Culturally Appropriate Verbal and Non-verbal Communication

Questions should be adapted to age and acculturation level. It is important for the health care provider to slow down when communicating with an Indian elder, especially during initial encounters and when explanations of treatments/medications/health care decisions are being given. Questions should be carefully framed to convey a message of caring, and not indicate idle curiosity about the culture or cultural practices.

Conversational Pace

American Indian languages have some of the longest pause times, compared to other languages, and especially English. Elders frequently complain that English speakers “talk too fast”. Silence is valued, and long periods of silence between speakers is common. Interruption of the person who is speaking is considered extremely rude, especially if that person is an elder.

Non-Verbal Communication

Physical Distance: Several feet is usual comfort zone.

Eye Contact: Not direct or only briefly direct, gaze may be directed over the shoulder, and sustained gaze as this may reflect aggressiveness.

Emotional Expressiveness: May be controlled, except for humor

Body Movements: Minimal

Touch: Not usually acceptable except a handshake