Lack of education often means they don't know what they want.

At my old job at St. Mary, I saw a lot of low income clients that often do not even speak English. And I can really tell those who simply can't speak English cause they are new to this country to those who have been here for years and yet did not learn English. I can tell those that left their country cause they were poorly educated and did not have good livelihood in their home country. And guess what, they also do not have good livelihood here cause they don't speak English and have no skills/education to prosper them. But let me not digress further to what I am trying to say.

What is it that differentiate those uneducated non English speaker to those who had education? It is their ability to make decisions for themselves regarding their healthcare needs. After seeing a particular client for 8 or 10 Physical Therapy sessions, we need to reevaluate them for their progress and for their needs to either continue more therapy or get discharged. In every instance, I always attempt to get what the patient/client wants. After all, if they say they do not want anymore therapy, I can't force them to keep on coming for more. I can give them my recommendation but I can not force them. So it is very important that I know what they want during those reevaluation sessions so I can write up the appropriate report. Either a discharge report due to patient request or a "more therapy" recommended report to their doctors if more is indeed needed. And as I discovered, the uneducated patients often can't make a decision if they want more therapy or not. They always say they will ask their doctor if they need more therapy. Sure I can understand that they defer the decision making to a learned professional but it is not rocket science to know what one wants. Even after asking them if therapy was helping to guide them in knowing if it is worth while to return for more or not, these uneducated patients still can't muster an opinion on how their own healthcare should proceed. Don't tell me that they probably did not understand what I am asking them cause I speak Spanish to them. And if I have a shred of doubt that there is still a language barrier that prevents them from knowing what they want, I have our Spanish interpreter ask them the same question. Still they don't know what they want.