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Toni Talks about PT Today

A Language Barrier

Published April 26, 2011 11:34 AM by Toni Patt

Because of its size and location, the hospital where I work serves a large population of non-English-speaking individuals. We have an in-house staff of interpreters available upon request. They handle all the more common languages such as Spanish and Farsi. We also contract with outside companies for help with languages that aren't so common. We even have a language line available by phone if nothing else is available.

That's all well and good. It makes my job easier. With a little planning, I can communicate with my non-English-speaking patients. I also rely on family members when translators aren't available. Even if they speak minimal English, they can usually answer basic living-situation questions and help with the orientation questions. I base my rehab recommendations on what I can learn in a visit or two, so every little bit helps.

Lately I've noticed a troubling trend. More and more non-English-speaking patients are being admitted without family available. They usually come in through the emergency room but aren't accompanied by anyone. That makes things challenging for doctors trying to identify potential stroke victims. It's hard to get a history when the patient doesn't understand what's being asked. It's even harder when the patient doesn't speak English and is aphasic.

I run into the same problems when I try to evaluate those patients. We need family members to provide us history and living-situation information. We need them to explain what is going on with the patients. Today I worked with someone who was confused and only speaks Swahili. That doesn't fall under the category of a more common language here in Houston. I didn't get very far. I think she can walk but without knowing her living situation, I can't make recommendations.

Where are the families? I would love to know that. They know their loved ones don't speak English. They also know their loved one is confused or not making sense. Yet these patients are left unattended in strange environments, unable to communicate or understand what is happening. It must be terrifying. Sometimes it is hours but often days before someone shows up.

Remember, we're talking patients who are probably aphasic. It's going to be much harder for them to figure out what's happening than for a fully oriented person who doesn't speak the language.

It just doesn't make any sense. Being in a hospital isn't an ordinary occurrence. It seems to me someone would make an effort to be present at least the first day to help explain things and answer questions. There have also been times when we've been unable to reach family members to get information and consent for treatments. Messages are left but no one responds. I find it hard to believe that out of an entire family, no one has access to a telephone long enough to call the hospital and ask how the patient is doing.

I know there are lots of reasons that families can't be at the hospital. Most do everything in their power to do the best for the patient. It's the few who do nothing that I don't understand.

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