ArticleJournal of general internal medicine2026
Language Preference Is Associated with Goals-of-Care Communication and End-of-Life Care in Dementia.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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Authors and funding
9 authors.
Funding
Abstract
backgroundPeople 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.
objectiveCompare end-of-life care characteristics among people with dementia and PLOE versus those preferring English.
designRetrospective cohort study.
participantsDecedents 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
resultsAmong 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.
conclusionsDecedents 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.
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Registered trials
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