By Marge Knoth, Author, Activity Professional
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Author, Activity Professional
Valley Press Books

Marge Knoth attended Purdue
University and took her activity
director training at Indiana
University and her social
service at Ball State.  She is
the author of ten books for
activity professionals. Her
books have been used as
teaching guides in colleges,
trade schools, and in activity
director courses throughout the
U.S. and Canada. They have
won both national and state
awards from the National
Federation of Press Women
and Women’s Press Club of

Marge has written a monthly
column, "A Letter from Marge"
for Current Activities in Long
Term Care.  She has been
published in Family Circle,
Lady’s Circle, Women’s Circle,
Indianapolis Woman, Christian
Science Monitor, Event,
various Christian and craft
publications, and other
magazines and newspapers.
She wrote a weekly newspaper
column called “Do You
Remember?”, and wrote and
recorded a long-running series
of nostalgic radio
commercials.  Also, she is a
motivational speaker having
traveled the United States and
Canada speaking at many state
and province activity
To Order Books by Marge Knoth
When Words Fail:
Crossing Cultural Barriers

You have a new resident. She speaks little English You speak only English. How do you
communicate? How can you involve her in meaningful activities?

As our world becomes smaller, more and more activity directors are finding themselves
with residents from diverse cultures and backgrounds. Unless you are multi-lingual,
there are no easy answers. Even so, there are ways to communicate without words.
People are people anywhere you go–with feelings, sorrows, hopes, and dreams.
Understanding a little about non-verbal communication and about other cultures can be
of great help. You may wonder why Henry is so affectionate, why Myrtle is so snooty, and
why George continually stares at you. Though these peculiarities can prove frustrating
to an activity director, to the resident his behavior is as natural as the place where he
was born.

Julius Fast in his most interesting book Body Language, and others, point out
characteristics pertinent to certain nationalities. As we explore some of them, I in no
way am saying that all people of a particular background must act in this manner.
Individuals are extremely disparate and cannot be put into any one mold. With that in
mind, let’s examine some of these distinctive traits and some differences in our

As Americans, we are used to a personal space about us. Unless we are intimate with
someone, this may be two-and-one-half to four feet. For New Yorkers, though, who are
often seen as cold and unfriendly, that personal space may be different. Because of
crowded conditions, the New Yorker’s personal space is not two to four feet, but rather
limited to his own body. Consequently, for a stranger to touch or speak to him on a
crowded subway or a busy street might be invading his personal space. Japanese
people like crowding together; it is a sign of warm, personal intimacy though they
seldom touch when talking to one another. Chinese people like 36 inches personal
space. To them, Americans get too close. Arabs are less concerned about personal
space. In conversation, they like to touch, feel, even smell the other’s breath.

As Americans we wait in lines--at the movies, check-outs, restaurants, and stop lights.
It is as natural as breathing. But suppose someone pushes himself in front of us in
line. No doubt we would be upset. But in some Middle Eastern countries, this might be
acceptable behavior. Koreans are not bothered by pushing and shoving in stores or
getting on and off buses or trains. They feel no need to apologize for this “unacceptable
in America” behavior. Australian and Polish people may choose to avoid the structure of
line-forming and just gather around in a group, much to the frustration of North

In America, if we are referring to ourselves, we point to our chest. Japanese point their
forefingers to their faces when referring to themselves. Chinese point to their nose.
In America, the “okay” sign is the thumb and forefinger forming a circle and held up. In
France and Belgium this would be an insult. It would be telling the person they are
worth “zero”.

We have probably all been guilty, at one time or another, of judging someone as being
“aloof.”  In reality that person may not be aloof at all; it is just in how we perceive them.
In the United States, it is natural to speak to our neighbors, if for no other reason than
proximity. For the English, though, that is not necessarily a reason to speak.
Relationships there may be formed on social standing more than physical closeness.
Because of England’s small size, the English people respect one another’s privacy by
not being overly friendly. With so much space in North American, we may not
understand how the English deal with privacy and may wrongly regard them as
detached or withdrawn. French people, on the other hand, respond to crowding in a
different manner. They like to be close, more involved with one another. Though
German people may appear reserved, it is because they very much covet their private
space and may go to great lengths to protect it. You may see many fences, hedges, or
walls on their properties.

Even silence can mean different things to different cultures. Chinese value silence
more than speaking. It is a sign of politeness and contemplation, perfectly acceptable,
and even customary. One should not interrupt another who is speaking. In China, if a
man proposes to a woman and she remains silent, he is not discouraged, but realizes
this probably means yes. In America, silence would indicate her uneasiness about
marrying him or maybe even refusal.

In Japan it is rude to blow one’s nose in public. They may carry a handkerchief, but only
for wiping the mouth or drying their hands when using public restrooms. In Korea men
have preference over the woman. He precedes a woman into a room , and she is the
one who helps him put his coat on.

Chinese love to applaud. When you enter their home, they may applaud you. You
should respond with a “thank you”. Also when they point, they use the whole hand not
just the pointing finger . Chinese hesitate to say “no”. If they are uncomfortable with the
decision or situation, they may lean their head backward and nosily suck in air through
their teeth.

