Service barriers and respectful practice

Tibetan Minnesotans are a well-organized community with strong institutions, and many families have been here for decades. Barriers still exist, and they can be easy to miss. Language access is one. Tibetan interpreters are relatively few, and elders who prefer Tibetan may be the people who most need help with health care, long-term services and supports, or benefits. Younger family members often help at home, but they should not be relied on for formal interpretation, especially about a parent's health or finances.

Identity and documentation can also be complicated. Many Tibetans were born in India or Nepal, some lived for years in exile without a national passport, and documents may list different countries. Forms that force a choice between China, India and Nepal can feel wrong to someone who identifies as Tibetan. The status of Tibet is a deeply political and personal subject. Do not describe a person as Chinese, Indian or Nepali based on a document, and do not ask for their views on politics. Where a form allows self-identification, offer it. Collect immigration status only when a program rule requires it, and follow that program's instructions.

Many older Tibetans experienced dangerous crossings, loss and long separation from family. Do not ask people to describe how they left Tibet or what happened to relatives. If someone chooses to share, listen, acknowledge it, and return to what they need. Some people may prefer to address stress or illness through faith, family or community before turning to formal services. That is a choice to respect, while making sure they know what services exist.

Good questions carry you a long way. What language would you like us to use, and for whom in the household? How would you like your name written? Would you like a family member present? Is there a community organization you would like us to work with? Know your referral options, including the Tibetan American Foundation of Minnesota for cultural and community support, and plan interpreter requests early, including telephone or video options when an in-person Tibetan interpreter is not available.

Fictional case: Tashi, an older Tibetan man, is meeting with Rachel, a county case manager, about in-home supports. His grandson, who is sixteen, offers to interpret because no Tibetan interpreter was scheduled. The assessment includes questions about Tashi's bathing, continence and memory. Rachel's form also asks for country of birth, and his document says India. The appointment was hard to schedule, and Tashi's daughter took time off work to be there.

Find out how your unit requests telephone or video interpreters for less common languages, including Tibetan, and how long it takes. Save the steps where your team can find them.

When a qualified interpreter is hard to find, what pressures push you toward using a family member? How could you plan ahead to reduce that pressure?