by Jacky Habib in Toronto 

Joyce Chan suspected something was wrong with her husband when he started losing his way to their local Tim Hortons five years ago.

“Instead of walking south, hed walk north and get lost. I would have to go out and look for him,” Chan, 77, recalls, about her 82-year-old husband, Peter. She says he lost his way one day when they decided to go out for lunch. “We didnt know where he was, but he had walked home by himself. He fell down quite a few times.” 

Peter was diagnosed with Alzheimers disease, a type of dementia with symptoms including a decline in memory, reasoning and communication skills and a gradual loss in ability to carry out daily activities. 

Over 700,000 Canadians live with Alzheimers and other dementias. According to the Alzheimer Society of Canada, for every person with the disease, two or more family members provide care. 

The diagnosis has taken a toll on Chan, who is Peters main caregiver. He has been on a waiting list for the last year to receive long-term care. The couple immigrated to Canada 48 years ago and have one adult son whom they seldom lean on for support because of his busy schedule. 

“Its not easy. Back home in Hong Kong, we have lots of relatives ... I can call them [for support],” says Chan. “We have been here so long and we have friends, but everyone has their own family and their own problems.” 

Reverting to native language, reliving trauma 

Sharon Tong, the support and education coordinator at the Vancouver Chinese Resource Centre (VCRC), says many of the seniors she works with came to Canada through sponsorship and this impacts the dynamic they have with their children. 

Elderly parents often insist they can manage themselves and are not forthcoming with their children about their needs, she explains. 

[quote align="center" color="#999999"]“They dont want to put an extra burden on their children, but they dont have a social network."[/quote]

“They dont want to put an extra burden on their children, but they dont have a social network, because a lot of their social networks are still in their hometown,” she says. 

The VCRC is an initiative of the Alzheimer Society of B.C. that began 20 years ago. The centre provides educational workshops in Cantonese and Mandarin as well as personal support and support groups for people with dementia and caregivers.  

It has filled a gap for people who struggle to find services in their native language.  

Ekta Hattangady, a social worker at the Alzheimer Society of Toronto, says losing the ability to speak English is a unique challenge for immigrants with dementia. 

“A lot of people revert to their first language,” Hattangady says. “The services that are available to them last year are no longer suitable to them because they no longer speak English.” 

The Alzheimer Society offers information in various languages as well as counselling with an interpreter. The most commonly requested languages are Italian, Portuguese, Greek, Arabic and Cantonese. 

Another challenge with declining memory is that people recall old memories, which can be especially difficult if they have suffered trauma. 

To deal with this trauma, Hattangady sometimes recommends attending programs or listening to familiar music, which has proven to decrease isolation and boost the cognitive processes of patients. 

[quote align="center" color="#999999"]“A lot of people revert to their first language.”[/quote]

Accessing culturally specific services 

For people with dementia who are in need of long-term care, dietary restrictions such as eating halal or kosher food can also be a concern. 

This is where places like the Yee Hong Centre for Geriatric Care come in. The centre was established in 1994 to serve the Chinese community. It now has four locations in the Greater Toronto Area serving several communities, including a dedicated unit for Japanese patients and another for South Asians. 

The Yee Hong Centre incorporates culture in all aspects of service delivery, from the food it serves to the staff on site, who speak the same languages as the patients. 

“When [patients] talk about home, they are talking about home in a small town in eastern China or a village in India,” says Yee Hong's CEO Eric Hong. “They may not realize theyre in Canada. Our programs cater to that so they feel theyre in familiar grounds and dont get anxious.” Cultural music and newspapers at the centre contribute to this atmosphere, he adds. 

Hong explains that the Centre also provides health care that is conscious of peoples experiences and expectations. 

[quote align="center" color="#999999"]"Even if [immigrants] get services here, sometimes they are not tuned into what a person of colour may want.”[/quote]

“Health-care [in Canada] isnt as straightforward as people expect it to be. Even if [immigrants] get services here, sometimes they are not tuned into what a person of colour may want.” 

