When we don’t speak the same language: Ways to understand one another in hospice care

Words can be very useful. They enable us to communicate our thoughts and feelings. We express our happiness, sadness, anger, frustration and love through words. Being able to communicate with our loved ones and friends is the foundation of our relationships. And words are very important when forging new relationships.

So when I received a phone call about visiting an Italian woman who spoke very little English, I did have some concerns. I told myself I would have to learn as much Italian as I could in the next six days so that I would be adequately prepared.

On my first visit, armed with my Italian handbook, a small memo pad with handy Italian phrases in my pocket (and a cannoli for good measure), I was nervous but ready for the challenge. I was very surprised at how little I glanced at my Italian book. Rather, I did a lot of listening—intense listening. I understood very little of what she said, but because of that I listened more closely to the tone of her voice and facial expressions.

In a way, not understanding what someone is saying can be a good thing. It prevents you from interrupting and so you are forced to listen better. It also makes you maintain eye contact since you are paying more attention to facial clues. You may not understand what someone is saying, but you are telling the person that “I am here. I am listening. You have my attention.”  Isn’t that what we all want when communicating with someone?

As time went on, my new patient seemed to welcome my visits. She told the nurses one day (in English), “This is my friend.” Each week family members left cards or other tokens of affection in her room, and she would point them out to me and talk about them. I spent time looking at family photos that she enjoys talking about. Several times I brought a book about Italy and we looked at pictures of art, architecture and Italy’s beautiful landscapes. Many weeks I brought watermelon (one of her favorite foods) and I could see the delight on her face as I opened it up. I knew she had a sense of humor, so I brought a DVD player and we watched some “I Love Lucy” episodes. Of course, I chose the ones where Lucy visited Italy. I found myself watching her watching the show. She was smiling and often turned to me during a funny scene and repeated what was said.

Not all of my ideas were successful, however. I brought tea for my patient one morning. She watched as I unwrapped the delicate teacup, poured the water and she even unfolded the cloth napkin and gingerly draped it over her lap. When her tea was ready, she took the cup from me, placed it down on the tray, and there it sat for the entire visit. I think she enjoyed watching me prepare it, but really wasn’t interested in drinking it!

Although I am endeavoring to learn more Italian, it is still difficult to understand what my patient is saying to me. But I believe that my weekly visit gives her an opportunity to say what she wants to say and to have an attentive ear. And although I am not sure how much she understands me, she always surprises me. I gave her flowers one week in October and put them in a paper cup that had snowmen on it. So there were beautiful fall flowers in a snowman vase! I apologized to my patient (not knowing if she understood me) and she looked at me and said, “That’s-a-OK!”

In hospice work, I have learned that there are other ways to communicate besides using words. It is not so important to speak fluent Spanish to a Spanish patient or to speak Italian eloquently to an Italian patient. Caring and compassion have a language of their own.



Holy Redeemer

Holy Redeemer

For nearly 80 years, the Sisters of the Holy Redeemer have served the community through their mission to care, comfort, and heal. The visionary Sisters created a health system committed to helping people achieve optimal health no matter where they are in life. This includes delivering exceptional medical care not only within the hospital, but also through our outpatient, home care, and long-term care facilities and services. As a result, our health system is well-positioned to serve the community now and in the future.
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2 Responses to “When we don’t speak the same language: Ways to understand one another in hospice care”

  1. Susan Seif

    Thanks, I appreciate your comments. Something to keep in mind for those
    who may be struggling with a family member who has Alzheimer’s, and
    may feel awkward about what to do/say. Your presence is most important in these situations, not necessarily having profound words to say.

  2. boomer98053

    What an exceptional article. If you substitute an Italian woman with someone with Alzheimer’s or other dementia who has difficulty communicating, you could use the same methods and be equally as successful. Imagine being the Alzheimer’s patient and experiencing someone who stays attentive and engaged during a visit. What a gift.


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