia (King et al, ). This workforce profile is similar to those reported in other developed nations that have an ageing population and skill shortages (Walsh & Shutes, ; Hart & Mareno, ; Small et al, ). There are an increasing number of studies across the globe on the impact of cultural diversity of care workers on services (Walsh & Shutes, ; Nichols et al, ), or factors affecting quality of care for residents from a CALD background in aged care homes (Runci et al, ; Kim et al, ).…”

“…Most studies on cross‐cultural care services in aged care homes have focused on staff communication with residents (Walsh & Shutes, ; Kim et al, ; Nichols et al, ; Small et al, ). This study extends upon previous findings by identifying how residents also contribute to cross‐cultural communication.…”

“…Unmet psychosocial care needs for older people are reported even in aged care settings that are culturally congruent (Ryvicker, ; Turjamaa et al, ; Ryan & McKenna, ). The cultural diversity of residents increases the complexity, making it more difficult for staff to meet individualized psychosocial care needs (Runci et al, ; Kim et al, ; Small et al, ). This study provides insight into how limited culturally and linguistically appropriate activities are in meeting individualized psychosocial interactions for CALD and non‐CALD residents.…”

Improving socially constructed cross‐cultural communication in aged care homes: A critical perspective

“…Effective CCC requires residents and staff to value each other and accommodate each other's communication styles (Gay, ; Ting‐Toomey, ). These conditions can only be achieved if they overcome widely reported barriers, for example not valuing people from other cultures, ethnocentrism and racially negative attitudes and discrimination in aged care homes (Bourgeault, Atanackovic, Rashid, & Parpia, ; Small et al., ; Walsh & Shutes, ). As such, it is important that CCC be embedded into the care provided for residents in aged care homes.…”