This includes addressing different perspectives on what constitutes healthy behaviour, and the relationship between a health practitioner and patient, he explains. 

Caregivers face challenges also 

Isolation is another common experience of people dealing with dementia and their caregivers.

Chan shares the difficulty in caring for her husband who she says has not been the same since his dementia has progressed. She says Peter was sharp, intelligent and had a decent build, but is now skinny, weak and needs help with tasks like using the microwave. 

Although hes a quiet person who doesnt converse with her much, Chan says when he gets sick, he screams at night and its tough to handle on her own. 

“I count my blessings every day,” she shares. “I like to play Sudoku and to watch TV and to listen to music, otherwise I will be very depressed. Ive got to keep up my spirits. I have to set an example for my husband. If I dont think positive, hell be worse.” 

Editor’s Note: Joyce and Peter Chan are pseudonyms as the couple did not want to be identified. 

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Published in Health

by Matt D’Amours in Montreal

It can be difficult for reporters to get information or comment from an organization for their reporting in general, but for immigrant journalists, language barriers and a lack of familiarity with public relations (PR) create unique challenges. 

Chantal Francoeur, a journalism professor from the Université du Québec à Montréal (UQAM), gave a talk at Concordia University last week focusing on the PR-journalist dynamic, and the power held by PR professionals. 

“When a real reporter wants access to an organization, there is just one entry, one person with whom the reporter can talk to: the PR professional,” Francoeur explains to a group gathered at Concordia’s Centre for Broadcasting and Journalism. “It’s the PR professional who holds the key that opens the door to an organization, and he or she acts as a gatekeeper and journalist watchdog.” 

Navigating language barriers 

For Jonathan Caragay-Cook, news editor at Concordia’s The Link newspaper, the PR doors may not open as easily as they do for other reporters. Cook arrived in Canada less than two years ago, and as an American of Filipino descent, he says that his inability to speak French often presents barriers when he reaches out to organizations in Quebec. 

[quote align="center" color="#999999"][Cook's] inability to speak French often presents barriers when he reaches out to organizations in Quebec.[/quote]

Last Fall, Cook reached out to an official from the Cégep du Vieux Montréal, a French-language college with a politically active student body. The official answered the phone in French, and Cook tried his best to string together a question using the limited words he knew. After a few seconds, the official told him that he couldn’t speak English and hung up. 

“I then realized that I just wasn’t going to get that perspective in my story,” Cook recalls. 

In other instances, Cook says that francophone PR professionals who do speak English have their prepared statements crafted in French, and are therefore wary of straying from their native tongue. 

Gaining more access

Although Cook’s experiences in Quebec represent clear obstacles, other immigrant journalists like Rita Latif has had a different type of difficulty when dealing with the PR machine. 

Latif, a Concordia University journalism student who arrived in Canada from Egypt in 2014, says that her biggest challenge has been adapting to the relative openness of corporations and institutions in Canada. 

“In Egypt, trying to reach these people is not as easy as here … it’s not something we’re used to,” Latif explains. “For us, these [officials] are restricted.” 

Latif says that she is still getting used to the notion that a journalist can simply perform a Google search and call a PR person or government official; she says it is hard to break out of her “safe zone.” 

Mistaking press releases for advertising

This lack of familiarity with public relations among immigrant journalists was examined in a 2015 study by April Lindgren, founding director of the Ryerson Journalism Research Centre. Lindgren looked at the case of Brampton, Ontario, and how the municipality’s attempt to reach out to the city’s ethnic media was initially plagued with issues. 

In 2007, Brampton’s communications department began distributing press releases to ethnic media outlets such as the Canadian Punjabi Post in an attempt to better reach out to the city’s immigrant population. According to Lindgren’s findings, however, this led to some confusion. 

