There is only one nurse on my Mom's floor who speaks Spanish n it's not even her first language. Most people speak Creole. They cannot communicate with her n she can't with them. It's very frustrating!!
Oh really? Read this Medicaid regulation to him" "Interpretive Guidelines §483.10(b)(3) “Total health status” includes functional status, medical care, nursing care, nutritional status, rehabilitation and restorative potential, activities potential, cognitive status, oral health status, psychosocial status, and sensory and physical impairments. Information on health status must be presented in language that the resident can understand. This includes minimizing use of technical jargon in communicating with the resident, having the ability to communicate in a foreign language and the use of sign language or other aids, as necessary." Then ask him how he intends to comply with the federal government. Let us know how that goes.
I would talk with the Director of Nursing again and mention that it is a requirement of Medicaid to speak in her language. If she does not offer a follow up timeline ask for one. Be professional but firm. Then find an attorney if they do not meet the timeline. If you can't afford an attorney call your county agency on aging and they ca help you find an inexpensive or pro bono Attorney to write a letter. Most Churches have an attorney in the congregation you can also ask at church. The letter from an attorney will get them moving.
type into Google “42 CFR 483,” and start getting facts. you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Facilities have to meet their resident's needs, including means of communication. They should, but law, have a Language Bank, listing all personnel who speak different languages. See the Administrator about this.
It does sound as if you're going to have to use the Federal law to find someone who can communicate well with your mother. With our much more diverse culture comes complications with language but these language barriers must be accommodated. We see it in hospitals and nursing homes that receive any Federal funding should also be held to this standard. Please let us know how you and your mother are doing. Carol
I'm not exactly sure what you want. What kind of "accommodation" do you want? Do you want every staff member whose primary language is Spanish? A facility is not required to have every staff member speak 8 languages to accommodate the patients & comply with Federal Law. In fact, no employees have to speak a second language at all, as long as they know how to speak, read & write English. What the Federal law means is that the facility must have access to a person to act as an interpreter and/or access to a language bank in situations where necessary, like emergency departments when trying to communicate with people that don't speak English. I won't even get into why your mother doesn't speak enough English to be able to communicate with nursing staff, but that's another story. I think your expectation that the nursing staff speak Spanish---especially as their primary language---is entirely misplaced here. The facility is in America, right? The primary language in America is English.
I'm sorry, but people living in a country where English is the primary language cannot expect others to learn their customary language because they refuse to learn how to speak English. If you live in America, there is no reason why you shouldn't be able to speak English. How long has your mother lived here? If you want your mother to be in a place where everyone speaks Spanish, you should think about putting her in a facility in Puerto Rico or Central America. Perhaps you can hire a private duty nurse or nurses' aide who speaks fluent Spanish to be able to act as an interpreter between your mother & the staff.
One thing that came to my mind as I read the comments about getting tough and forceful with the Nursing Home staff, is the possibility of them getting defensive and obstinate, and taking it out on your poor defenseless Mom. If a family member isn't around at all times, one never knows. They may start viewing her as a "problem" and be resentful. The suggestion from Too Young For This may be the way to go, if possible. If not a private nurse or aide who speaks Spanish, what about trying to recruit extended family members/friends who speak Spanish to go in shifts throughout the day to pop in and least communicate with her about any problems she's experiencing. My 90 year old aunt, who was deaf, had a very difficult time in a rehab facility after she fell and broke a hip. We family members tried to be there for her as frequently as possible because she couldn't communicate with anyone, and it was a frustrating experience for all involved... the nurses/aides/staff and the patient! Best of luck on this. It's surprising that even with a language barrier, there is still a method of communication that can exist through expressions, touch, kindness, and caring.
While I agree this is American and our language is English, Residents who have dementia often go back to the native tongue. And we as the Carers are going to have to work on a way to communicate with them. Requiring all languages be spoken is a bit much and will prove difficult.
I Agree with "TooYoungForThis" I am Spanish, and I never put my mother in a nursing home because she did not speak English. She came to the country too old to learn, so it was my obligation to keep her at home because I knew I could not ask for the nursing homes to have staff that speak Spanish. It is our obligation as the children of older Spanish Seniors to find other ways to keep our parents in a place where they are comfortable and taken care of, for me it was my house and I hired a PSW that speak Spanish. It is not the obligation of this country to make sure that every one speak Spanish to be able to communicate with us, many time it is the fact that so many places offers translators that holds Spanish people from learning English.
