The Omicron variant has fueled a dramatic spike in COVID-19 cases across the country. Southern California has experienced significant increases in hospitalizations. The high number of COVID-19 cases may prompt hospitals and clinics to reinforce visitor restrictions to control the spread. These restrictions can inadvertently compromise the quality of care of all patients—but pose unique challenges for Latinx immigrants and their families.
Scholars have long observed that children of immigrants – both minors and those over age 18 – often serve as language and cultural brokers—meaning that they translate or share resources with their immigrant parents, extended kin and the broader community. In the context of health care, children of immigrants are known to provide translation help during doctor’s appointments and even work alongside sympathetic staff to ensure their parents receive adequate care. My ongoing research finds that these children and adults play a powerful role in facilitating health care interactions because they are trusted sources and advocates for their parents.
Since 2018, I have conducted in-depth interviews with 60 adult children of immigrants who serve as language or cultural brokers for their parents in Southern California. Interviews reveal that children of immigrants serve as language brokers well into adulthood. During the fall of 2020, I conducted follow-up interviews with 30 of the original respondents to investigate how their brokering shifted during the pandemic.
Study participants noted that COVID-19 visitor restrictions impeded their ability to accompany their parents to health care appointments. This restricted access made it challenging for adult ‘brokers’ to provide support to their immigrant parents.
One man I interviewed, Victor, frequently accompanied his father to his doctor’s visits for severe arthritis. (Victor is not his real name as the identity of interview participants must be protected to comply with research rules). Given that visitor restrictions did not allow guests, Victor and his father came up with a strategy. They agreed that the father would FaceTime Victor when the appointment started so he could translate during the meeting. However, Victor never received the call. Thirty minutes later, his father called him. The appointment was over, and the doctor had apparently not let the father use FaceTime.
“They prescribed him some medication and we have no idea why,” Victor said. “Normally I ask all the questions but I wasn’t given a chance.” Without the support of his son, Victor’s father felt neglected and unsure as to why the new medication was prescribed.
Tracy (also a pseudonym) and her family tested positive for COVID-19 in early November, 2020. Tracy and her mother felt better after several days—but her father’s condition worsened. The family decided to take the father to the emergency room after he had difficulty breathing. Tracy worried that he would not be taken care of well because of his limited English: “I didn’t want to leave him alone,” she told me. “What if he can’t understand what’s going on? Who is going to help him?”
Tracy got creative and tried to help by making phone calls. She called the hospital three times a day to check in on her father. She was unable to directly talk to her father but received updates from a sympathetic nurse. Tracy’s father survived and is now doing better. But the overwhelming stress of not being able to help advocate for her father in person while he was hospitalized weighed heavily on her, even months later.
COVID-19 visitor restrictions lower the risk of virus spread but risk harming patients who need their family’s support and advocacy. Health care providers can implement three steps to meet the needs of this community.
- Minimize language and cultural barriers in the health care system.
Health care workers should ensure that patients understand any medical treatments they are receiving in their preferred language.
- Increase support for staff, and recruit multilingual personnel.
When stretched thin, quality care may be compromised. Hiring more multilingual staff and increasing resources for existing personnel can alleviate overburdened frontline workers.
- Adopt new strategies to make family support more accessible.
Family members—immigrant and native-born—are often kept out of hospitals. This causes an exorbitant amount of stress on the immediate family. Hospitals should consider allowing at least one visitor per patient, developing COVID-19 informational sheets in multiple languages, and adopting technology-based virtual or mobile phone visitations.
Vanessa Delgado is a Ph.D. candidate in the Department of Sociology at UC Irvine and her research explores how Latinx children of immigrants help their parents navigate linguistic, cultural and legal barriers in the U.S.