Supporting Family Caregivers Across Language Barriers

Canada is one of the most diverse nations in the world. With over 200 languages spoken across the country and more than 7 million people speaking a language other than English or French, it’s no surprise that language impacts the caregiving journey. Whether it’s the caregiver or the care recipient who is more comfortable in their first language, communication barriers can make a challenging situation more difficult.

Language barriers aren’t exclusive to immigrants. Francophone, Indigenous, and Deaf or hard-of-hearing family caregivers also experience language barriers. Day-to-day caregiving, associated administrative tasks, and supporting medical care are all roles where communication impacts caregivers’ ability not only to fulfil their responsibilities but also to take care of themselves. Important information gets missed. Questions go unasked out of embarrassment or uncertainty. Decisions get made without a full understanding of the options. Support, including financial resources, could be missed.

Overcoming language barriers for family caregivers in Canada is a work in progress that can’t move quickly enough.

​The range of scenarios is broad

Family caregivers already carry an enormous emotional load. Add a language barrier on top of that, and the experience can quickly become overwhelming. There are many scenarios at play, and they all look a little different. Here are some common situations where language barriers create friction for family caregivers.

Caregivers or the care recipient (or both) speak English or French, but not well enough to clearly understand complex medical or administrative language.

The care recipient spoke English or French but is retreating into their native language because of their illness. This is more common in patients with dementia or other neurological diseases.

Neither the care recipient nor the caregiver are confident in English or French and are reliant on phone calls with other family members to coordinate care.

The care recipient or the family caregiver is Deaf or hard of hearing.

The potential harm of miscommunication

Family caregivers and healthcare providers are already using a range of tools to try to overcome language barriers. The challenge isn’t zero communication, but rather partial communication that leaves gaps.

Technical medical details can be misinterpreted, potentially leading to reduced efficacy of treatment or even harm. Caregivers can miss key information, for example, learning about tax credits or other financial resources. Accessing support or arranging appointments can be difficult if a phone call is required. Care recipients and caregivers may be distressed by miscommunication and feel too embarrassed to seek help. The patchwork approach, using phone calls with relatives, Google Translate, and gestures, may be better than nothing but still not good enough.

Breaking down the barriers

The good news is that barriers can be overcome, and there are practical steps both caregivers and the systems serving them can take. If you support a family caregiver who is facing language barriers, or are one yourself, here is what you need to know.

You have the right to request language assistance in a healthcare setting: One of the most important steps is to ask for a professional interpreter. Many hospitals and health authorities have access to professional medical interpreters, either in person, by phone, or via video. Depending on the scenario, accessing these resources doesn’t always happen on time. This shouldn’t deter families from asking.

Tap into community groups where the language is spoken: Community groups rooted in ethnocultural roots often provide support for caregivers, including support for overcoming language barriers. This can be helpful when trying to understand programs like the Canada Caregiver Credit, home care services, and long-term care applications.

There can be downsides to relying on a family member or friend – especially when it comes to medical treatment: While common, relying on family members to translate can lead to errors, especially when the content is complex. If the family member is completely fluent in both languages, some risk may be reduced. If you are supporting a caregiver with translation, encourage them to ask questions until they’re crystal clear. One of the biggest errors a well-meaning friend may make is to edit out details either for ease of translation or to soften the blow of difficult news. Everyone should agree that as much detail as possible should be communicated, and if necessary, ask healthcare staff to slow down or repeat information. Use a transcription tool to capture notes that can later be translated.

Tap into technology, with some caveats: Digital language tools have exploded since Google Translate. As transformative as they may be, there are some downsides to relying on digital tools for caregiving translation needs.

Not all tools are appropriate for medical terminology. Free translation apps such as Google Translate are okay for general, day-to-day use. When it comes to doctor’s appointments, prescriptions, or any other medical situation, an affordable app designed for medical scenarios, such as Care to Translate, Mabel, or MediBabble, will be better. However, it’s important to remember that not everyone can use digital tools. Depending on ability, access to technology, vision and dexterity, these tools may not be appropriate.

Another thing to consider is that apps are only as good as the hardware they’re delivered on. Many apps, especially ones that involve video conferencing, will only work well on newer, more expensive devices. And connectivity can be an issue, especially in hospital or remote settings. So while technology may be great sometimes, for some people, it won’t work all the time, or for everyone.

Healthcare providers, social workers, and care coordinators have a responsibility to ask about language needs proactively: Rather than waiting for a caregiver to raise the issue, those in a position to spot potential language barriers need to step in. Family caregivers and care recipients may not know they can ask for help or may be too embarrassed.

Create multi-lingual resources: Using plain language in written materials and ensuring multilingual resources are visible and accessible are key to supporting family caregivers who speak English or French as a second language.

Reframing language barriers

If you’ve ever tried to learn another language, you’ll know it can be very humbling. It takes courage, even more so in a high-stress situation. If you know a family caregiver facing language barriers, let them know they’re doing an extraordinary job. Family caregivers often go unrecognized for their efforts. Recognizing not only the caregiving role but the specific efforts they’re making around communication can help reframe it as a sign of strength. Removing any stigma from language barriers helps family caregivers focus on the care recipient.

The issue of language barriers in family caregiving highlights how complex the caregiving role can be and how a community effort is needed to support all family caregivers.

If you are looking for caregiver support resources in your language, contact your local 211 service (dial 2-1-1) or visit 211.ca to find services available in your community.