All of my current carers and most of my past agency carers have had English as a second language. Here are some of the issues I’ve faced.
I get the impression that my carers don’t always grasp the level of issues that their lack of englsih profficiency creates. It is of course possible that they have noticed and are embarrassed or prefer not to talk about it. I think sometimes this is the case, but often times they seem oblivious or think I am not being clear. For example whilst giving people instructions I need to be quite specific, but the carers fail to realise that’s what I am doing. For example today the carer was looking in the front of a drawer. I said “Can you look in the rest of that drawer please?”. She closed the drawer and opened the next one. I explained again but she just asked which drawer! I couldn’t think of another way of meaning the same drawer but the parts she hadn’t looked at yet.
Carers don’t understand when I am referring to one of anobject and when I am referring to many. I tried explaining that I had said ‘that’ drawer, and not ‘the’ ‘drawers’ but it went above her head. Similarly I might ask for one glove so say ‘a glove’ but then another carer will say that i said ‘a gloves’ and the first carer will say ‘how many?’.
Directions are also a big problem. Up, down, under, above, more gentle, slower etc are all a problem. Some tasks I am able to do myself but with pain and illness. Sometimes I find myself doing it myself to show them and just hoping they can do it next time, but other times it is not something I can do and I just have to keep explaining until I am exhausted and we are both frustrated.
Carers use incorrect terminology which leads to confusion. I can understand “shall I on the light?” (Although it takes me a minute) but if you keep saying “Shall I open it?” I’m unlikely to guess that you are referring to taking my tshirt off.
Carers don’t seem to adapt their language and learn as they go along. My fridge and freezer are still interchangably a ‘fridger’, and ‘conotrane’ is still ‘conotol’ despite months of my confusion followed by explaining to them. This takes more energy for me to work out what it is that they are trying to get across and over the course of a shift that really adds up. I understand that it can take a few repetitions but it also just feels like my carers are set in their ways sometimes or don’t see the importance of learning the correct terminology.
Carers don’t seem to understand “pardon?” or even “what did you just say?”. They then go on to give poorly contextualised additional information, or they just don’t say anything in response and prettymuch ignore me because they didn’t understand. Sometimes I have to explain in three different ways that I didn’t hear what they said and don’t understand what they mean. I feel like I am continuously trying to paraphrase what I mean so that carers understand what I am saying but I don’t always feel like they afford the same effort to me.
Carers might use language in a way that people outside of their culture find rude. For example I had a carer who would say “What?” instead of “pardon?”. It was really abrupt in tone too and I never knew if she meeant she hadn’t heard what I said, hadn’t understood what I said, or was otherwise displeased with what I said. I pretty much always interpreted it initially as the latter because in my own culture that’s usually what that tone would mean. I am ashamed to say that I usually ended up sounding a bit pissed off in response! It took me ages to realise what was happening. That same carer would say “Hello?” if I didn’t answer her within a few seconds, even if I was talking to someone else. It drove me up the wall! My current carers all say “Say it” if I pause for a second during speech. I initially took this to mean “hurry up then” or “I dont think I will like what you have to say so just get it over with” but apparently it is more of a polite way of saying “it is ok to say whatever you need to say”. It still grates though and I invariably forget what I was trying to say!
I have had carers get frustrated with me and say “you know what I mean though” and I have to explain that no really, I don’t! The times it is most difficult is when they are trying to say something new so I have no context to work from. Because they think I am just being mean about their English they then don’t go on to explain more what it is that they mean.
All of the above can make care really frustrating. I feel like I am not being heard and understood and I feel like I am having to put a lot of work in to communicating. I think a few things combine to make this a big problem. Firstly agencies are recruiting people with too little English to do the job sufficently. Secondly the agencies should be providing these carers with the communication and language skills they need to do the job. Just as they might need to know how to use a hoist, they should also be taught how to understand directions. It really surprises me that care agencies don’t see this as a necessary part of training. Lastly carers need to be taught the value of listening and adapting to a client’s needs. Things like that if you don’t understand you should have the confidence to ask for clarification, because ignoring that they even said anything is a lot worse.
I am relatively lucky at the moment. I have had a lot of carers with a lot less English but I really have found this is a massive problem within the care sector and I wish that someone would think of better ways to tackle it even if it is just a basic training pack and reference sheet explaining and teaching directions and specific words needed. I have also learned that carers/PAs and clients/PA users need to feel comfortable having a dialogue and saying “When you say this, what do you mean?”. That last one has been invaluable even with people with English as a first language. I once had a PA ask me what I meant by ‘ta’ because she had been interpreting it as patronising for weeks! I had to explain I literally just meant a short hand way of saying thanks!