Meetings between health and social care staff may be characterised by routine invasions of personal space that can make either party uncomfortable. Healthcare settings often involve a chance in the cultural norms that we can rely on in other aspects of our lives - for example, physical examinations require staff members to come into the space that is normally reserved for those we know intimately. Staff will be used to this, but for the person on the receiving end of the examination it can feel very uncomfortable. Indeed, these invasions of personal space have been identified as triggers for service users to exhibit behaviours that staff perceive as challenging.

However, it is not only service users who may experience discomfort at the invasion of personal space in the work setting. Staff meet people from a range of different cultural backgrounds, who habitually prefer a different personal space than the staff member is used to. It may occur with people from different national or ethnic backgrounds, or with service users who may be vulnerable in communication exchanges - such as those with learning disability or autistic spectrum disorder.

The below video looks at an interaction between two people from different cultural backgrounds. Observe the way in which each person's idea of personal space clashes with the other. Once you have watched the video, return to page 110 the book and have a go at the questions in Box 5.6 to help put what you have learned into practice!

The spoken or written word is not the only way to communicate!

Some service users, such as those with hearing impairment or learning disability, may make use of language systems that are primarily based on gesture (such as sign language or Makaton). In these situations, the staff member is the less competent communicator: what may appear to be a casual, unimportant movement may actually be a very specific request.

Of course, it would be unrealistic to expect health and social care staff to learn all the potential languages that they are likely to encounter. However, just as it is polite to learn a few basic words when holidaying in a foreign country, it is important to learn a few basic phrases that belong to the most vulnerable communicators in health and social care settings.

Members of Communicate2U have created a song to help you learn some basic Makaton, and to remember simple rules for communicating with vulnerable people. Watch the video to hear the song, which will help you to put what you have learned into practice! Once you have watched the video, you can return to Box 5.8 on page 113 of the book.