November 21st, 2012 at 10:00 am
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4 tips for patients, caregivers with limited English

by Dorian Martin

Hospitals can be very confusing places for anybody, but one can only imagine how difficult they can be for someone who has limited or no proficiency in English. The machines, the doctors coming in at odd times for examinations, the nursing staff coming in to adjust the tubes entering the patient’s body — all of these things may cause additional stress for both the patient and the caregiver who can’t really understand English.

In addition, a hospital stay may be more dangerous for these patients, as shown in research published on the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality website. This 2007 study tracked reports of physical harm arising from adverse events in certain U.S. hospitals, identifying some major differences between patients whose primary language was English and those with limited English proficiency (LEP). When errors occurred during hospitalization, approximately 45 percent of English-speaking patients experienced no harm, compared to 40 percent of LEP patients. In the case of errors or adverse events during hospital stays, LEP patients showed a higher rate than English-speaking patients of temporary or permanent harm.

Advice for those with limited English proficiency

If hospitalization is required, there are some resources for patients and caregivers who do not speak or understand English well. The Agency for Healthcare Research and Quality (AHRQ) website has information in Spanish on communicating with health care staff and ways to help prevent medical errors. Dr. Carolyn Clancy, who is an internist, researcher and director of the AHRQ, has four recommendations:

  1. Request a professional interpreter if you or a loved one is staying in the hospital. Dr. Clancy stated that many hospitals actually have interpreters on staff or can provide one through videoconferencing or teleconferencing. Patients are typically not charged for an interpreter’s assistance.
  2. Don’t ask a friend or family member to translate during the hospitalization. Translating can be very stressful, and professional interpreters are less likely to make mistakes than people who have not been educated on how to be a translator. Medical terms may be especially difficult to translate, even for people who have good English skills. Dr. Clancy cautioned that children should never be asked to serve as an interpreter in a medical situation.
  3. Don’t be offended if the doctor involves an interpreter. Dr. Clancy explained that doctors want to make sure they can get all the information they need and can fully answer all of your questions.
  4. Get information about follow-up care. Before being discharged from the hospital, be sure to ask questions about when and how to take any medications and when to schedule follow-up appointments. Find out whether any medications prescribed by the hospital have side effects or could interact with other medications being taken. Ask whether there are any complications that might arise from the procedure.

Communication in health care settings can be challenging even when everyone speaks the same language; it may be hard to remember all the points you want to ask about. I offer some tips on how to talk with doctors in another blog post.

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