1. English Proficiency
Many Filipinos take pride in their ability to read, write, and speak English. They may feel offended if asked about the need for an interpreter.
2. Culture-Based Communication Guide
Though many elderly Filipino Americans can communicate in English, there may be challenges when they are confronted with high-stress situations.
For clinicians working with older Filipino individuals, the following guidelines may be useful:
- When the cadence and inflections in spoken English make it difficult to understand the patient, ask permission to seek the services of an interpreter. To avoid offending the patient, explain that the purpose of having the interpreter is to reassure the clinician that the medical terms are accurately described to the patient.
- It is important not to use family members/friends as interpreters for health care related issues.
- When introducing the need for an interpreter, do so in a respectful manner as in the following model presentation:
“Mrs. Kabayan, I want to discuss some important issues related to your health. I know that you speak English. However, with your permission, I would like to request the presence of an interpreter today. An interpreter will help both of us communicate clearly with each other, I do not mean any disrespect. I just want to make sure that we give you the best possible care and using an interpreter will help ensure this.” - Questions such as “Do you understand?” or “Do you follow?” may be considered disrespectful. Instead, ask the patient to repeat the instructions with the explanation that the feedback process is for the clinician’s benefit to ascertain whether he/ she has done a thorough job.
- For elderly Filipino Americans who are less educated and have minimal acculturation experience, never make the assumption that a “Yes” answer means that she or he understood the discussion or agrees with the decision or opinion of the health care provider.
In most cases, “Yes” merely means “I heard you.” Filipino older adults who are used to high-context communication may feel puzzled and offended by the preferred precision and exactness of the American communication process. - Many older adults, particularly those from intergenerational households, look to a trusted adult family member as their “surrogate decision maker” and would expect the clinician to keep this individual informed of issues related to their health. Such a preference may not be expressed or openly discussed by the elder or the family member.
- It is considered disrespectful to challenge, question, or express disagreement with an authority figure such as a health care provider. To encourage open communication, providers need to reassure a reticent or passive elder that asking questions or expressing opinions would not offend them.
- Use phrases that connote relationships such as “Our aim is,” “This is your problem” and “We are working on this.“
- Clinicians should explore and listen to older adults’ beliefs about health and illness. Be respectful of their behaviors. Patiently explain from your perspective what has to be done and why.
- When an older adult is accompanied by other family members, seek the elder’s consent before disclosing sensitive and private issues in order to maintain the patient’s privacy and autonomy and avoid embarrassing the patient.
