The ethnic elderly in Metro Toronto Hospitals, nursing homes, and homes for the aged: communication and health care.

The ethnic elderly in Canada have remained a somewhat isolated group of seniors who become known when they enter our health care system as "aliens in their own country." They face the double jeopardy of not only declining sensibilities and increasing disabilities that frequently accompany old age but also the psycho-social deprivation of being unable to communicate with caregivers in their institutional health care settings. Communication may be critical to effective, efficient, and equitable health care service delivery for ethnic elderly individuals. This study attempts to develop a database on the ethnic elderly persons, examine the extent of communication problems they face in hospitals, nursing homes, and homes for the aged in Metro Toronto, and report on the institutional responses to the situation. Nursing unit supervisors who completed the questionnaires (N = 77) reported that communication was essential to the health care needs of the ethnic elderly individuals. A majority of health care institutions had developed some form of interpreter services albeit frequently informal, unprofessional, and ad hoc. Without interpreter services problems developed that in some cases were seen as critical to the health care of ethnic elderly individuals. Even with interpreter services available, problems developed, suggesting that the services provided were not effective in some cases. It is suggested that further study be conducted to examine the relative effectiveness of formal, professional, and informal interpreter services. Few institutions had workshops or training to help staff understand ethnic variations on the perceptions of illness and health.