Contact your local or state long term care ombudsman. The ombudsman is an advocate for those residing in nursing homes and assisted living facilities. The ombudsman can advocate for a translator to be made available for your mother. By law, they must provide someone who can speak your mother's language.
Why did you put your mom in a place where she cannot communicate with staff? Either find another place or make up what staff is saying. Not an effective alternative...
1. Learning new languages is hard even when you are forty-something and don't have dementia.
2. Getting a Spanish interpreter is pretty easy. Easier than getting Marshallese or ASL interpreters, por ejemplo. They also have phone interpreter services. So, it should not kill them to use one regularly, nor to post a few key Spanish phrases in the room. Por favor, por que hay problema con eso?!!
Nursing homes in America require employees to be able to speak the English language. I understand the need to have an interpreter when medically necessary, but not for everyday conversing. You need to find a plAcement that is more Spanish oriented or provide your own daily interpreter.
I understand the responses that she should be able to speak English in the U.S. but clearly that is not going to happen at this point. Invest in some sort of tablet device to be left at her bedside. Make clear to everyone that it is there and the Director and/or administrator to follow up to prevent theft. There are great apps to translate text into speech and speech in to speech from and to any language. Tablets can be purchased fairly reasonably these days and probably less than for one shift of caregiver translators. My sister has a speech to speech app on her phone and is able to communicate with a resident at Mom's AL who speaks English but her native language is Italian. In her dementia she often slips in to Italian and it can be very stressful. All the caregivers speak English and Tagalog but none speak Italian. At times this becomes a game and the residents love it. Another resident speaks Dutch and English and my sister did some Dutch translation and the ladies were so pleased to hear their own language.
I placed my mom in ALF in April 2014. Before her dementia she spoke fluent English even though Spanish was her native language. Earlier in her illness I noticed she was speaking less and less English. Her MD stated she would eventually not be able to speak it at all. Strangely, she understands when being spoken to in English so the staff at the ALF are able to deal with her the majority of the time. They are quite nice and seem to be taken with her, saying she is a sweetheart (what, my mother? really?) Yes. They love her! anyway there have only been a few occasions where they had to call me to try to see what was wrong with her, but even with a Spanish speaker on staff she could still not understand what my mom wanted. It turns out, i couldn't either. It's the old dragon, nasty, hateful, thieving, horrible, Alzheimer!
Allfor, is the problem mostly that staff can't understand what mom wants, or that mom can't understand what staff is saying to her? agreed that there should be real at ion staff available, but in the short term, how about this..and know that I use this with my mom lingual enlist speaking mom...an index card that says "call my daughter" with my phone number. A card that says " I'm in pain" a card that says "I need to use the bathroom". My mother has had a stroke and has aphasia. She has some speech but not when she's upset. We've found cards like these to be a real boon.
I know my comment does not address the problem directly, but I have found another solution for my wife (age 63). I met and married her in Cuernavaca, Mexico 42 years ago and she still has family there. Since I can't possibly afford long term care in the US, I placed her in a deluxe facility in Cuernavaca at a cost of less than $800 a month. She gets food she is accustomed to eating, round-the-clock care in her native language, a perfect climate for being outdoors and exercise, and she is making friends with the other patients -- something she could NEVER do in the US. The separation from her has been agony, but she is much better off and happier than ANY place in the US -- and I don't have to go bankrupt providing for her. I myself will never seek long term care in the US. It's only for rich people or those who have spent themselves into poverty; it's a disgrace.
I like the idea of flash cards, one side the English version, one side the Spanish. That should help until they get someone on staff who speaks Spanish. Also: on the cards it might help to have a phonetic version of the Spanish on the side that staff look at and attempt to say when they are showing the written Spanish side to your mom. Bahn yo. Aug wah. No habla a Spann yole.
I don't think any Federal law could possibly be interpreted that every non-English speaker would have 24/7/365 interpreter at their beck and call. That's totally ridiculous. The country is like 17 Trillion in debt.....get real, the basic language of this country is English. If you don't like that then start a campaign to change it, but it won't happen in your lifetime. Even English speakers won't be happy with staff speaking in a NE accent, or Southern, or perhaps Australian accent. If you're on Medicaid, get over it, and pray that you have family or deep friendships nearby who can Help You. The government does not have to cater to your every need.
