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I know that the hourly pay for an aide at even the highest level nursing home is very low. And, it's not a great job, to say the least. But, still....when an aide has such a thick accent that I cannot understand what the aide is saying, let alone my mother who is 91 and hard of hearing, it seems to me that the aide should not be working there.


The accents are one issue. I understand that aides are low paid, but why is it my problem, and my mother's problem, to try to understand an aide who has a thick accent?


The ability to appropriately speak to a hard of hearing resident/patient is another issue.


I have been told, more than once, that all staff is trained to get within 3-4 feet of a hard of hearing patient when speaking.....and speak directly.....not to say something when walking out of the room or when moving around the room. But, that's not what happens. I have seen it. Countless times.


Please don't....even with the best of intentions...mention hearing aids. We tried that. My mother is fine with the phone and with the TV and when someone speaks directly to her close enough.


All I want is for the staff to get close enough to my mother and actually look at her and speak to her directly.


And, yes......after 3 years of home health care givers, and now almost 2 years of nursing home aides, not all of which...but many of which....have accents that, as I have said already......I cannot deal with this.


Any advice?

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Can you tell the aid directly when you see them doing it? Basically call them on the carpet and tell them you know that they are supposed to get 3-4 feet away and speak directly to the resident.

I have a very hard time understanding any accent, so I am constantly asking people to please slow down and repeat what they said. I do this with the attitude that it is my problem, which it is, light or heavy accents throw me, but I think that being kind when calling them on their behavior will get better results.

Also, thank them when you see them taking good care. It is a tough environment to work in and it's a tough environment for all people with foreign accents right now.
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anonymous903302 Apr 2019
Thank you. I appreciate your response.

Yes, I do all of that, when I am there, in person. And, I have brought up the issue at plan of care meetings. And raised the issue on the phone with the floor nurse and the nursing supervisor.

If I cannot understand an accent, I always ask, politely and calmly, to please speak slower and repeat. In person and on the phone. And, I do say please and thank you, all the time. And, I do give praise. Even when someone is just doing their job, not doing anything special or extra.

Fact is, some of the aides just don't care enough. Because they are getting paid (as some other poster said) peanuts, and the job can be horrible.

I place double blame: on the nursing home for not paying enough attention, and on the aides who know....and they do know....that their residents cannot understand their accents.
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It sounds as though the facility should run a short training session for all the Aides about communication. They have the policy right, and it isn’t being followed. ‘Reminder’ training sessions are quite normal, and would be the best way to get all the Aides to be more conscious of what they should do.
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My advice would be (as well as Margaret's excellent suggestion to nudge the facility's managers) to engage with individuals and tell them what you would like them to do. Nicely.

E.g. "my mother understands you better if she is face to face with you, and you speak slowly."

The accents issue is an interesting one. The choice you have is not between aides who speak standard English or aides whose English is heavily accented. It is between the heavily-accented aides or no aides at all. No it shouldn't be your problem or your mother's, but that is the choice. We haven't trained enough aides from our own countries, and we haven't treated elder care as a respected vocation. Pay peanuts, and begrudge them even the peanuts, and you're not going to get talented linguists with high levels of interpersonal skills and self-sacrificing compassion who are also prepared to handle incontinence.

But the reason I say it's interesting is that it is remarkable how quickly we do adapt to different pronunciations. I don't speak a word of Hindi - except those which have been adopted in English, like shampoo - but I can perfectly well understand even newly-arrived Indian people who are speaking English, even if their accents are so thick they make their relatives cringe. It is a human tendency to think "oh I can't understand this person" and stop listening; but in fact if you ask the person to repeat what s/he said you will get the hang of the differences before you know it.

You might also bear in mind that these people are trying to learn, and out of ordinary charity help them with that. It is fine, if you do it kindly, to correct pronunciation by repeating words so that they can imitate you. It is also an excellent way of building positive relationships.
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worriedinCali Apr 2019
“We haven’t trained enough aids from our countries”. Curious what you mean by that? I know you aren’t in the US, but the OP is and our country is a beautiful melting pot and English is not our official language. There are many people who are from this country (born here) and speak English as a second language.
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Caring for the elderly is a sad job. It is difficult to be on the front lines watching people decline. It is hard work to change their diapers, to shower them, to move them in bed when they can’t budge, help them up when they can’t stand. It must be devastating to slowly watch them lose their skills, their language, their functioning. I know healthcare workers that needed to change professions because they were depressed after losing patients they were caring for.

Can you imagine going to another country, learning another language, cleaning up after their elderly and then being criticized about the way you pronounce words?

Kindness goes a long way! There are some healthcare workers that you must like more than the others. Be friendly and kind to them. Treat them how you would like to be treated. Ask them about their family (they are helping you with yours). Challenge yourself to make them smile. They will sparkle.

