Case Study 4

A 65-year-old Marshallese woman comes in your office with complaints of not feeling well and abdominal pain. She is accompanied by a man who sits in the room and answers questions for the patient. The patient speaks little English. Her companion speaks some English and tries to translate your questions to the patient. When you ask a question about childbirth, whether there has been any vaginal bleeding, etc. he does not convey the question to the patient nor does he answer you.

	What might the geriatrician do?
Answer:	You should realize that the companion is the spokesperson for your patient, and that she will not answer any questions without his permission. Very personal questions will usually not be answered. In this case, you may try to ask if there is another female that could help to translate for your patient.

You want to examine the patient, but as you approach she is sitting up and holding onto her abdomen. What should you do?

	What might the geriatrician do?
Answer:	You need to ask permission to look at and feel the patient’s abdomen from the patient as well as the male in the room, who is there as her guardian. The abdomen is a very private area and is not something commonly shared with others, even doctors. Sometimes there will be a female family member with the patient, but usually the patient is accompanied by a male family member.