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While the adoption of Bill 7 makes Francophone seniors fear the risk of losing access to care in French, the management of cases of dementia observed in hospitals and long-term care centers is making a comeback.
It is clearly established that access to long-term care in French is a quality and safety factor for Francophone seniors. The major risk now is to increase dementia in affected patients if communication is not in their language. The transfer of a vulnerable French-speaking patient to an English-speaking care center would have the consequence of accentuating the cognitive loss.
Several studies show it: receiving care in a language that is not one’s own opens the way to numerous medical errors. For many experts, it is a matter of life or death.
Linda Cardinal, Francophonie researcher, has worked on French-language services in the field of mental health. According to her, “the lack of understanding of patients by attendants or doctors can lead to diagnostic errors, as shown by the work of Dr. Prudhomme”.
“It is not an incongruous request to want care in one’s own language,” she emphasizes.
Sean Keays, general manager of the Foyer Richelieu in Welland, reveals the existence of a project of 148 studies on the influence of language and quality of life in the face of dementia.
“These studies, McMaster optimal aging portaldemonstrate that among French-speaking patients – who are in a French-speaking home – there would be less depression than in an English-speaking home, even if it offers better care,” says the director.
The elderly person in a home is in fact in a state of vulnerability. “Each instability will aggravate the condition of a demented person”, assures Linda Cardinal, “not having service in one’s own language jeopardizes patient safety”.
Relieve dementia
Frank Knoefel, holder of the research chair on dementia in primary health care at the Bruyère research institute and doctor at the memory clinic at the Elisabeth-Bruyère hospital, assures us “that it is obvious that, to give good care, we need to approach the person in their language”.
In order to understand the person’s symptoms, but also to perform a physical examination, “we need language, if I don’t want to terrorize the person,” says the expert.
“I better explain to him why and how I’m about to do it.” If I approach a person to give them a bath, touch them or help them undress, without explaining to them, they will get scared. »
“Except in prison, you don’t catch a person without explaining what you’re going to do,” he adds.
For the specialist, “a person with dementia forgets where she is, even if it’s the same doctor who has been treating her for a month, she won’t recognize him. It is dramatic, because it aggravates the stress and the situation”.
Dementia is an irreversible condition. Elderly people who develop it almost all see their cognitive state deteriorate. It then seems that the only means of relieving this loss of reference, therefore the last bastion here, would be the language.
The return to the mother tongue
“Long memory comes back in aging people,” says Linda Cardinal. “We see this in all countries. Mother tongue is an important aspect of health, from mental health issues to Alzheimer’s. »
“It’s sad,” she says, “because in the pandemic these people were very affected and the Francophones were perhaps a little neglected.”
For Frank Knoefel, you have to understand the importance of your mother tongue. “When you are born, you don’t understand anything. Then, we learn a first language, gradually, we will learn a second language or more and so on. Imagine an onion and its rings, its different layers. »
“Dementia, it disintegrates the onion, it removes a layer, one after the other”, describes the doctor. “Automatically, the further the cognitive impairment progresses, the more we return to our first language. »
Care in French for people with dementia is therefore more important. “If we are treated in a language that is not our own”, assures Mr. Knoefel, “the patient will become more and more agitated”.
“The agitation will cause medication to be put in and these medications will affect thinking, it’s a circle. »
For Sean Keays, “it is not the fault of the patients, nor of the hospitals if the beds are blocked, it is the system which has let medicine down”.
“Currently, in southern Ontario, for every 1,000 people, there are 5.85 long-term care beds and for Francophones, there are 0.90 beds, which is less than one bed per 1,000 French-speaking patients. »
It is therefore understandable that the Ontario government is finding a solution, but it is very important to think about the situation of people with dementia, explains Sean Keays.
In the eyes of the two researchers, studies and analyzes show that it is a question of safety and a higher risk of mortality among French-speaking people, if the aspect of linguistics is not respected.