Lost without translation

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Emily Mongan
Emily Mongan

At the end of sixth grade, I had to make a big decision: what foreign language to take for the rest of my education. Students at my school received a semester of French and a semester of Spanish, and then got the choice of which language they wanted to continue through the end of high school.

The reasons why my friends and I chose the languages we did varied. One friend liked Mexican food better, so she chose Spanish. Another wanted to visit France, so she went with French. My 12-year-old self decided Spanish would become more valuable while living in the United States and when, eventually, I would start applying for jobs.

To this day, I haven't used Spanish in any of my jobs, and I haven't taken a Spanish class since my sophomore year of college. But I've recently started brushing up on my skills with the Duolingo app (it's free!) in the interest of one day traveling to South America, and the belief that I will eventually be placed in a situation where speaking Spanish may come in handy.

For healthcare workers, that day may come sooner than you think — in fact, it's probably already arrived. A recent study in Home Health Care Management and Practice has found that only 20% of home health visits across a two-year period were language concordant, with both the healthcare workers and patient speaking the same language.

That's an important finding, the study's New York University-based research team says, in an age where 1 in 5,000 households speak a language other than English. Language barriers between healthcare workers and the patients they care for can have care-related consequences as well, including higher risk of readmissions, longer inpatient stays and more adverse events.

Researchers found patients who spoke Korean, Russian and Chinese had the highest percentage of language-concordant home health visits. Visits between workers and Spanish-speaking patients only achieved 13.1% concordance, despite the fact that Spanish is the second-most spoken language in the U.S.  

While the study focused on home health care, it has implications for workers across the healthcare spectrum, said lead researcher Allison Squires, Ph.D., RN, FAAn.

“The broader significance of these findings is that as societies diversify through immigration, the demand for language-concordant health services will rise," Squires explained in a release on the study. “Locations that are 'new' to managing the linguistic diversity brought about by changing immigration patterns, can learn from organizations in locations with more experience handling the issue and potentially find mutually beneficial solutions to addressing the problem.”

Squires also noted that how healthcare providers handle language barriers between frontline workers and patients can say a lot about the company's' cultural competence, biases or potential discriminatory practices.

“A failure to adequately respond to demand for language-concordant services could, for example, be a reflection of how staff deliver and organize care or an organization's operational philosophy around addressing health disparities in the populations they serve," Squires said.

Of course there's no one-size-fits-all fix for the issue. Facilities in different locations will care for patients who speak different languages, and the current worker shortage in long-term care means providers may not have the luxury of waiting to fill a position until a candidate comes along who speaks a second or third language and can communicate effectively with residents who aren't native English speakers.

Squires herself notes that her study is a starting point in addressing language barriers in healthcare, and how they're managed in other healthcare settings.

Until then, providers can take Squires' advice to use other healthcare organizations that have already tackled the issue as a resource, to make sure both workers and residents can communicate effectively and meet their goals.

Follow Emily Mongan @emmongan.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.