May is a 38 year old woman who was sponsored by her husband from China 12 years ago. She soon got married after arrival and had three children: Kevin (11 years old), Dianne (9 years old) and Bobby (4 years old). Her children all attend private school. May primarily speaks Mandarin and has limited verbal and written English skills. Her husband David, who is a COO at a computer software engineering company, speaks and writes English fluently.
Diagnosis
May was diagnosed a few years ago with ALS and is now developing increasing symptoms requiring more care. Her husband is abrupt in some of the communication with his wife and children and always feels tired. He is working fulltime and is now taking on more responsibilities with the children.
Concerns
May is afraid of how the symptoms will develop and is really upset about her diagnosis. She feels like she is losing control physically and mentally, and cries often when she alone. May wants to be a good wife, mother and take care of the family, but is not able to fulfill these roles. She is starting to get a pressure sore on her coccyx from sitting for long periods. She is having harder time with swallowing and occasionally panics that she cannot breathe. Pain is also starting to be an issue, as it gets worse the more she stays in one position because her limbs and joints get stiff. She is now experiencing urinary retention and may require a foley catheter. May has been seeing a traditional Chinese medicine practitioner who does acupuncture and supplies traditional Chinese medicine to cure her disease.
Formal / Informal Supports
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May does not have family in Canada at this time. The couple have been working on sponsoring her young sister and parents over from China; however there have been some difficulties. May had been quite involved with the Chinese community and participated in many volunteer activities at the church she attends. She is receiving on hour a day of home support under Long Term Care in the morning to assist her with bathing and dressing and the daily per diem is high so David is wondering if private care would be less expensive.
Initial Visit
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Using a translator to help communicate, May shares she is experiencing increased fatigue, pain and decreased appetite. May is staying in bed for longer periods during the day. You notice her grimace when she turns in bed and she winces as she sits up. May states that up until a month ago she had been feeling very well. Her mood is low and she is crying at times throughout the day, although never in front of the children. She became tearful when speaking about David’s love and the responsibilities that he has taken over from her. She is not able to actively participate in her faith community. She no longer feels she is able to be the mother to her children that she wants to be.
Reflection
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01
What are some things to consider when using family or friends to help translate?
02
What are some strategies for effective communication when using translation services?
03
What might you ask May to contribute to your holistic assessment of her health and situation?
04
How might you engage with May and her family to support the care needs they identify?