Proper primary medical care is difficult for limited English-speaking seniors to find. PASSi wants to change that

Those with limited English proficiency (LEP) often struggle to find proper healthcare in their native language. This leads to miscommunication with their physicians, and often, negative health outcomes.

The two biggest obstacles for LEP seniors in Philadelphia to receive proper health care are language barriers with their doctors and arranging transportation to appointments.

Penn Asian Senior Services (PASSi), which provides linguistically-attuned senior services for Asian and other LEP seniors in Southeastern Pa., is looking to streamline care for their seniors, in order for them to age in place more comfortably, and better manage their chronic health conditions, by increasing access to primary health care in their native language.

Last week, PASSi received a $100,000 grant from the Cigna Foundation to begin to incorporate on-site primary care into their already-existing home health care and adult day care services. Their hope is to effectively create a “healthcare hub” for their approximately 800 low-income seniors to access all the care they need in one place, translated in all 19 languages they speak.

Ken Yang, executive director of PASSi, said his experience as a Korean-American helps him understand the unique difficulties facing LEP seniors.

“As English is now my native language, I don’t have to concentrate on understanding what someone is saying. In the clinician/patient relationship, that’s magnified,” he said. “That kind of linguistic bridging… we think is going to impart more understanding, more comfortability and a deeper clinician/patient relationship that we hope is going to lead to convenient access.”

Yang said this will be especially helpful for seniors to better understand how to manage chronic conditions, like diabetes.

“A lot of the Asian cuisine is built off of a staple of simple carbohydrate rice. But what we’re going to try to do is [say in Korean], ‘Elder, replace the simple white rice with multigrain rice,’” he said. “It’s the ability to have that ‘within cultural’ rapport that hopefully can lead to greater adherence and improved health outcomes.”

LEP seniors often rely on their family members for help with everyday things like reading their medicine bottles, interpreting doctor’s instructions, and generally managing their conditions.

While Yang doesn’t speak Korean fluently, he still often finds himself helping his LEP family members with daily tasks.

“My brother’s father-in-law, who’s Korean, just visited me for some help reading this English language document,” he said. “My Korean is not great, but we do the best we can, and it’s something that we hope that we can address in perhaps an even more important setting, such as health care.”

PASSi development officer Peter Buzby said they want to make the process more streamlined.

“It often falls on the next generation to serve as interpreters for seniors. But it’s not an ideal solution for a number of reasons, one of which being that a large proportion of Asian seniors are linguistically isolated. They live in houses where no one speaks English, so they might not have somebody they can ask to interpret, or they might just be uncomfortable always asking people for help,” he said. “So while, in some cases, asking friends, family, the next generation to serve as that bridge works, it’s not ideal. The seniors would rather get care in their own language.”

PASSi reports 85% of the seniors they serve have chronic illnesses that require daily treatment.

In addition to physical health care, Yang said they want to add mental health education into their programming.

“In many Asian American and Asian cultures, the mental health aspect, problems of anxiety, depression, those are unfortunately things that are still carrying a stigma,” he said. “Mental wellness and mental well-being checks are a part of our adult day care already, so we want to follow up on that with even more depth and with a greater scope.”

PASSi wants to eventually expand to add optometry, physical therapy, and occupational therapy into their practice.

“It’s pretty much where we become almost a one-stop-shop where you’re able to not only receive care from your regular doctor,” Buzby said. “But also if you need follow-up assistance, or some kind of specialized care, we’re able to provide that service.”

Clayton Fitch, managing director of PASSi, said providing their seniors with physicians who speak their language will ultimately lead to better health outcomes.

“Whether it’s simple instructions, or taking medication, or wound care, or anything else on that spectrum, being able to ask your doctor a question is one of the things that I think all of us take for granted, but it’s very important in the care practice.”

Fitch said the grant will also allow PASSi to provide free transportation for their seniors to receive care.

“All the seniors involved in the program are Medicaid eligible. So very few of them have access to their own vehicles,” he said. “Even if they do live in the city, that can be a challenge because most of the transportation brochures and apps are written in English or in Spanish. Very few are written in Korean or Chinese, so it becomes a process, even if they have access to public transportation near their home. Navigating that system becomes a challenge in terms of language access.”

Renovations are expected to begin soon on PASSi’s building located in Philly’s West Oak Lane neighborhood. They expect to hire a nurse practitioner and clinician by the fall, and eventually incorporate specialized medicine into their practice in a few years.