I agree with Margaret that we need to first consider how much education the patient and family will require prior to beginning these difficult discussions. As nurses, we always need to gather how much knowledge the patient/family has about the topic prior to going deeper with new education. I also agree with Emily, that this can be an even bigger issue with immigrant populations and people that do not speak the same language. We have also run into problems where the interpreters that we use for some of the languages that are not as common will be speaking a different dialect when interpreting. Families are already overwhelmed and sometimes do not feel confident enough or do not want to be a burden so they do not speak up that they are not completely understanding. Always important to get good background information about education levels and assess how the patient/family are feeling prior to starting any type of new education.