You can’t tell someone's literacy level just by looking at them. A person may present themselves well, speak well, and appear to understand what is going on, however this does not mean that they truly do. The language used in the health field is not commonly used in everyday language and even those with good educational backgrounds may not understand what their diagnosis means or what is being asked of them. Even someone who normally manages health information well may have increased difficulty under certain circumstances. When a person is feeling anxious, or overwhelmed with too much information, they may not be able to understand or use health information as well as normal. At the end of the day, it is best to use simple, clear language to avoid any opportunity for misunderstanding