Inuit interpreters engaged in end-of-life care in Nunavik, Northern Quebec

Figures & data

Table 1. Communication guidelines in EOL care.

Working with Inuit health interpreters at end of life: guidelines for nurses and physicians
Time, time, take time – establish relational foundation for care, ensure clear communication
Keep sentences short
Learn about moral dilemmas faced by interpreters
Recognise that not all medical terms and procedures are translatable in Inuktitut
Explain why questions are asked of patient and families, sometimes repeatedly – avoid intrusion
Use visual illustrations with the patient and with interpreter at the same time
Shift the power dynamic when possible – recognise patient, family and interpreter knowledge, efforts and expertise
Welcome patient request for interpreters who appear to understand – interpreters may be requested as cultural mediators and providers of emotional support
Model through example – mentor caregiving techniques for families
Invite family to participate in care in home and hospital care settings
Explain difficult news to the interpreter ahead of time as this allows time for clarification and allows time for interpreter to address own emotions before speaking with patient
Explain the rationale of potentially controversial or emotionally loaded messages to interpreter – this equips the interpreter to communicate the spirit of a message and to address patient’s reactions more clearly
When using a telephone in interpretation, do so progressively rather than just one long conversation
Familiarise with worldviews, spiritual beliefs of patient and family – i.e. let patients know that even doctors cannot know the time of death
Attune to non-verbal messages looking at the patient, not the interpreter when speaking
Respectfully invite input from interpreters concerning how to communicate difficult messages, community contextual factors, and cultural knowledge
Be clear, provide potential scenarios concerning the potential impact of extraordinary life-sustaining treatment
Let go and let it be, attuning to patients who do not want life-saving interventions
Recheck the comprehension of patient – clarify when misunderstanding is not necessarily a problem with interpretation
Learn some words in the patient’s Inuktitut dialect and use them
Attend funerals when appropriate, asking if this is perceived as a gesture of support or an intrusion
Guide families and patients in communicating frustration – recognise causes of stress, set limits, clarify communication expectations
Seek help to address the social suffering surrounding patient care
Educate communities about medical procedures, dying process through public health announcements – radio, Facebook, video, illustrated brochures, in Inuktitut
(See [28])

Hordyk S, Macdonald M, Brassard P. End of life care inuit in Nunavik Quebec. Submitted to the Nunavik regional board of health and social services. 2016. 188 pages. Available from: http://digitool.Library.McGill.CA:80/R/-?func=dbin-jump-full&object_id=137708&silo_library=GEN01

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