Health Care for Navajo Elders Requires Bridging Language, Culture

Jun 21, 2016

Navajo spiritual tradition accepts old age as a natural part of life, but that’s doesn’t mean aging is easy – especially when language and culture can make it difficult to communicate with doctors.

Credit Althea John / Navajo Times


Rising sun decals in patient rooms at Flagstaff Medical Center indicate which way is east for Navajo patients.
Credit Melissa Sevigny

Thelma Begay grew up on the Navajo Nation near Page. As a child, she begged her father to let her get an education at the nearest boarding school, 100 miles from where her family raised sheep.

“And I didn’t know a word of English, nothing,” she says. “I only talked Navajo, you know. So that was 1944 when I first went to school.”

Begay’s eighty-one now and her health isn’t what it used to be. She moved to an assisted living facility in Flagstaff last year after having her left foot amputated. Begay says even though she speaks English now, it’s difficult to talk to her doctors about her health.

“Some words are hard, you know,” she says. “Some don’t even have a name.”

Diné is a descriptive language. There’s no one word for cancer or dementia. Illness and memory loss are thought to be imbalances with nature, something to correct with ceremonies, not necessarily western medicine. Still, many Navajo elders come to Flagstaff for specialized treatment and long-term care. There’s only one assisted living facility on the vast reservation.

Geri Kinsel-Begay is an interpreter at Flagstaff Medical Center. “I always tell people, you know, I get paid to speak my language,” she says, “this unique, beautiful language that came from my grandma and grandpa.”

Kinsel-Begay says she acts as a voice for her grandparents when she interprets for elders at the hospital. “You know, the doctors use these real long words, like for example maybe subdural hematoma,” she says. “How do you explain to grandma and grandpa that’s a procedure that’s going to be performed on them?”

Sometimes she has to give the news of a terminal diagnosis or ask a patient to write a living will. Cultural taboos make that difficult. Kinsel-Begay’s grandmother taught her never to speak the word “death.” She says, “Can you imagine the culture shock that it brings? Because we were taught to not let that word enter your mind or come to the tip of your tongue.”

Kinsel-Begay uses a kind of bilingual storytelling to create a cultural bridge between Navajo elders and medical providers. It’s a role many caretakers have to play.

Charlotte Beyal takes care of her 92-year-old mother-in-law, who speaks English, but still needs help understanding her doctor. With the doctors, it’s maybe,” Beyal says. “Maybe it’s this. Maybe it’s that. And so that’s really confusing to Navajo patients, who are saying, what am I doing here?”

Beyal believes taking care of an elder is not a burden; it’s an honor and a joy.

“I go over to the old folks’ home and I see so many just sitting in wheelchairs,” she says. “I go in and say Ya’at’eeh real loud, and they all respond Ya’at’eeh!” They just want to be acknowledged, Beyal says. In Navajo tradition, old age isn’t something to fear. It’s something to celebrate. 

Supported by BBB Revenues from the City of Flagstaff and Flagstaff Arts Council