Say yes to that cup of tea! Sharing food builds trust

Get in touch with patients’ cultural practices 

Anyone listening to news programs in recent months will say that we are a nation obsessed with food and eating. If the news report isn’t talking about overeating and obesity rates, it’s focusing on the latest diet program to find favor with the public.

While the media may be focusing on food and our culture, home health managers may be overlooking the social importance of sharing meals or food with patients, says Gottfried Oosterwal, PhD, director of the Center for Intercultural Relations in Berrien Springs, MI. "Universally, eating together is a way to form a bond, build a sense of community, and develop trust among people," he explains.

"In different parts of Africa, strangers are not allowed into a village until they have shared a meal with someone from the village; and in Mexico, a business lunch may last two to three hours with no business discussed at all," notes Oosterwal. "We don’t want to do business or share our personal information with strangers, but if we’ve shared a meal, we aren’t strangers," he adds.

Unfortunately, many home health agencies have policies that prohibit a home health employee from eating or drinking in the patient’s home, Oosterwal says. Adherence to this policy can make it difficult, if not impossible, to establish a trusting relationship with members of different cultures, he points out.

It is important to understand how the different cultures represented by your patients view food. Home health employees need to be aware of the differences and know how they can make the first visit a step toward a trusting relationship, as opposed to an offensive experience for the patient, Oosterwal says. "There are many resources that explain cultural differences, and you can also rely upon your own employees who share the same cultural background as that of your patients," he notes.

Even with resources that are available to help you understand cultural differences, remember that immigrants do become "Americanized," Oosterwal notes. For this reason, be prepared to follow the patient’s lead in terms of how they want the visit to begin, he suggests.

Staff members don’t have to completely ignore a policy about sharing food with patients, but they should be able to have a cup of tea or coffee and a few cookies with a patient on the first visit, Oosterwal continues. A trusting relationship is an important part of providing good patient care in home health, and the first visit is the point at which that trusting relationship is begun, he points out.

Keep conversation light

While drinking the tea, the nurse should not discuss business, Oosterwal says. "Although we are very task- and time-oriented, it is important to take a few moments to make the visit personal rather than businesslike," he says. "It doesn’t take much time to ask questions that put the patient at ease," he adds. For example, asking patients how long they have lived in the city, admiring a garden in their yards, or commenting on pictures of grandchildren that are displayed are all ways to show that you are interested in the patient as a person rather than a chart that needs to be completed.

To really strengthen the trust you are building, be sure to share something about yourself, says Oosterwal. You don’t have to share personal secrets, but you can refer to a spouse or a sibling who shares the same career as the patient, or you can mention a vacation trip to the city in which a patient’s child lives, he adds. The information you share should be simple and demonstrate that you’ve been listening to the patient and that you have something in common with him or her, he explains.

Once you’ve spent a few minutes getting to know the patient and letting the patient get to know you as you’ve had tea together, you can begin with assessment questions and completion of forms, Oosterwal says. "The key to developing a trusting relationship is to show interest in the patient, and the sharing of food along with nonbusiness talk for a few minutes is the best way to demonstrate your interest in the patient," he adds.

[For more information about food and culture, contact:

Gottfried Oosterwal, PhD, Director, Center for Intercultural Relations, P.O. Box 133, Berrien Springs, MI 49103. Phone: (269) 471-1325. E-mail:]