Munich , Germany

Culturally-Competent Workforce for the Elderly

Project EiKu, GAB München

January 31, 2018

Managing an eldercare facility with a culturally diverse workforce poses challenges: how can workplace processes be shaped to effectively integrate cross-cultural issues?

As more refugees and migrants enter the German workforce, the challenges of integrating and managing a diversity of cultures, voices and attitudes in the workplace also increase in scope and scale. In Munich, an HR consultancy has developed a new approach to workplace training and integration for a diverse workforce in responds to the challenge: How to create a culturally sensitive training program to manage a culturally diverse workforce and high staff turnover?


The shortage of skilled labor is a growing problem in Germany affecting small and micro enterprises as well as larger companies; public institutions and social enterprises are also struggling with a shortage of employees. In an aging population the health and nursing sector is particularly hard hit. Much of eldercare in Germany today is supported by workers with multicultural backgrounds, with increasing numbers of foreign skilled workers in the health and care professions coming to Germany seeking recognition of their education under Germany’s new laws. As a result almost without exception,workplaces in the health and care sector consist of highly diverse teams. This brings welcome resources reflective of the country’s growing multiculturalism. However, it also creates challenges in the workplace that require new culturally inclusive approaches.

EiKu – Culture sensitive training

GAB München is a consultancy firm in Munich, Germany that works on the challenges of the changing world of work and labour. Their client, MÜNCHENSTIFT GmbH is one of the largest service providers for the elderly in Munich, with around 1,800 employees and 3,000 residents in 13 long-term care facilities.

MÜNCHENSTIFT GmbH has many staff members hired from outside of Germany, mainly from Eastern Europe. Linguistic and cultural differences amongst staff members, compounded by different educational and training traditions in their countries of origin, resulted in numerous and conflicting approaches to health care, generally, and to the culture of care for the elderly, specifically. MÜNCHENSTIFT struggled with how best to manage this diversity, both to ensure quality and consistency of care, and to maintain an effective and functioning workplace.  These differences impacted issues of internal communication, workplace culture and employee coordination.

In 2015 Migranet-IQ asked GAB München to design and test a new training model that could provide more coherent and effective training for new staff working in MÜNCHENSTIFT’s facilities for elderly care. In recognition of the challenges of meeting the needs of such a diverse workforce,  a participatory development approach was recommended. The result was EiKu – Culture Sensitive Training.

GAB München developed a cultural competency model that takes into account both organizational, and individual diversity and culture, as well as effective communication techniques. Two tangible products were developed: a tool kit “Passgenaue Einarbeitung” (Precision Fit) and a visual guide in the form of comic book to help workers with low literacy skills in the German language get through the introductory training successfully.

Elisa Hartmann, Researcher and Consultant at GAB München, says it was very important for all workers, especially for non-native speakers who were new to the “way things are done,” to be effectively oriented to the organization’s standard of care. Employers must be clear about what is expected of workers. And workers also need to have space to reflect, clarify and confirm their duties and responsibilities on the job. Hartmann found the comic an essential component of the new training program. It gave workers something in their hands they could read and refer to, visualizations that explained things, regardless of language or literacy barriers.

Workplace training materials that clearly introduced and laid out the steps and procedures of what appeared to be mundane daily tasks were able to reinforce the underlying precision and complexity required of the task to new workers. But GAB München went one step further, asking the worker “How did you do this in your old work place? What is new here? What surprised you about this approach?” Hartmann says that this type of reflection is critical. Instead of correcting new hires with the negative implication of  “you’re doing it wrong,” this participatory approach creates space for a dialogue between new workers and their colleagues about individual and workplace cultural differences.  In the process, staff and management learn a little more about each other, their respective skills and backgrounds,  and how it all fits into the work requirements of the company.

