I moved my Mom and Dad to an Adult Family Home two years ago. My Dad passed away in April of this year, but Mom is still in the AFH. I've always worried about the language barrier between the caregivers and the patients. The home only has caregivers from Kenya, and none of them speak english very well, and they don't understand when I ask them a question. Mom gets agitated because the caregivers don't understand her. They forced her to wear a bra, after I had instructed that they don't put one on her, but instead let her wear the undershirts.
I ask caregivers about Mom's medications, and none of them know how to go to the patients binder for information, and they don't understand the MAR. They are all nurse delegated, but most of them don't even know how to check the blood sugar levels, let alone know how to give an insulin injection.
There's no abuse or neglect, and I don't want to move Mom ever again, but the language barrier is a big concern. What can I do?
Is there any law that says the caregivers must be able to communicate and understand what is being said?
14 Answers
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If u don't want Mom wearing bras, then take them out of her room. They can't put on her what isn't there. Put a note on top of her "shirts" with "these are to be put on in place of a bra". I had a white board on Moms refrigerator where I wrote notes to the aides and they could write notes to me.
I find that its not so much there is a language barrier but that they speak too fast. Ask the RN to have them talk slower and face the person.
Anyway, clear communication is essential. I would relocate my mom in such a situation, knowing that in time she would adjust.
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Is there someone there that could obtain the information QUICKLY if they had to call 911?
Do they know who gets what medication and when? And are they documenting when it is given?
These are things that wold be very concerning to me and I would probably report the facility and the situation to the state Ombudsman.
Now a simple solution to the bra...Remove the bras from your mothers room. That way they can not put one on her. If you need to have her wear one when you take her out you can bring one when you come get her. I would just leave the t-shirt if it is more comfortable for her.
As far as "abuse and neglect" It might be considered neglect if the person that is caring for you ignores your questions, ignores your requests and does not answer you...all these things could happen if they do not respond to your questions, requests or your moms questions and requests or if they do not answer either of you. This might be taking the definition a bit far but if your mom started to complain about pain would they understand her? respond to her? if not that would be neglect.
If you still want to keep her there, and believe me, I do understand the rarity of finding good caregivers, then you, family members, and/or friends need to come up with a schedule and commit as a team to visiting throughout the week. Buy a Swahili dictionary in a bookstore or online and point to words when you cannot get a point across. It helps. They will show you words to, and you get some connection. It will also help establish a relationship with the caregivers. Kindness goes a long way. Pick your battles in this situation, but never compromise medical care and safety. Always have the ombudsman’s number on you, call the state office, and get basic info, so if you do need to contact them, you are not going trial and error in a possible crisis.
Imagine yourself in a foreign country where you do not speak the language and you are trying to tell someone you don't want to wear a bra...or you would like to have hot oatmeal instead of cold corn flakes. That is about the situation your mom is living in right now.
No neglect by those caregivers? Fantastic!
(17) The provider and resident manager must assure that there is:
(a) A mechanisim to communicate with the resident in his or her primary language either through a qualified person on-site or readily available at a times, or other reasonable accommodations, such as language lines; and
(b) Staff on-site at all times capable of understanding and speaking English well enough to be able to respond appropriately to emergency situations and be able to read and understand resident care plans.
This law still leaves a lot of latitude so there's no undue burden on the caregiver, but it stills requires "English" to be the language spoken well enough to read and understand resident care plans.
Thanks everyone for responding to my question.
If my Mom spoke another language, I would have sought out a specialty care facility which could bridge the language barrier.
The caregivers are as kind as they can be when they don't understand what the patient is saying. The only way I get anything communicated effectively is by email. I don't mind the accents, but I do mind the inability to understand or speak english well enough to work in a facility which requires a lot of complicated communication.
If I were to go to another country, I would learn the language well enough to work in the field I desire. If I don't speak the language well enough, then I would need to find a class to attend so I can learn it, and also a job that doesn't require me to be as skilled in the language, until I do learn it.
When a caregiver can't differentiate He from SHE, so when they are telling me something, and refer to my Mom as "He" I think they're actually talking about someone else. Ugh!
This isn't being racist, it's being real.
If they consistently are from Kenya is it possible to get an app for yourself that would allow you to communicate with them?
I agree that there should always be a person at the facility that can communicate with the paying customer. Have you spoken to the owners about the repercussions of something happening and no one being able to assist because of the language barriers? These are lives at stake, in AZ we had a kennel full of dogs that perished because of dereliction of duty and they are being prosecuted to the hilt, can you imagine if it was human lives that were tragically cut short? I would talk to the owner and get this addressed for everyone's sake. Those caregivers could be facing issues that they can't understand and it just sounds unreasonable all the way around.
Let us know how it works out.
What's necessary in our society is people that can communicate. This is about communication, not race. This is about my Mom being able to tell the caregiver that she's in pain, and the caregiver understanding it and knowing what to do about it.
I was a caregiver. I chose to work in that field. I knew what the pay was. None of the caregivers go into a job thinking they're going to get rich. When I go to visit Mom and talk to the caregivers about how Mom is doing, I leave exhausted. I try so hard to understand what is being said, and then I feel guilty because I had to have things repeated to me, and I have to repeat the same question over and over, rephrasing the question, and talking slowly, so maybe, just maybe, there's no misunderstanding.
The caregivers are good with Mom. I am grateful for that. They keep her clean, fed, and safe. That doesn't mean I should overlook the issue of communication.