The Linguist is a languages magazine for professional linguists, translators, interpreters, language professionals, language teachers, trainers, students and academics with articles on translation, interpreting, business, government, technology
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How could they avoid 'Elderspeak' – a high-pitched use of simplified language like babytalk? 26 The Linguist Vol/56 No/4 2017 www.ciol.org.uk FEATURES Boyd Davis and Margaret Maclagan look at the fast-growing issues of communicating in multilingual dementia care settings Language incompatibility is seldom mentioned in policy reports on ageing as a potential barrier to dementia care. It is an issue, however, particularly for multilingual older people and their families, and especially for newcomers to a country. Migrants make up a significant proportion of the elderly population. In the US, for example, people aged 55 and over comprised 25.7% of migrants between 1970 and 2000, although the majority of migrants were in their late 20s to late 40s. 1 These older people are frequently lonely and often depressed. The new country is different. The food is different. The smells are different. Those with dementia have a silent and misunderstood condition that is likely to be culturally stigmatized. If they lived at home prior to relocating – and according to Martin Prince et al, 94% of people with dementia in low and middle income countries do live at home 2 – they are cared for, even hidden away, by family members, who may not understand that they have a condition that warrants medical care and external support. They and their families bring their habits, language and cultural values with them across international borders. If they are placed in any kind of assisted care home, rest home or memory care residence, it is quite possible that they will not understand what their caregivers and medical personnel are saying to them, or asking them to do, wash or eat. A survey of dementia care for ethnic minorities in 36 ageing centres across 15 European countries reported that language- based issues, whether verbal or non-verbal, caused 64% of the problems in assessing or rating dementia severity or in being able to offer culturally appropriate services. 3 It is unlikely that the percentage has decreased since the survey was conducted in 2011. Every major report by foundations and agencies, from the World Health Organization (WHO) to the UK's Runnymede Trust, emphasises the need to increase dementia care resources and caregiver training in the face of growing numbers of people with dementia worldwide. Multilingual Interaction and Dementia is a language-focused effort to exemplify that need. 4 Ten chapters, including an introductory overview by 22 researchers, look at language interactions among residents and staff in Irish-English in Ireland; Chinese, Hindi and Punjabi in Canada; Arabic, Kurdish, Turkish, Persian and Finnish in Sweden; the multiple languages of international staff in the US and Sweden; and internet-based training in dementia assessment in English, German, French and Spanish. The issues raised include what kinds of interaction can be supported; what kinds of training can be given to a caregiver who does not share a language with a resident's family members, or have access to an interpreter or someone who can serve as a cultural broker; how can they obtain any reliable assessment of what a resident can still do; how that caregiver can get the resident to come to lunch, join an activity or take a shower. Training for staff Language can be a barrier to staff as well as residents. There are various cultural and linguistic challenges for multilingual nurse aides, many of whom are also newcomers to the country. Our goal has been to develop training for culturally sensitive care through gerontology and linguistics at UNC Charlotte, North Carolina. Whether we are working on certification coursework for second language/multilingual paraprofessional (unlicensed) assistants to professional healthcare workers, such as nurses, or on continuing education/in-service training for second-language caregivers in care home settings, the challenges around language and culture are similar. Space, time, touch – with and without gender issues – religious preferences about food and expected mealtimes all needed discussion, explanation and exploration through role-play. Newcomer staff were unsure when it might be appropriate to use colloquial expressions and specific technical vocabulary, or how to address residents: 'Auntie', 'Grandfather', 'Miss', first name, endearments? How could they avoid 'Elderspeak' – a high-pitched use of simplified language that sounds like babytalk? Training also needed to discuss culture-based gestures that could be misinterpreted, and to deal with staff expectations about what Care across languages