Scholarlink

Background <p>People with dementia and preferred language other than English (PLOE) in the United States may face communication-related barriers to high-quality end-of-life care.</p> Objective <p>Compare end-of-life care characteristics among people with dementia and PLOE versus those preferring English.</p> Design <p>Retrospective cohort study.</p> Participants <p>Decedents with dementia (2011–2021).</p> Main Measures <p>(1) Documentation of a goals-of-care discussion, (2) presence of advance care planning (ACP) documents, (3) hospital-based healthcare utilization, (3) palliative care consultation, (4) in-hospital death.</p> Key Results <p>Among 7777 decedents, 725 (9%) had PLOE and 7052 (91%) preferred English. The median age at death was 84&#xa0;years and about half of patients were female. Those with PLOE were more likely to have a documented goals-of-care discussion in the 6&#xa0;months preceding death compared to those preferring English (62% versus 45%, adjusted risk difference 0.08; 95% CI 0.04–0.13). In the last 30&#xa0;days of life, those with PLOE were more likely to visit the Emergency Department (ED), be admitted to the hospital or intensive care unit, and die in-hospital (adjusted risk difference 0.09 95% CI 0.04–0.14, 0.06 95% CI 0.01–0.11, 0.06 95% CI 0.02–0.09, 0.11 95% CI 007–0.14 respectively). Differences in frequency of ACP documentation and palliative care consultation were not detected.</p> Conclusions <p>Decedents with dementia and PLOE were more likely to have documented goals-of-care discussions and similarly likely to have ACP documents and palliative care consultation, yet had higher hospital-based healthcare utilization near end-of-life. Future studies should investigate whether high healthcare utilization is goal-discordant for this group. Future efforts to improve end-of-life care for those with PLOE might prioritize ED and hospital-based interventions, recognizing their critical safety-net functions, as well as ensure that people with dementia and PLOE and their families have sufficient cultural and linguistic support to engage in high-quality end-of-life communication with their healthcare providers.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Language Preference Is Associated with Goals-of-Care Communication and End-of-Life Care in Dementia

  • 期刊论文

  • 发表日期：

    2026年3月30日

查看全文
  • Lauren R. Pollack,
  • Lois Downey,
  • Ruth A. Engelberg,
  • James Sibley,
  • Linda K. Ko,
  • Kimiko Domoto-Reilly,
  • Lyndia C. Brumback,
  • Annie T. Chen,
  • Rashmi K. Sharma

摘要

Background

People with dementia and preferred language other than English (PLOE) in the United States may face communication-related barriers to high-quality end-of-life care.

Objective

Compare end-of-life care characteristics among people with dementia and PLOE versus those preferring English.

Design

Retrospective cohort study.

Participants

Decedents with dementia (2011–2021).

Main Measures

(1) Documentation of a goals-of-care discussion, (2) presence of advance care planning (ACP) documents, (3) hospital-based healthcare utilization, (3) palliative care consultation, (4) in-hospital death.

Key Results

Among 7777 decedents, 725 (9%) had PLOE and 7052 (91%) preferred English. The median age at death was 84 years and about half of patients were female. Those with PLOE were more likely to have a documented goals-of-care discussion in the 6 months preceding death compared to those preferring English (62% versus 45%, adjusted risk difference 0.08; 95% CI 0.04–0.13). In the last 30 days of life, those with PLOE were more likely to visit the Emergency Department (ED), be admitted to the hospital or intensive care unit, and die in-hospital (adjusted risk difference 0.09 95% CI 0.04–0.14, 0.06 95% CI 0.01–0.11, 0.06 95% CI 0.02–0.09, 0.11 95% CI 007–0.14 respectively). Differences in frequency of ACP documentation and palliative care consultation were not detected.

Conclusions

Decedents with dementia and PLOE were more likely to have documented goals-of-care discussions and similarly likely to have ACP documents and palliative care consultation, yet had higher hospital-based healthcare utilization near end-of-life. Future studies should investigate whether high healthcare utilization is goal-discordant for this group. Future efforts to improve end-of-life care for those with PLOE might prioritize ED and hospital-based interventions, recognizing their critical safety-net functions, as well as ensure that people with dementia and PLOE and their families have sufficient cultural and linguistic support to engage in high-quality end-of-life communication with their healthcare providers.