Lessons from Mi Abuelita

Her chest rose and fell in sync with every beep of the machine next to her hospital bed. She lay there peacefully, unaware of the heartache five generations of her family were enduring alongside her. My grandmother was fighting for her life.

The worst part – her condition wasn’t caused by old age or even illness. Instead, a reckless driver ran a stop sign. With already-brittle bones, the doctors told us there was little they could do for her badly broken vertebrae – the very backbone that seemed to uphold our entire family for so long.

It would be days before she would wake up; weeks before she would leave the hospital; years before the pain would subside; and every day thereafter would be lived with very little memory and even less mobility.  We never left her side.

Although she was born in the United States, my grandmother was raised in Mexico. So, she relied on us – her grandchildren and children - to navigate the healthcare system for her. As a patient, she faced two major obstacles: she was a monolingual Spanish-speaker and also illiterate. She had always been afraid of being hospitalized because she thought she wouldn’t have a voice.

Luckily for my grandmother, she had an entourage of family members to support her and contribute to medical decisions. We were always there to help transition her back to the community health center where she received regular care, making sure her providers there received a full update on her health and procedures, medications, and more.

Unfortunately, this is not the reality for many Latino families. Often, there is no one to help them navigate a complex and fragmented healthcare system that doesn’t always speak their language and doesn’t always offer support. A recent Foundation survey found that Latinos, compared to other safety-net patients, have weaker relationships with their care providers and are less trusting of medical professionals. This is not, however, the result of being Latino, but rather a function of language barriers and varied education levels. This means that the problem is not intractable.

Improving the patient experience for Latinos will require providers to develop meaningful connections with patients and improve communication. This includes finding new ways to stay connected, like texting and e-mailing with Latino patients who have access to the Internet and smartphones. Team-based care models have also proven promising, especially when nurses or providers on the care team are bi-cultural and bilingual. These approaches have the potential to bridge the gap and empower Latino patients and their families.

In my role at the Foundation and in my life, I am reminded that there is more work to be done in order to transform our healthcare system into one in which everyone has a voice, no matter how old, no matter their income, and no matter what language they speak. For my grandmother, my parents, and the next generation, I won’t stop until we get there.

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