Multilingualism: An Essential Ingredient of Culturally Competent Healthcare


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By: Evelina Silveira, President, Diversity at Work in London Inc, Publisher, the Inclusion Quarterly

Everyday occurrences and unprocessed feelings usually form the basis of my blogs. Today’s is no different. It is Tuesday, and I am still thinking about the elderly Italian woman I saw over the weekend in a long-term care facility and left wondering: Is there a better way to meet the needs of residents who do not speak English?

I don’t know Rosa (name changed to protect her identity) but I do know that she is Italian as I recognize some of the words she yells or her conversations to imaginary people. No one understands what she is saying and nurses and attendants just continue to speak to her in English, or they ignore her completely because they just don’t know how to communicate with her. Residents will refer to her as “the crazy one” or the “one who is always screaming”. I only know a few words in Italian, but I happened to recall the expression, Che bella ragazza. I decided to look directly at her and say these words to her, checking to see if there was a response. For a moment, she paused as she appeared to hear something familiar and I only had wished I could remember more. I had just referred to her as “a beautiful girl!”  Her face temporary lit up and my heart was warmed. If only, I could have a conversation with her, I thought.

I had to wonder, what was it like for her to be in a home where no one understands her. How frightening to become invisible and voiceless. What a disappointing way to end the remaining years of one’s life.

The need for multilingual staff and volunteers is extremely important in effective healthcare delivery. As more immigrants are entering these facilities, I believe that we could be at a crisis point if we do not do more to address this issue especially in long-term care. Even though the immigrant resident may be fluent in English, for reasons I don’t understand they will often resort back to their mother tongue especially as dementia sets in.

While it may be impossible to have staff who can speak all the languages the residents do, there should be more effort made to provide care to them in their own language.

Here are some recommendations for providing more multilingual services in long-term care.

Employee Recruitment . Research the demographics of your community and include foreign language competencies in job postings based on what you find and on your current service needs.

Libraries and Print Materials. Consider purchasing or asking for donations of multilingual books, periodicals and tapes that residents can enjoy. Add international media.

Foreign Language Training.  There are many low-cost and no-cost ways of learning another language. Conduct a Google search and you’ll find many that are free.

Create a Picture Dictionary With Basic Words and Salutations. These small gestures could go a long way with keeping the resident more stimulated in addition to increasing the competencies of the employees.

We are facing unprecedented changes in healthcare and creating more culturally competent organizations do not have to be costly. Using existing community resources and becoming more innovative in the recruitment, selection and retention of employees can go a long way with developing more inclusive services.

 

 

The Complicated Dynamic of Racism in Long Term Care


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By:  Evelina Silveira, President,   Diversity at Work in London Inc. and author of  Diversity and Inclusion on A Budget:  How to have a more engaged and innovative workforce for little or no dollars.

Go to almost any long term care facility in the London, Ontario area and the racial divide will be very visible when it comes to who is a  front-line worker versus a resident.  Race and ethnicity become very pronounced.  British name plaques sprinkled with a few Southern European ones grace the corridors of the residence.  These facilities are home to a largely female population, and the leadership is usually comprised of women of British origin.

When we look more closely however, we will see that visible minorities form a good part of the staff involved in direct service delivery.  In London, this means primarily Filipino, Sudanese, Ethiopian, Eritrean, Latin American and Eastern European women.  For the most part, the residents have had very little contact with these groups and are unfamiliar with them, and consequently   deep-rooted racism, prejudice and stereotypes are not uncommon.

We have to remember that the cultural and racial demographics did not change much until the mid 1980’s in London, Ontario.  These residents probably did not grow up, live alongside and work with people who looked different, sounded different and did things differently.   It should be expected that they may have feelings of discomfort when they are in such a vulnerable position when they have to rely on these workers for so much of their basic care and sense of safety.

However, this lack of comfort can lead to racism causing devastating consequences for these workers.  False accusations, physical assaults against the workers and racial slurs can all be hurled at the people who are entrusted to look after them.  Feeling powerless, and afraid to report any problems for fear of losing their job, many minority workers have to face the additional brunt of racism while they go about their jobs caring for our family members in low paying positions with little opportunity for advancement.

Administrators will note that while many residents may keep their racial intolerance to themselves, if they are struck with dementia their filter is often lost.  It means that racial minorities who work in dementia services will deal with the effects of racism to an even larger degree.  It is a very slippery slope as we cannot punish people with dementia for what they say, so what do we do?