[quote align="center" color="#999999"]“Some new arrivals [to Canada] don’t understand the PR world.”[/quote]

The study indicates that there was a lack of familiarity among ethnic outlets with this form of communication, and some newspapers simply published the releases in full. Others even sent the city a bill for advertising fees. 

“Some new arrivals [to Canada] don’t understand the PR world,” Lindgren says. “These newspapers were not able to distinguish between a press release and an advertisement.” 

In light of these difficulties, the city of Brampton made changes to their communications process, which included a plan to hire a “specialty media coordinator”, and to translate all media releases into French, Punjabi, Urdu and Portuguese. 

Understanding the intention

While this type of outreach can be useful in acclimating immigrant journalists and ethnic media to Western-style public relations, Tom Henheffer, Executive Director of the Canadian Journalists for Free Expression, says sometimes there are other intentions at play. He points to former minister of national defence and multiculturalism, Jason Kenney, as an example. 

[quote align="center" color="#999999"]"[Kenney] really infantilized them because ... it was an opportunity to speak to these guys and get a positive headline.”[/quote]

“Kenney, under Stephen Harper, made a point of being in the ethnic press at every chance he could … they thought a small paper would be excited to be able to get someone high-up in government,” Henheffer says. 

“But [Kenney] really infantilized them because ... it was an opportunity to speak to these guys and get a positive headline.” 

Issue not often discussed 

Speaking with New Canadian Media after her lecture on public relations, Francoeur says that different outlets will have unique perspectives on the challenges of dealing with PR professionals. 

When asked if the issue of limited access for immigrant journalists has ever come up in her classroom, Francoeur says it has not, but that this shouldn’t be taken as a sign that the problem doesn’t exist. 

“Our journalism programs are pretty homogenous ... and it doesn’t provide the whole, representative picture,” Francoeur explains. 

“Student journalists already have difficulties reaching PR people. Do they have more difficulty because their name sounds different? I don’t know … and maybe I don’t know because we don’t have that many [immigrant students].”

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Published in Arts & Culture
Monday, 02 November 2015 01:58

Family Not the Best Interpreter of Maladies

by Lucy Slavianska in Toronto

Language barriers can have a negative impact not only on initial access to health services, but also on the quality of health care and treatment outcomes.

In Canada, three main groups of patients can face language barriers: newcomers who still haven’t gained enough fluency in one of the official languages; French speakers with limited English living outside Quebec or English speakers in Quebec with limited French; and some members of First Nations and Inuit communities.

For immigrants and refugees, language barriers are generally considered a "newcomer" issue, which is overcome once the immigrant learns enough English or French to become independent of interpreters.

However, even after several years in Canada, some immigrants are still not sufficiently able to understand the official language of the province they reside in. According to a Health Canada report, “Language Barriers in Access to Health Care,” such immigrants are “more likely to be women with young children, the elderly, poorly educated or those suffering traumatic events or psychological disorders.”

The report also says that some immigrants are able to communicate adequately in everyday situations, but face difficulties in coping with “highly stressful health-related events in a second language.”

[quote align="center" color="#999999"]Lack of privacy and confidentiality, embarrassment, and other kinds of psychological discomfort are some of the disadvantages of using family members and friends to translate.[/quote]

Pitfalls of using non-professional interpreters

For patients who face language barriers, it is a common practice to visit hospitals and physicians’ offices accompanied by family members or friends acting as interpreters.

This practice has its advantages – these non-professional interpreters are easy to find, often compassionate, and in most cases accompany the patient at no cost. The stress of falling sick and visiting a hospital in a new country can be reduced if the patient feels supported, physically and psychologically, by loved ones.

But this experience is not always the case.

Soon after Aiko (not her real name), a 15-year-old girl from Japan, came to Canada to join her father, she started to experience menorrhagia – excessive bleeding that lasted more than seven days each month.

However, with no knowledge of English, she was reluctant to see a doctor. She felt uncomfortable talking to her father or her stepmother (with whom she had a conflict) about her problem, and couldn’t imagine going to a physician’s office with one of them as the interpreter and talking about her period in their presence.

