Although many American Indian older adults speak English, some are monolingual. Literacy level should be assessed, especially if written forms or educational materials are used.
“Probability” statements do not translate grammatically in some Indian languages, and may be misinterpreted as fact. Negative information may be culturally inappropriate, as “thought and word” may give reality to negative conditions, in some Indian traditions.
Discussion and Translation Issues
Indirect discussion (e.g. someone other than patient in similar situation) is preferred to direct questioning. Older American Indians often need time to translate concepts into Indian language or thought, and then back to English/western thought to answer. Language Line Services may not be proficient in American Indian languages, of which some 150 are still spoken.