There is very little in the research about what might be the best solutions to the problem of racism against direct care workers in senior residences.  It can be challenging because long term care is a resident’s home. To complicate matters, residents who are hard of hearing report real challenges understanding those who have heavy accents.  But can long term care facilities be doing more to embrace the diversity of their staff?  The answer is yes.  Here are a few suggestions, but we need more.

 1.   Advertise languages spoken at your long-term care facility. –  Use your website, boast about it in your pamphlets and create a welcome sign for your front lobby that is multi-lingual and showcases the languages spoken.

 2.  Have multicultural displays.  Work with families, residents and employees to showcase various cultures in your lobby.  You might want to designate a multicultural week where you could have display tables that residents and family members could preside.  This is a great way to let everyone know that your home respects and celebrates culture.  Don’t forget to include posters that show respect for diversity and inclusion.  Include a few new food choices.

 3.  Solicit ideas for new recreational activities.  Do you have a resident who enjoys working on a craft project that is unique to     their  country of origin?  Would they be interested in teaching others how to do it?  Your multicultural staff could provide insight into some foods, outings, music and crafts.  The possibilities are endless; all the while learning about one another can be fun.

4.  Intake Assessments.   It is important to let residents and family members know about respect policies that you may have regarding your employees.  Depending on the resident’s health condition they may or may not be able to adhere to them. Ensure that you include some culturally based questions about:  values, end-of life decisions, language spoken.

 5.  Onboarding for New Employees – Ensure that all employees are told about the supports that are available to them when it comes to any bullying, harassment and racism.  Racism can take a toll on a worker’s mental health and performance, and they need to know what it looks like and where they can report it without jeopardizing their job security.   The leadership needs to take reports of racism seriously and be prepared to create a work plan that can protect them that is respectful to the worker and the resident’s rights.

6.  Take a Team Approach.  While little can be done to change the behaviour of elderly residents, a lot can be done to create a supportive team environment for the person who is experiencing the racism, reducing some of the negative effects.  Workers may be assigned to work in pairs to deal with difficult residents or be removed from dealing with the problematic client altogether.  Communication is the key.  Remember to involve the worker in the plan.   Leaders should also take a proactive approach to speak with the resident if they are coherent and finding out what their concerns are.  The resident may have some legitimate concerns that may be wrongfully dismissed as racism.  However, if racism is the issue this is an opportunity for the leaders to demonstrate to the resident that the worker is qualified to do the job just as the rest and should be treated with the same respect.  This is an important action the leader must take to demonstrate to the worker that their concerns are treated seriously and that while he/she may not have the confidence of the resident their boss believes in them.

If your organization has faced similar situations, please leave us your comments about what worked.

 

 

 

 

 

 

 

 

 

 

Planning Inclusive Meetings and Special Events


ImageEvelina Silveira, President, Diversity At Work in London Inc.  Publisher of the Inclusion Quarterly

Recently, I was perusing a business magazine that had a section dedicated to meeting planning. It was written by a professional in the field yet I could have sworn that the article was at least 20 years old. There was no attention to the new realities of planning business
meetings that host a wide range of guests from different cultures, religions and abilities. It was the same old same old. Someone reading this article may have thought that they had all of the information they needed to make their next event a success — but they didn’t.

No doubt, the business world is more complicated these days. It can be very intimidating, especially if you feel forced into thinking outside the box for the first time.

Don’t fret. Guess what? A lot of the ideas won’t cost you much or nothing at all, but they really make a world of difference when it comes to making your staff, co-workers and guests more comfortable with participating. Before you know it, it will become
just a regular way of doing business.

1. CROSS-CHECK THE PROPOSED DATE OF YOUR MEETING.
Does it coincide with any religious or cultural events? Are the dates of your meetings scheduled on days when children are off from school?  Tip: Keep a religious/ cultural calendar handy along with elementary school calendars.

2. INVITE ACCOMMODATION REQUESTS.
Ask participants well before the meeting to place their accommodation  requests in by a certain date.

3. CHOOSE AN ACCESSIBLE LOCATION.
Your venue should be equipped with ramps, elevators, accessible bathrooms etc. However, you will also want to consider having your event or meeting in an area that is easily accessible by public transportation.

4. CHOOSE A CATERER/MENU PLANNING.
Depending on your group of participants you may want to consider halal or kosher catering if you know that you will be having Jewish or Muslim guests. If in doubt always ensure that you have lots of vegetarian options.  Sit down meals are best if you are expecting guests with mobility challenges. If you choose to have a buffet, assign a volunteer to assist the participant with getting their meal.

5. IF POSSIBLE PROVIDE MEETING MATERIALS IN ADVANCE.
By doing so, you give participants an opportunity to ask any questions, obtain translations if required or just give them more time to absorb the information if they have challenges with reading comprehension.