I agree that no one is going to have an interpreter all of the time. That's unrealistic. However Social Services should have someone who can figure out some kind of way for the people to relate. It's all about balance as with most things. Trying to help people with their needs while being realistic about how much can be provided. Good call, PrettyGood. Carol
I have to agree with TooYoungForThis and Debralee. This has always been a bone of contention with me. Although the United States was founded on immigrants and we certainly are a melting pot, the official language of the United States is English. I feel if people wish to emigrate to this country (legal or otherwise), the onus upon them is to learn the language of the country they are planning to live. I know if I were planning to live out my days in France, I would learn French; Italy, I would learn Italian. I know it's hard to learn a new language when you're older, but I would certainly make concerted effort to try.
That said, I would not have put my relative in a facility where she could not understand the staff or where the staff could not understand her. Is it possible to move her to a different facility?
That said, the index card idea is a good one. Perhaps you can have certain phrases translated from Spanish to Creole and have your Mom use them with the staff. If she has been diagnosed with Alzheimers or other dementia, this may not be useful if she cannot use them on a consistent basis and that will only agitate or frustrate her more.
PrettyGood, when I read your post it reminded me that my Mom [97], who still lives on her own with Dad in their own house, would have a difficult time if she needed to go into a continuing care facility because even though my Mom was born and raised up north here in the States, she has a hard time understanding anyone with a Boston accent, a heavy New York accent, a southern accent, or someone speaking the Queen's English.
Mom wouldn't have been able to work at the previous company where I was employed, 20 different languages were spoken, thus English with 20 different accents :)
Dear people, consider that the individuals we are finding care for are very old, came here when there were many obstacles for non English speakers and Most women remained at home with their children. Maybe later born individuals will have no problem with Engish, but be kind to these brave soles who managed adversity to be here.
Also, there are so many people seeking work, finding and training a bilingual worker seemed worth the effort.
Use the law. I agree with Pam Stegman. People complaining that the elderly should speak English are being right wing reactionary bullies. Even if the elderly person learned English and used it fluently as a younger adult, it is possible they can't use it any more. Beyond that many people cannot learn a second language as an adult. Are you learning any new languages?
My parents came thru Ellis Island and due to quotas, had to live in Canada until their was space in the quotas for their nationalities. Even then, they had to have sponsor families. When they sent their kids to public school, and the kids didnt know English, the teachers or social services paid a visit every so often to the homes to make sure English was being spoken at home. My parents quickly learned English. How different the process has become. And my parents are staunch Democrats not " rightwing reactionary bullies" (what exactly is that inflammatory labelling trying to accomplish? Certainly not helpful to discussion at hand here).
"Interpretive Guidelines §483.10(b)(3)
“Total health status” includes functional status, medical care, nursing care, nutritional status, rehabilitation and restorative potential, activities potential, cognitive status, oral health status, psychosocial status, and sensory and physical impairments. Information on health status must be presented in language that the resident can understand. This includes minimizing use of technical jargon in communicating with the resident, having the ability to communicate in a foreign language and the use of sign language or other aids, as necessary."
Then ask him how he intends to comply with the federal government. Let us know how that goes.
Attorney to write a letter. Most Churches have an attorney in the congregation you can also ask at church. The letter from an attorney will get them moving.
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Carol
I'm sorry, but people living in a country where English is the primary language cannot expect others to learn their customary language because they refuse to learn how to speak English. If you live in America, there is no reason why you shouldn't be able to speak English. How long has your mother lived here? If you want your mother to be in a place where everyone speaks Spanish, you should think about putting her in a facility in Puerto Rico or Central America. Perhaps you can hire a private duty nurse or nurses' aide who speaks fluent Spanish to be able to act as an interpreter between your mother & the staff.
2. Getting a Spanish interpreter is pretty easy. Easier than getting Marshallese or ASL interpreters, por ejemplo. They also have phone interpreter services. So, it should not kill them to use one regularly, nor to post a few key Spanish phrases in the room. Por favor, por que hay problema con eso?!!
Good call, PrettyGood.
Carol
That said, I would not have put my relative in a facility where she could not understand the staff or where the staff could not understand her. Is it possible to move her to a different facility?
That said, the index card idea is a good one. Perhaps you can have certain phrases translated from Spanish to Creole and have your Mom use them with the staff. If she has been diagnosed with Alzheimers or other dementia, this may not be useful if she cannot use them on a consistent basis and that will only agitate or frustrate her more.
Mom wouldn't have been able to work at the previous company where I was employed, 20 different languages were spoken, thus English with 20 different accents :)
Also, there are so many people seeking work, finding and training a bilingual worker seemed worth the effort.
How different the process has become.
And my parents are staunch Democrats not " rightwing reactionary bullies" (what exactly is that inflammatory labelling trying to accomplish? Certainly not helpful to discussion at hand here).