Everyone has a need to withdraw from time to time. As Americans, we just go off by
ourselves for a while–perhaps shopping, to the woods, or just stay home for the
evening. The Arab who desires privacy, even while in the presence of others, might just
withdraw into himself. The Englishman might do likewise. As Americans, when we
perceive such behavior, we may feel snubbed or insulted. Our awareness of these
diversities can help us become more tolerant of others. If we see a person continually
stroking or fondling an object, we might recognize it as a plea for understanding. He or
she may be lonely, frustrated or uncomfortable.

Even how we look at one another can cause conflicts. In our country, etiquette does not
allow a man to continually stare at a woman. For a Frenchman, though, this may be
perfectly acceptable behavior, even complimentary to the woman. Arab men look each
other directly in the eye as they talk. American men, on the other hand, limit eye contact
because it could mean other things. It might even be a threat to their masculinity. If a
child does not look us in the eye, we might assume he is lying to us. In Puerto Rico and
other Spanish speaking countries, out of respect, children refrain from looking an adult
in the eye.

In China and some Mediterranean countries men might walk hand in hand. In America,
this would no doubt be scorned. East Indians and some Middle Easterners can be
offended if you hand them something with the left hand. This may be because in some
countries the right hand is used for eating and the left hand for bathroom needs. If one
bears the bottom of his feet, some Mediterranean cultures are offended. A Filipino was
outright angry when her American roommate placed her shoes on the closet shelf
overhead. By having the soles of her shoes above the head, it was an offense against
her person, much like we would say, “being walked one.”

A nurse assisted a woman, whom she thought to be of Egyptian heritage, in giving birth.
The woman was almost hysterical screaming unmercifully at her husband in her native
tongue as he cowered in the corner saying nothing. Finally the nurse grabbed the
woman and instructed her to get hold of herself. The woman slapped the nurse across
the face. Later the nurse understood. It seems in the woman’s country, the female is
subservient. Only when giving birth is she free to speak her mind to her husband. I’m
sure you get the idea how dissimilar cultures can be.

So what can you, as an activity director, do to help the transition or residents who come
from other backgrounds?

Though language barriers are difficult, there is one gesture that is absolutely universal–
the smile. It is understood in any language. A frown, a wave, or a wink, also, are all
easily recognizable.  Other common sign language might include: putting our first finger
to our lips meaning “quiet”;  folding one’s hands to express prayer; holding a hand up
meaning to “stop”; or motioning one
to come with and an upturned palm and moving fingers. Most international residents
can appreciate a gentle hug, a warm squeeze, or our sitting with them and holding their
hand. Still some, because of culture or just personal preference, may not want to be
touched at all. We must be sensitive. We can listen and let them talk, even if we don’t
understand their language. When we give instructions to those not totally familiar what
our language, we can speak slowly and make directions brief.

Much can be communicated by drawing simple pictures. We all know residents can
express themselves by using picture boards indicating food, rest, drink, bathroom, and
recreation. Still, let’s look at some other ways to involve those from other cultures in our

* We can have their families and friends tape messages for them in their native tongue.
* We can play their native music on tape or CD for them.
* We can show travelogues about their homelands.
* We can display in the facility or in their rooms, flags from their native countries.
* We can take residents to ethnic restaurants.
* We can have in-house food demonstrations, preparing their native foods. They can
help cook or at least give advice on how to do it.
* We can purchase foods from specialty stores and hold a facility tasting party.
* We can research their holidays at the library or on line and celebrate them at the
* We can contact our nearest university’s international center and ask them to provide
native dancers, musicians, or speakers.
* We can contact high schools and ask them to provide foreign language students to
communicate with residents or sing with them, or provide native entertainment.
In addition, we can hold “special events” with particular countries in mind.
* Perhaps a “Caribbean night” with reggae music, tropical dishes like chicken, rice,
black beans, and passion fruit.
* A Mexican fiesta might include tacos, bright ponchos, a piñata for residents to break
open and to eat the candy.
* An German Oktoberfest might feature accordion music, German waltzes, yodelers in
native costume, and red-checkered tablecloths. Foods can be pretzels and beer,
sauerbraten, bratwurst and sauerkraut, and German chocolate or black forest cake.
* You might hold a Chinese New Year celebration with a simple parade, masks, and
Chinese food. Let residents try chopsticks.
* The Irish can be honored on St. Pat’s Day with shamrocks, green hats, a jig
demonstration, and Irish stew.
* You could hold a special tea complete with Japanese tea, and dainty tea set, a
Japanese flower arrangement, a Japanese newspaper, and a speaker.
* Consider holding a “Black History Month.” African and Afro-American culture can be
brought out with songs, dance, and food. Invite guests to speak, sing, dance. Post
photos of prominent black figures: George Washington Carver, Martin Luther King and
Rosa Parks.

The ways of bringing an international flavor to our activities are virtually endless. By
providing these special days, we can help those residents whose heritage is different
than our own feel more at home and enlighten our other residents about different

Sure we are going to have difficulties communicating with residents who have little or
no understanding of the English language, but as activity directors, we are very
ingenious.  If one thing doesn’t work, we try another. When all else fails, we can still
offer a soft voice, a listening ear, a gentle smile, and a warm hug. Patience and love go
a long way, as does a heart full of genuine love. And that is one thing activity directors
are seldom short of.

God bless you all. Marge