6. PROVIDE CLEAR SIGNAGE AND NAME TAGS AND MATERIALS.
Use large print contrasting colour signs and high contrast name tags. Each  participant should have a name tag if there is a new member to the meeting. Consider the above with your PowerPoint presentations and handouts. Opt  for a larger font size like 18 and fonts like Verdana and Arial that are sans serif.

7. ALLERGY ALERT.
Ensure that your promotional materials indicate a scent-free environment. If you are planning to use balloons , choose a non-latex brand. Food allergies should be taken care of early on in the planning stages when you invite requests for accommodations.

8. CHAIRING THE MEETING.
Remember to indicate any changes in topic, break times and adjournments. Whenever possible, try to stay on schedule as some of your guests may have medical issues that they need to take care of during a break at a certain time.

9. KEEP ISSUES ABOVE BOARD.
While it is nice to get support for your position, trying to create a lobby group outside of the meeting spells exclusion. As a practice, strive to keep all related discussions within the meeting to avoid some members having an unfair advantage over others.

10. ADDITIONAL GUIDELINES.
While it is sometimes difficult to do, challenge participants who are trying to “pull rank in the room”. Remind meeting participants of simple rules like speaking one at a time, attentive listening, respect for different opinions and for confidentiality.

While these suggestions may not seem like a lot, by following these tips you will have opened the door to many more people to participate and enjoy your event more freely.  Creating inclusive events requires us to put ourselves in the shoes of many other people and look at the barriers that might be present and seek solutions.

 

 

 

 

In Praise of Generation Y


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Evelina Silveira, President, Diversity At Work in London Inc.  Author of Diversity and Inclusion On A Budget:  How to have a more engaged and innovative workforce with little or no dollars.

Hey there, Evelina!”, the e-mail salutation reads. Do I know this person? It seems that they must know me, right? Because they are so familiar? Nope. I never met them in my life! Probably a Generation Y’er  I figure, who is sending me this in their casual and unassuming way.

Born during 1981- 2000, Generation Y’s unique characteristics have stirred up a lot of turmoil in the workplace especially when it comes to their Baby Boomer bosses and co-workers. Whether it’s their tattoos, piercings, flip-flops, self-care or their need to be wired, connected and  informed  — the workplace will never be the same. Sorry Boomers! Laden with labels like: “disloyal”, “uncommitted”, “self- serving”, “techno-savvy”, “fun-seeking”, “lazy”, and “immature”; these children of Baby Boomers have  experienced more freedom, less responsibility, little in the way of criticism, and some would argue too much praise.

Consequently, employers complain that they don’t take work seriously, can’t handle criticism and feel they are entitled to privileges and rewards that others do not get and that they do not deserve. The disconnect begins here. After all, how do we get four generations to work together for the first time?

As a Generation X’er, I understand the harsh criticism bestowed upon Generation Y’ers; but at the same time I think that our generation understands them better than the Boomers. Generation X’ers were the first generation to dispel the myth that getting a university education will automatically land you a “good job”. We were working in call centres, as clerks and service jobs with our university degrees when the first recession hit in the 1980’s. But Generation X’ers approach to this phenomenon was a little bit different. Because of fewer jobs, our “latch key” socialization meant that we looked for solutions within ourselves. We decided to make our own jobs, creating the largest generation of entrepreneurs ever.

Generation Y’s solution to the shift in the economy is different. Strategically, Generation Y put their cards on the table right at the beginning with their prospective employers letting them know what they need from them, instead of what they can offer. Taking a completely different approach from previous generations, the Generation Y’er can come across as self-serving. That is where some of the conflict and misunderstanding begins along with many other disconnects in workplace values.

I am not a big fan of theories of generational differences although I believe there are some merits to the observations about various age groups but I don’t think they are absolute. I strongly believe that social class, birth order, and cultural differences play larger roles than age. The research in this area is arguably centred around privileged white youth who live in the suburbs, so it could be unrepresentative.

Despite the criticism lodged against Generation Y’ers, when it comes to diversity they really get it. Parented by those who lived through civil, women, and gay rights movements, Generation Y’ers have had a strong initiation into equality. Attending inclusive schools with children who have disabilities, exposure to more cultural and racial differences as well as a variety of family  compositions: this generation is more socially and environmentally aware. Of all the generations, they will have more of a propensity toward social justice and want to know the impact of their work.

When it comes to helping your organization develop a diversity strategy, ask a Generation Y’er. You can bet that the strongest supporters of diversity and inclusion in your workplace are Generation Y’ers. Not only have they been more exposed to a
rapidly changing diverse world —it is natural to them and they embrace it.

