title: Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare.
abstract: BACKGROUND
  Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigations on interpreting practices in multilingual elderly healthcare from different healthcare professionals' perspectives. This study examines issues concerning communication and healthcare through a particular focus on interpretation between health professionals and patients of different ethnic and linguistic backgrounds. The central aim of the project is to explore interpretation practices in multilingual elderly healthcare.
  
  
  METHODS
  A purposive sample of 33 healthcare professionals with experience of using interpreters in community multilingual elderly healthcare. Data were collected between October 2013 and March 2014 by 18 individual and four focus group interviews and analysed with qualitative content analysis.
  
  
  RESULTS
  The main results showed that interpreting practice in multilingual elderly healthcare was closely linked to institutional, interpersonal and individual levels. On the organizational level, however, guidelines for arranging the use of interpreters at workplaces were lacking. Professional interpreters were used on predictable occasions planned long in advance, and bilingual healthcare staff and family members acting as interpreters were used at short notice in everyday caring situations on unpredictable occasions. The professional interpreter was perceived as a person who should interpret spoken language word-for-word and who should translate written information. Furthermore, the use of a professional interpreter was not adapted to the context of multilingual elderly healthcare.
  
  
  CONCLUSIONS
  This study found that interpreter practice in multilingual elderly healthcare is embedded in the organizational environment and closely related to the individual's language skills, cultural beliefs and socio-economic factors. In order to formulate interpreter practice in the context of multilingual elderly healthcare it is important to consider organizational framework and cultural competence, cultural health knowledge, beliefs and customs.
authors.affiliation: Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden. emina.hadziabdic@lnu.se.|Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, SE- 351 95, Växjö, Sweden. emina.hadziabdic@lnu.se.
authors.forename: Emina
authors.initials: E
authors.lastname: Hadziabdic
authors.affiliation: Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden. christina.lundin@liu.se.
authors.forename: Christina
authors.initials: C
authors.lastname: Lundin
authors.affiliation: Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden. katarina.hjelm@liu.se.
authors.forename: Katarina
authors.initials: K
authors.lastname: Hjelm
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003144:Communication Barriers; D054521:Cultural Competency; D018864:Cultural Diversity; D003695:Delivery of Health Care; D004641:Emigration and Immigration; D005190:Family; D005260:Female; D017144:Focus Groups; D005851:Geriatric Nursing; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D014171:Transients and Migrants; D014175:Translating