A few months later, she started feeling weak and tired, and she fainted one morning in the kitchen. At the hospital, a blood check showed that Aiko had developed iron-deficiency anemia as a result of the untreated heavy bleeding.

Her father translated during the examination. She was embarrassed when the physician asked her about her menstrual cycle.

“The doctor was a woman and I might feel okay talking only with her in the room,” Aiko remembers, “but because my father was there, I didn’t want to answer. It was terrible.”

[quote align="center" color="#999999"]Even if good intentions are present, the use of untrained interpreters still carries serious risks of errors in translation that can lead to misdiagnosis and improper treatment.[/quote]

Aiko had to answer all the questions and eventually made a full recovery, but until her English improved, she dreaded seeing a physician again.

Lack of privacy and confidentiality, embarrassment, and other kinds of psychological discomfort like those Aiko experienced are some of the disadvantages of using family members and friends to translate.

But there are other, even more serious disadvantages: sometimes the interpreter may not act in good faith and can twist the information in a way that can harm the patient. Also, important sensitive information – about domestic violence, psychiatric illness, substance abuse, sexually transmitted diseases, and so on – may be hidden from the physician or distorted. 

But even if good intentions are present, the use of untrained interpreters still carries serious risks of errors in translation that can lead to misdiagnosis and improper treatment.

A 2003 research paper, “Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters,” concluded that mistakes in medical interpretation are common, and errors made by untrained interpreters are significantly more likely to have potential clinical consequences than those made by professional interpreters.

Professional interpreters: specially trained

For all these reasons, hospitals in Canada often use independent and specially trained interpreters.

In Toronto, for example, many hospitals find professionals though RivInt Interpretation and Translation Services, managed by the Elspeth Heyworth Centre for Women (EHCW). The centre has a roster of about 600 professionally trained people who cover more than 80 languages. 

[quote align="center" color="#999999"]The good news for the patients is that they don’t pay for interpreters – the expenses are covered by the hospitals.[/quote]

“Since our clients are most often hospitals, our interpreters are mainly specialized in health care,” says Sunder Singh, executive director of EHCW.

“We don’t take anyone who is not language tested and trained. One of the main elements of the training is mastering the medical terminology. The participants have to become familiar with all kinds of medical words and learn their equivalents in their own languages.”

Singh adds, “Another important element is the understanding of the responsibilities of the job. For example, interpreters have to be aware that the information communicated between the patient and the medical staff is strictly confidential. Interpreters who don’t obey that rule would not be called to work again and will lose their income."

Training is provided by different colleges and organizations like Seneca College, Barbra Schlifer Commemorative, Multilingual Community Interpreter Services and others.

“Training is expensive,” Singh says, “usually between $800 and $2000, but if the participants become good interpreters and the hospitals are satisfied by them, they are called again and again. And if the language is on demand, then there is a quick return on the investment.”

The good news for the patients is that they don’t pay for interpreters – the expenses are covered by the hospitals.

“The hospitals pay [the fees for] the language services to us,” Singh explains, “and we pay the interpreters at market rate. The federal budget, unfortunately, doesn’t pay a lot for interpreters’ services, so the hospitals keep aside some budget for that – because they understand how important professional translation is.”

While across Canada there are organizations that provide new immigrants with information about the Canadian health-care system, there is a growing number of newcomers who still don’t know about these resources. As such, this is part of an occasional series by that will look into access to health care for immigrants.

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Published in Health

New Canadian Media provides nonpartisan news and views representing all Canadian immigrant communities. As part of this endeavour, we re-publish aggregated content from various ethnic media publishers in Canada in an effort to raise the profile of news and commentary from an immigrant perspective. New Canadian Media, however, does not guarantee the accuracy of or endorse the views and opinions contained in content from such other sites. The views expressed on this site are those of the individual writers and commentators, and not necessarily those of New Canadian Media. Copyright © 2019 All rights reserved