So, before you reprimand your Generation Y’er for not wanting to work overtime hours for free: relax; let your hair down; plug in your iPod and put on a pair of your favourite flip-flops and recognize the positive attributes of this deeply misunderstood  generation.

Signs the Political Correctness Police Has Taken Over Your Workplace


Evelina Silveira, President, Diversity At Work in London Inc.,  Author of Diversity and Inclusion on a Budget:  How to have a more engaged and innovative workforce with little or no dollars.

 

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“When I grow up, I’m gonna marry a tinker, tailor, soldier, sailor, rich man, poor man, beggar man, thief, doctor, lawyer or Indian chief”.

In the 70’s, this was the skipping song we chanted as little girls. The goal was to land on the “rich man” or the “doctor”. Any other kind of a husband signaled a doomsday marriage. Fortunately, a lot has changed for the better and our evolving language has captured the humanness, equality and the need for all people to be included.

In this effort to restore equity to groups which have been on the margins forever, have we in the process gone too far with creating other inequities in the workplace? I think that we have. We are a long way from having a balanced workforce. Let’s take a look at some typical examples you find in the workplace. Is your workplace guilty of any of these?

• You don’t have a Christmas celebration in the workplace even though over half of Canadians identify themselves as Christian and even those who don’t still celebrate some aspects of Christmas.
• You appease the demands of one group in the workplace at the expense of the other, because you don’t want to be labelled as a _______.
• You withhold information that could advance social change or contribute to the betterment of the community because your findings shed a negative light on a group or groups of people.
• You allow behaviours from certain groups of people who you would never allow from others.
• You ignore performance issues from people of designated groups because you don’t want to ruffle any feathers.
• Diversity of thought and politics are not permitted.

In these cases, we are talking about “Fear” which seems to be the norm in organizations that have swung too far on the left of the pendulum when it comes to political correctness. Legislation for sure makes people scared; there is more of it now than ever before. Many organizations let too many behaviours slide because of the fear of law suits and complaints. It is better to take proactive steps at creating workplaces that everyone can work in, instead of trying to police everyone’s thoughts, words and actions.

 

Is Your Team Building Inclusive?


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By:  Evelina Silveira, President,  Diversity at Work in London Inc, author of Diversity and Inclusion on a Budget:  How to have a more engaged and innovative workforce with little or no dollars.

Imagine. What would it be like to be escorted into an auditorium en masse to spend endless hours listening to speeches from your leader? Maybe the leader is feared or respected. The theme of his/her talks emphasize the importance of collaboration, discipline and commitment to collective values. You have no choice but to attend or you might be penalized in some shape or form.   For many people who were raised in communist countries they have had these experiences of attending mandatory events to demonstrate their solidarity with the mission and values of the State. They were given updates on the progress that had been made, the work that still needed to be done, and what they could do as a group to advance the State goals.

Could any comparisons be made to our Western-style of team building? You might say that it is not possible:  How can you make the comparison? While not all leaders are feared nor are the penalties for not buying-in so harsh, there are definitely consequences if you don’t “tow the Party line”.

I have been told by many people who grew up in communist countries, that aspects of our North American team building remind them of some of the unpleasant experiences of their country of origin where there was little opportunity for individual expression. The retreats or games, border on superficial and stressful because of the endless amount of small talk in a culture that still seems new. Team building is challenged if you have people in your group who feel that this is yet another exercise in “group think”.

Rock climbing, boot camps, bowling and a whole load of other physical activities that may be on the list for  team building.  I recall one of my workshop participants telling me that her husband dreaded their annual team building event because it involved all kinds of physical competitions and he used a wheelchair. The company never considered his feelings or tried to figure out a way that he could participate. You cannot build a team by excluding some of its members.

What about events that involve drinking alcohol and partying? I once had a client who confessed that now that his team was comprised of more women, people of other faiths and cultures, he was not so sure that the yearly drinking and partying fest in Las Vegas would be such a great reward for everyone! I had to agree. I encouraged him to look at other ways to build his team and consider more inclusive rewards programs like gift cards, cleaning services, and a monetary bonus.

Do you feel like playing Ker Plunk on a Friday afternoon to build a stronger team? Or does playing video games sound like a better idea? With four generation working together for the first time, we need to choose activities that everyone will enjoy or be willing to try.

Team building organizers must consider: cultural perceptions, accessibility, gender, religious obligations, and generational differences. It  is not a single event each year but must be cultivated on a daily basis. One of the easiest ways to build an inclusive team is to ask the individual members for feedback and ideas. Be prepared to implement them and show the progress of their ideas along the way.

 

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