Pacific Islanders: Language Barriers in Long Term Care Facilities

Rocio Ramos
HCA 480
04/25/16

Pacific Islanders: Language Barriers in Long Term Care Facilities 

Differences in the language spoken by residents and staff in long-term care facilities create a variety of problems. Many older adults living in long-term care facilities speak English as a second language or may not be able to speak English at all. Bilingual residents are often reported to return to speaking their native language in advanced stages of dementia, even if they had not used it recently (Soingleton K, Krause E, 2013).  According to the U.S. Census Bureau, there are approximately 48 million people in the United States whose primary language is not English and that cannot readily speak or comprehend English. Approximately 10% of the elderly population in the U.S. was born in another country. The number of elderly immigrants is expected to rise to about 20% by the year 2050, with the total number of elderly immigrants quadrupling to approximately 16 million (Tjia J, Mazor K, Field T, Meterko V, Spenard A, & Gurwitz J, 2010).

As a result, language and communication barriers in the nursing home setting are becoming a real concern — and facilities need to respond to these issues in order to provide quality care.  In this blog the main focused is Asian Pacific Islander and the language barriers they face living in a long term care facility. Asian Pacific Islanders (API), is a very diverse group. It consist of a variety of sub-groups including: Chinese, Filipino, Korean, Japanese, Asian Indian, Vietnamese, Laotian, Cambodian, Thai, Hmong, Hawaiian, and other distinct ethnic groups. With this diversity comes a variety of languages, customs, and culture (National Service of Elder Abuse, n.d.). Each little sub group experiences language barriers differently, some have a variety of services to help minimize such barriers but others have very limited help and have a harder time communicating with their doctors or other staff members. Unfortunately, the API elderly population needs are not well-researched, their concerns are often not addressed by current public policies, and very few programs and services are designed for their specific needs. Language and cultural barriers are difficult barriers to care since programs and services designed for a broader population are often inaccessible to API elders due to limited outreach efforts in their communities (Ross T, 2015). In addition to these barriers the API elderly population is currently facing a number of critical health disparities, including a disproportionately high prevalence of hepatitis B, tuberculosis, and dementia. Furthermore, elderly API population show a greater prevalence of dementia than the total older population, while Asian American elderly women have the highest suicide rate of all women aged 65 and older (Yoo G, Musselman E, Lee Y, and Yee-Melichar D, 2015).

Considering the many critical health disparities faced by the API population and the lack of researched done for them, it is extremely important for LTC facilities to be able to communicate appropriately in order delivery the best care possible. Effective communication usually involves getting the patient’s attention and understanding through both his/her spoken language and patient educational materials. There are several choices available for nursing homes to communicate with persons that are not proficient in English.  These include using family members or friends, professional interpreters, bilingual staff or language line services.  Best practices include making use of a readily accessible and qualified language services provider. Another way of addressing language barriers between staff and residents is by having bilingual or multilingual staff, social workers, activities therapist, or administrative assistant who speak multiple languages. Another approach could be the visual board approach consisting of a display board which can be easily mounted on walls.  These cards will have the translated words or phrases mounted on the boards, can also be removed or replaced within seconds. This will allow staff to practice phrases in different languages and communicate with their patients/residents better. Here are two examples of the poster boards and phrases, one translated to Russian and the other one to Spanish.

Where is the pain?

Good-Yeh Boh-leet?

Thank You!

Gracias!

All of the adequate services mentioned above will help staff and residents communicate a lot better with residents. Such services will not solve the problem completely but it will defiantly help the facility deliver the best care possible to its patients who speak little, or  no english.

Citations

Tjia, J., Mazor, K. M., Field, T., Meterko, V., Spenard, A., & Gurwitz, J. H. (2010). “Nurse-Physician Communication in the Long-Term Care Setting: Perceived Barriers and Impact on Patient Safety”. Retrieved April 23, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757754/

Singleton, K., Krause, E., “Understanding Cultural and Linguistic Barriers to Health Literacy”. (2013, September). Retrieved April 23, 2016, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tableof
Contents/Vol142009/No3Sept09/Cultural-and-Linguistic-Barriers-.html

Yoo G., Musselman, E., Lee, Y., and Yee-Melichar, D., “Addressing Health Disparities Among Older Asian Americans: Data and Diversity | American Society on Aging”. (2015, February 26). Retrieved April 23, 2016, from http://www.asaging.org/blog/addressing-health-disparities-among-older-asian-americans-data-and-diversity

Ross, T. (2015, May 12). Language Barriers and Poverty in the AAPI Community - Talk Poverty. Retrieved April 23, 2016, from https://talkpoverty.org/2015/05/12/unspoken-problem-language-barriers-poverty-aapi-community/

National Service of Elder Abuse. “Mistreatment of Asian Pacific Islander (API) Elders”. (n.d.). Retrieved April 23, 2016, from http://ncea.acl.gov/Resources/Publication/docs/NCEA_API_ResearchBrief_2013.pdf