Building a confident and optimistic workforce

Effective training is greatly facilitated by the confidence and initiative of the new employee. A positive outlook makes for a better learner. So it is important to reduce the barriers of linguistic and cultural difference that can adversely impact the onboarding experience of new employees in a diverse workplace. For GAB München, training is successful when new employees are quickly able to act independently and assume responsibility for their tasks. The domino effect of feeling confident about how they do their jobs helps their social integration in the workplace. When you feel more comfortable with your colleagues and can see yourself as part of the team, its also possible to imagine being with the organization for the long term – thus, reducing the high staff turnover and low retention rates that were costing MÜNCHENSTIFT time and money, and reducing the quality of care to their residential clients.

GAB München’s tool box and comic take into account both the worker’s core training needs and management’s need for a staff training and development tool that works in a culturally diverse workplace. At GAB München, the concept of cultural sensitization and cross cultural competency is based on the assumption that every new employee has their own individual culture and cultural orientation. The more diverse the workforce, the more important it is to take this into account in the on-boarding and training process. Good training in a standardized service setting like elderly care means designing training with existing and new employees for a specific situation. The approach must be practical, based on the daily work realities of staff, not a theoretical model of diversity integration.

GAB München approached this as a social innovation issue. True innovation would only be possible if the project was participatory and included a diversity of voices. They developed an approach that included staff at all levels of the organization, from all teams. They had additional principles, key to the project’s overall success:

Employees are experts in their work – employees working in the residential areas where the eldercare work is provided are the best situated to know whether the training is working, and what is not. Actively involving the employees and giving them the opportunity to contribute their knowledge and skills is essential.

Broad information and transparency – as many employees as possible, as well as workplace supervisors and management staff should have the opportunity to share their experiences, ideas, fears and wishes during the development of the training program.

Results need to be anchored into the organization, at all levels – relevant decision-makers need to be included as early as possible and actively engaged during development process so that they can link the model with the existing structures and processes within the organization.

Cultural Competency is a Two-Way Street

Building cross cultural competency into the organizational culture as a whole, and not only among some workers, is important. among local workers was important. GAB München is quick to point out that an interest in cultural competency among foreign workers should not be assumed simply because of their backgrounds. People with diverse backgrounds often have no interest in discussing culture. According to Hartmann, many have no interest in being singled out as ‘migrants’ and simply wanted to be more effective at work. By ensuring cross-cultural competency training is offered to all staff, organization can avoid the stigmatization of the’other’ and help reduce conscious and unconscious bias from subverting innovation and good decision-making in the workplace.


GAB München’s participatory cross cultural competency approach to workplace learning and collaboration has produced an effective training model for the culturally diverse workplace. The tool box provides concrete recommendations for action, guidelines and simple visual overviews of complex systems and explanations of daily tasks for new trainees.

To date, this small pilot project was developed and tested successfully in only one part of the large eldercare organization. Hartmann is hopeful that they will be able to continue the work across the organization.

Word of their success is out! The training model as already being used by other similar organizations. Their model, toolkit and comic are a “made-in-Germany” solution for a globalizing world – to be replicated within and outside of the elder care sector, across Germany and internationally.

Source: Reprinted with permission from the HireImmigrants website.

Making it Work for You:

  • Start your approach with an analysis, or sense-making, to ensure that all relevant challenges are identified and described.
  • Participation from all levels of the organization is essential. All voices, from different departments to different leadership levels and front-line workers ensure that the solutions are based on actual challenges, not perceived issues. Training should be jointly designed by employees and managers.
  • Assume solutions exist within the organization. Workers faced with challenges will have ideas about how to meet them. Make sure they have the opportunity to voice their ideas.
  • Don't assume cultural competence is a one-way need. Diversity and inclusion have many roots, discuss and build this competence among all staff.
  • Approach on-boarding and workplace training from a practical perspective. Staff are likely very busy doing their work. Effective training is practical and meets a perceived need.
  • Be open to unorthodox approaches to training and training materials. In Project Eiku, the visual comic approach had much more impact than the training toolkit. Be creative with materials and training approaches, especially when language or literacy might be a challenge.

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