Turn this situation around for yourself and your loved one with positivity.
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JoAnn29 May 2019
But accents are very hard for those who have hearing problems. My husband hears words different then they actually sound to us. Throw in an accent, forget him being able to understand. Anyone working with a patient/resident has to look at them and make sure they are understood. I go thru this all the time with my husband with people who were born and raised in the US. Its very frustrating and has caused problems because people don't take the time to make sure they r understood.
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It still shocks me to read this thread.

Prejudice against skin color and accents? Is this group in a pre-civil rights time warp? Haven’t we seen the horrors of hate and cultural insensitivity enough lately?

Our society (and world) has become very international. Look around.

Signs all over the U.S. are now bilingual, product packaging is multilingual.

Many of our best medical researchers, doctors and nurses in hospitals (as well as medical students) were born abroad. I’m sure many of you have gratefully received the benefit of their care. I bet you weren’t complaining when you did.

We should all cooperate and be thoughtful to one another, sensitive to cultural differences, and color blind to differences in skin tones.

We should be as patient with them as we hope they will be with our loved ones.

Expectations that healthcare workers (or anyone, for that matter) speak fluent, articulate, perfect English (with no accent) are unreasonable and out-of-date.
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Isthisrealyreal May 2019
You act as though they aren't prejudice against English speaking people, if they weren't they would learn the language after 25 years here. It has nothing to do with what you are implying, it's about respect all the way around. I don't care what you look like, or what your 1st language is, if you move to a country you learn the language of the land, don't think for one minute if you went to the country they left that you not speaking the local language would get you anything but the run around. It is a sign of respect in other cultures to at least attempt the language.

I am sick of people trying to make me feel bad for being a white, English speaking American. I have nothing to apologize for and I will call you on rude, disrespectful behavior even if you're purple. It is about human dignity and it goes both ways.
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The thing is, we need to leave the ethnic stuff out of the equation.

It is not unreasonable for CNAs to check that their clients understand what they have said.

Focus on that issue.
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anonymous903302 May 2019
Thank you.

My concerns have nothing to do with ethnicity. I am kind of amazed at some of the implicit comments that I am some kind of racist. After several years of in-home and now nursing home caregivers, I know that there are some accents that are very hard to understand -- not just for my elderly mother --- but also because I cannot understand them, and I have no hard of hearing issues or dementia.

It's not about race or ethnicity.

I agree: all caregivers should care whether their patients/clients/residents can understand them.
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Your first sentence about “great nursing home” should be your focus.

Almost all of us are descended from immigrants. We are so lucky that enterprising, hard working individuals are willing to get their CNA licenses and help us care for our parents. This is physically and emotionally stressful work. We couldn’t do it without them.

This kind of feedback is not constructive —it only serves to humiliate the individuals that are giving you service and may be counterproductive.
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Isthisrealyreal Apr 2019
Treating a senior citizen in a degrading attitude is unacceptable and should not be tolerated. If people don't want to do the job, they should get in a different line of work.

An azzhole is an azzhole in any language.
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Maybe this needs to be discussed in a separate thread. Just FYI the U.S. has no official language nor religion. There's a reason for that.

My mom in SNF late 2016 into early 2017. Some of her best aides were Jamaican and Bahamian. Thick accents. Great caregivers. This was high end place, which we were lucky to get a spot for SNF.

Some of you complaining maybe have never been abroad where signs are in 6 languages and dialects are as varied as cuisine.

Also, learning a second language might be good for cognitive sharpness.
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worriedinCali Jul 2019
I agree with you Seg, and that’s an excellent point about other countries being multi-lingual. Canada has 2 officials languages, right? French and English. The USA might as well follow their lead and make our languages English and Spanish because those are the 2 most spoken languages here. English is one of the most difficult languages to learn as well, that’s why I dislike people saying to learn it or leave the USA. It’s a difficult language to learn.

and I don’t know if it’s just California or maybe just my county but.....there are a LOT of Filipino caregivers here. And they are wonderful at what they do, despite their accents. They are nurses, CNAs, and medical assistants. Most medical assistants at the doctors offices are Hispanic-not necessarily Mexican because we have a lot of people from El Salvador and Guatamala here too. But in my lifetime as a Californian, most medicinal staff I encounter do not speak English as their first language. Sure they mispronounce common “American” names but they are still good at what they do.
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Regarding accents, my Mom always had difficulty understand people who had accents even if the person was from the southern part of the U.S., people from Boston and even New York City... [sigh].

My Mom even had issues with my mother-in-law who had a French accent mixed with a southern drawl as she came to the U.S. when she was in her 20's, a war bride.

The kicker here is that Mom parents were from eastern Europe and had a very thick accent. You would think she would have had a better ear for language.
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You know, my mom was in a non diverse, Lily white memory care facility. All aides Caucasian. But man they could butcher the English language. When she was still with it cognitively, she would correct their grammar.
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