This is the second topic related to Latino Culture & Healthcare. In this case doña Sandra and I were talking about Latino Patients and the influence of families. Specifically, the importance of family and its influence on Latino patients. Some of the questions that doña Sandra addressed are:
What is the meaning and importance of family in Latino Culture?
What is the real influence of the family in medical decision making?
What norms and expectations might Spanish speakers have about companions during medical visits or hospital stays?
Here is our conversation with subtitles in Spanish (no English in this one). This is a great medical Spanish listening comprehension activity!
Some of the challenges that many of my healthcare clients talk about are:
- The number of family members that attend appointments with the patient or stay with him/her at the hospital
- The differences in family unity between the US and Latin America, and how it affects communication and decision making
- The decision making process and how to not exclude important stakeholders
Some of Sandra’s insights into Latino culture are:
- Sandra tells us that family members tend to be very close to each other. She says: “the situation of one is the situation of all”, and healthcare is not the exception of the rule.
- Even if the patient is of legal age, it’s likely that a family member will go with them. The family wants to know what’s is going on with their relative. So they will send a companion to the appointment with the patient to be the spokesperson for the family.
- In some circumstances, when the health condition is complicated, patients prefer not to say anything. To avoid this situation, a family member accompanies his/her relative to make sure they hear the updates from the provider.
- Also, some patients don’t ask questions or require more information (we talked about this in our first blog post related to the Authority and Power Differences between Providers and Patients), so the relative who is accompanying the visit is in charge of asking clarifying questions. The companion may also give more information and deeper insights about the patient’s current health condition than the patient.
Doña Sandra illustrates this with her own anecdote. She says:
Some days ago, my son had a car accident. It wasn’t too serious but his siblings immediately went to the area of the accident, and of course, I went as well.
My son was already in the ambulance and the paramedics who were taking care of him gave me information about his health condition right after I arrived, it didn’t matter that he was a man of legal age and he was conscious. Also, the paramedics allowed me to go with them in the ambulance on the way to the hospital.
Also, at the hospital, after he was seen, the doctor approached me to let me know about the procedure, the medicines he needed and the next steps.
The next topic I asked doña Sandra about was the family’s impact on the patient’s motivation.
She says the impact is really strong because of the solidarity the patient feels from their partner and children, their parents, aunts and uncles, cousins, etc. So it translates into emotional strength and this emotional strength translates to a better treatment for the patient.
Even more, in some hospitals and clinics, before any procedure, the providers ask for the companion because it’s not common to be alone in the hospital.
Then I asked about the influence of the family on medical decisions or how the decision making process plays out inside the family.
Doña Sandra says that, for example, if the patient needs a surgery, all the family members will be informed about it and they are going to ask the doctor about the causes, benefits, and risks of the procedure to bring support and give their opinion about it to the patient. They would comment on their thoughts about the surgery and if it would be beneficial or not to the patient. Although the patient will make the final decision, the family influence is central to his/her decision.
Another anecdote from doña Sandra:
My aunt had a tumor in the uterus so a surgery was needed to remove the reproductive organs, and I was the one who took her to the medical appointments and who talked with the doctor. She was aware of her health condition but I was in charge.
At a certain moment, she had to sign the surgery authorization form but she said she was going to wait for me. Then, she explained the procedure to me and asked for my opinion, so I told her: “Well, you’re not going to have more children and it’s not good for your health to have that tumor”. Then she said “ok” and signed the papers.
Finally, doña Sandra says it’s very important to give the family some time and space, that way the members can discuss the procedures and help the patient make a decision. Of course, this is only possible when they have the option, it is not required when an emergency happens (although they will always want to know more information about the patient in any case).
Some Useful Phrases / Algunas frases útiles
- ¿Dónde está su acompañante? (Where is your companion?)
- Si quiere hablar con su familia sobre la operación, déjeme saber por favor (If you want to talk about the operation with your family, please let me know)
- ¿Es usted el/la acompañante del paciente? (Are you the patient’s companion)
- Esto es lo que ha pasado con el paciente (This is what happened with the patient)
- No se preocupe, le/la mantendremos informado(a) (Don’t worry, we will keep you informed)