When it comes to details like specifics of a person who'll be put in the home of a loved one there seems to be a limit on that. I simply asking if they had a staff member who was close to the cultural origin of a relative or even spoke the language and I was quickly answered with a blanket legal policy regarding the non-discrimination policy they abide by verbatim. Very business like tone. What I don't understand is, this is a very personal type of placement, with a lot of grey area to cover. Can this not be a part of cultural sensitivity? Is there no way to have a conversation about what would best suit someone on a personal level to best pair up the case? Is that so offensive? Yet, when these agencies are placing the employee, behind their closed doors, they ARE considering all of those details to best pair up the case. It's not just a part of a simple matter of a "Skill Set" that would satisfy the criteria. Help me out here. Am I just looking at this from a biased lens?

Prejudice and comfort with those similar/different from ourselves is often more subtle than overt racism, although that exists. In our case, we asked for Spanish speakers since my mother's first language is Spanish and it is easier for her to relate to a Latina culturally. The market being what it is, often the client is white/middle class/native speaker and the care provider is a person of color and an immigrant who speaks English as a second language. Misunderstandings are bound to arise and the home needs to handle expectations on both ends, some of which are cultural.

Agencies need to take a firm stand against racial/ethnic discrimination, bottom line. They legally cannot and should not make assignments based on race/ethnicity. The patient/family should be told that fact. If the patient/family insists that the agency assign them someone based on race/ethnicity, they should be offered a referral to another agency. Putting this burden on the aide - to be "more sensitive" and "not take things personally" and "understand the elder and sickness" is totally inappropriate. Aides should not be subject to a "hostile work environment," which includes being assigned only to "certain" clients and the expectation to put up with client hostility based on race/ethnicity. Get some integrity and backbone, home care agencies!!

I agree that a strong accent or limited English can be a barrier. However, many cultural differences- between caregiver and client and caregiving agency and caregiver- are the result of subtle differences in communication styles and perceptions. I once gave a seminar to caregiver agencies on cross cultural communication and they were amazed on how their perceptions based on their own socialization could distort how they saw the caregivers that worked for them.

Communication is indeed key. A heavy accent or lack of mastery of English can get in the way of that very critical element. I have seen elders objecting to certain aides not because of their skin color or clothing but because they can't understand them. Most of us can listen carefully and eventually get into the rhythm of the speaker even if the English is less than perfect. But when you are hard of hearing and a little confused to start with, hearing unfamiliar vocabulary spoken with an accent can totally ruin communication.

No matter how much you care in your heart, you have to be able to communicate in a way the care recipient can understand.

I don't want to deny anyone employment. I don't say your English should sound like a native in order for you to work! But to work with elderly persons in a role where communication is critical, one of the requirements should be spoken language that is easily understood by the clients.