When The Written Word Is Not Understood: A look into the language of the provider and the client

The Awakening

We spend years learning a language that is part of what makes us a social service provider or a professional. That is quickly followed by employment that requires an additional language laced with acronyms. Oh how good it feels to use that terminology with our coworkers. Ah, but then as we begin to provide direct service, we quickly have to learn another language – that of the people we work with if we expect to be understood.

Can excellent verbal skills be misleading?

As a social service administrator for many years in several settings, part of my success may be attributed to quickly adapting to cultures and language. From quickly learning to lose the multi-syllable vocabulary when confronted with a blue collar/rural community, to the ethnic variances in Chicago through learning some of the nuances of Black English to now – which brings me to the focus of this blog… when the written word is not understood. Examples include caregivers who work with aging individuals and individuals from the community who seek assistance to apply for benefits including completion of required forms.

Highly verbal but uncomfortable with the written word?

For many years, I had the pleasure of working with the most caring and considerate people possible who were caregivers for elderly clients. Those who provide the frontline services to the aging community have a deeply rooted sense of caring and respect. Often, they are the first to become aware of changes in cognitive skills, an onset of illness or other condition of their client. Para-Professional Caregiver/Companions are often highly verbal and personable… BUT many of them have learned to use their oral skills to mask the fact that the written word is a mystery to them. It becomes apparent when their client makes out a grocery list and what is purchased is far from what is requested…. Completing simple forms, such as a time sheet, may be a puzzle to them. When confronted with this dichotomy, checking their employment application often reveals misspelled street names and several other examples… sometimes including the name of a child. It is necessary to be certain the person completes the initial application in person without assistance. It is important that these highly skilled people continue to find employment where they can be so effective. It is also important to be certain that they are not placed in the awkward position of having to read beyond their capability. Recognition of verbal strengths while accepting limitations in the ability to read and write should not be a barrier to appropriate employment which can be a win-win situation. Rather, we need to be sensitive to the limitations, not cause embarrassment, and build on their strengths.

Helping with Paper Work

As someone who meets in person with several individuals each week to assist them with applications for Medicare D, IL Circuit Breaker, Medicaid, Senior Freeze and whatever other issues they may present, I find it requires adapting to each individual’s language comprehension and culture. If the clients were able to read and write easily or use a computer, the need for assistance to complete forms would not be necessary. Appointments are made with some indication of why the person is seeking assistance. It is essential when they arrive that there be a conversation about what they hope to achieve that day. Often, the stated purpose for making the appointment and their real needs are vastly different. Again we see the importance of language and understanding what our clients need no matter how we are working with them. The simplest of forms can prove overwhelming and the computer is a puzzle. Returning clients have become incensed at the notion they have to bring information annually because they are convinced it is stored in the computer from year to year. Some clients are hostile until a relationship has been established. Due to a lack of comprehension, they are justifiably afraid of being taken advantage of. A letter that only requires a signature may have been seen as a threat because they only read the first paragraph and panicked. Rather than reading a bit further, they quickly make an appointment to have the letter interpreted. Sometimes a part of the time I spend with client is on the phone/computer obtaining essential information which they didn’t think it was necessary to bring in order to complete an application. Whether in person or over the phone, interpreting the questions on government forms can present its own set of language challenges. Due to lack of information, perhaps two of the most difficult clients to work are 1) the person who has a sense of entitlement, resulting in the person being very demanding, often because of severe deprivation which conditioned them to function in this manner, and 2) The other extreme and perhaps the most painful, in my opinion, is the elderly person who has been paying high taxes on a small home, never realizing that s/he is eligible for tax relief, assistance with utility bills, food and other benefits. The key to successful service is to constantly be aware of and sensitive to what the client brings to the table. A goal for every client is to enable them to do as much as they can for themselves… often a very fine line in determining their comfort level in the process. Enabling our neighbors to become aware of what they may be eligible for and then to assist them obtain those benefits often means constant probing, an exhausting challenge and at the end of the day… the reward of knowing we helped them access important resources. Yet, I often ask myself, did I fully comprehend his/her needs and help in every way possible? In the listening process, did I cull the essentials from the flow of expressed concerns?


Nan Anderson’s career began as a group worker evolving into social service administration. She served as Executive Director of a YWCA where she started a shelter for victims of domestic violence and finally as Executive Director of Seniors Action Service, a nonprofit agency providing aging services. Current activities as an aging advocate include Age Options Advisory Council, Community Assessment Chair, recruitment and benefit committees; Make Medicare Work, assist individuals apply for benefits; American Society on Aging, regional program committee; National Committee to Preserve Social Security and Medicare, presenter and event organizer; and Aging Well Conference committee and Film Fest chair.


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