Certain behaviors may indicate that a patient is illiterate or does not understand the language and that the patient is too embarrassed to admit this. These clues can help the healthcare provider to recognize a potential problem and to respond appropriately.


(1) The patient claims difficulty reading textual material (poor eyesight, forgot glasses, need reading glasses, etc.)

(2) When presented with textual material the patient suddenly remembers an important appointment and wants to leave.

(3) The patient admits to difficulty reading or makes an indirect reference to a problem (such as hating paperwork).

(4) The patient asks to take a form home rather than to complete it immediately.

(5) The patient signs a form without reading it.

(6) The patient insists that a family member or friend be present.


Differential diagnosis:

(1) poor eyesight or double vision

(2) disability after a stroke

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