This chapter explains the importance of using a certified medical interpreter and how to appropriately use this service in a hospital setting. An interpreter needs to understand cultural beliefs and be able to effectively communicate the information between two individuals who are likely from different cultures. The trained and culturally sensitive medical interpreter can communicate verbal information and serve as a cultural bridge between two individuals who could have very different beliefs about everyday interactions with others. Culturally competent medical translators pay close attention to both the verbal nuances of language and the nonverbal norms and customs that may be significant in a health care interaction. The chapter also discusses the importance of patient perception on follow-through of treatment, the idea of cultural competence, and how to appropriately communicate and use interpreter services. It provides some case examples of successful and unsuccessful interpretation.
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- Go to chapter: The Effective Use of Certified Medical Interpreters in the Neurorehabilitation Setting
Neurorehabilitation has become more of a global phenomenon and is not necessarily limited to industrialized or Westernized societies. Culture often connotes concepts of race and ethnicity when discussed in the context of health care disparities. Socioeconomic and other demographic variables make up the majority of the balance on discussion regarding culture in health care. Multicultural neurorehabilitation must emphasis “multiple”, and do so in a dynamic manner. In other words, at any given time, multiple cultures operate in each interaction and in each therapy delivered in the neurorehabilitation setting. Recently, there has been increased interest and research into the newly developing field of cultural neuroscience. Several models are available to conceptualize the influence of culture in human functioning. The most persuasive model is one that mirrors a dynamic, ecological system.
This chapter deals with major health care issues that social workers need to be familiar with in working with immigrants. It provides an introduction to the many complex, interconnected issues that social workers and their immigrant clients face as they navigate the US health care system in an attempt to obtain quality health care. The chapter focuses on some of the implications for social work practice that arise from public health issues and provides discussion questions and several case studies. Social workers can and should be vigilant in advocating for increased translator and interpreter services at their agency or medical setting, not just for the convenience of the patient, but for his or her safety and improved health. Social workers in the field of health care must actively address the issues of language, culture, and income/health insurance status as well as legal status when working with immigrants.
This chapter focuses on a profile of low-wage immigrant workers. It explains the rights and remedies available to immigrant workers under labor laws and explores the conditions and factors that lead to their abuse and exploitation. The chapter illustrates the barriers that prevent employers from enforcing labor and employment laws, including lax enforcement of laws by government agencies, the threat of deportation by immigration agents, and government programs that hinder workers from exercising their rights. Immigrant workers will be essential to keep the economy strong, to serve as caretakers for the aging population, to contribute to existing health care and Social Security systems, and to help shape the future of the Unites States. Despite government safeguards and nonprofit advocacy, the unfortunate reality for many immigrant workers is that violations of labor and employment laws by their employers are rampant, particularly in low-wage industries.
Given the many roles that grandparents play in lives of their grandchildren, policies can be critical factors in their support and in their familial relationships. This chapter explores key policies impacting grandparents and thus their grandchildren. It focuses on policies affecting kinship care, as grandparents face a multitude of issues that can impact both their own well-being and that of the children they are raising. As involved and committed grandparents may have been, their concerns are at risk of being ignored, as they must prove to court that their custody or visitation rights are in the child’s best interest. Among the most vulnerable are those who are raising their grandchildren on marginal incomes without adequate housing and healthcare, and who must deal with service providers insensitive to their concerns and needs. Finally, policies that address the needs of grandparents must provide a vital framework for strengthening both families and society.
Robert Butler coined the term “ageism”. Butler described ageism in three realms: stereotypes and prejudices against older adults, discrimination against individuals, and institutional practices and policy that disadvantage older adults or perpetuate discrimination. He believed that ageism accounts for disregard for older people's rights seen in public policy. He saw it in the failure of institutions to address the needs of older people or protect their rights, citing as evidence government's failure to protect older people against mistreatment or to enforce nursing home regulations. He saw it in the lack of attention to older people in disaster preparedness plans and in the institutional ageism that leaves many older people impoverished and vulnerable. Although Butler and others saw ageism as standing alongside other “isms” other forms of injustice and discrimination it never achieved their traction. This chapter explores why. The chapter discusses elder abuse, ageism in healthcare, workplace, and public policy and politics.
A dramatic shift has occurred in the field of long-term care in recent decades in how providers talk about those they serve. This chapter explains what consumer rights are and suggests how they might apply in long-term care. It considers obstacles that older consumers with physical and cognitive disabilities may face as well as barriers imposed by the markets themselves, such as the failure of healthcare to respond to market forces that are supposed to drive prices down and lead to new and improved products. It acknowledges the special rights of users of medical care, nursing homes, assisted living facilities, and health plans as articulated in patients' rights and residents' rights declarations and agreements. The chapter finally makes the case that consumers' rights should be a component of elder justice and that elder justice advocates and the public need to understand how to exercise and protect them.
The root causes of social injustice are in part centralized around wealth inequities, politicians and legislation favoring the wealthy, discrimination, and a Darwinian mentality (Greenwald, 2011; Marini, 2012b; Warren, 2014). This chapter explores the ramifications of social injustice in America focusing on those with disabilities. It discusses the ripple effect of poverty, oppression, and disability, and its subsequent deleterious impact for equitable treatment and opportunity. Beginning with prevalence statistics regarding poverty in general and disability specifically, the chapter segues into an exploration of the domino and vicious cycle effect of inequitable education, employment, health care, and health. The resulting psychosocial impact on minorities and those with disabilities is a reciprocal occurrence among these populations interfacing with an arguably apathetic societal and political populace. Finally, the chapter discusses a dialogue regarding the social justice counselor and strategies for counseling and advocating for this most ignored and disenfranchised population in America.
The history of treatment and attitude toward people with disabilities has often been marked by societal fears, intolerance, ambivalence, prejudice, and ignorance regarding disability. The independent living movement essentially evolved as people with disabilities learned from the social activist movements concerning minority civil rights, consumerism, and women’s rights. Ironically, because of medical advances, the life expectancy and quality of life for people living with disabilities in industrialized nations continue to improve from a medical perspective for those who can afford health care. To this end, the United States continues to arguably have a "survival of the economically fittest" mentality if universal health care is not soon realized. For the estimated 76 million baby boomers presently transitioning to retirement, the golden years may not be something to look forward to given the increasing health care costs.
When it comes to aging, medical conditions quickly become one of the most important issues facing people. As people grow older, they are more likely to have medical conditions that require attention and that can hinder their ability to perform the daily tasks of living. Improved medical care and prevention efforts have contributed to dramatic increases in life expectancy in the United States during the past century. They have also produced a major shift in the leading causes of death for all age groups, from acute illnesses and infectious diseases to chronic conditions and degenerative illnesses. This chapter describes medical conditions experienced by older adults and outlines the major features of continuing care retirement communities, assisted living communities, and nursing homes. It also highlights the difficulty many people face in paying for the long-term care they need and discusses the significant financial burden of long-term care.