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Care of the older person
Older adults in the USA with limited English proficiency have high rates of intensive end-of-life care and low rates of palliative care and advance care planning
  1. Zahra Rahemi1,
  2. Olga F Jarrín2
  1. 1 School of Nursing, Clemson University, Clemson, South Carolina, USA
  2. 2 School of Nursing, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Zahra Rahemi, School of Nursing, Clemson University, Clemson, South Carolina, USA; zrahemi{at}

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Commentary on: Abedini NC, Downey L, Engelberg RA, et al. End-of-life healthcare utilization and palliative care use among older adults with limited English proficiency. J Am Geriatr Soc. 2022 Oct;70(10):2847–2857. doi: 10.1111/jgs.17913. Epub 2022 Jun 7.

Implications for practice and research

  • Clinicians should ensure that patients with advanced and terminal illnesses receive culturally and linguistically appropriate information about their prognosis and treatment options.

  • Research is needed to understand the impact of advance care planning on healthcare utilisation among patients with limited English proficiency.


There is growing evidence linking end-of-life care with the diversity of sociodemographic backgrounds and engagement in advance care planning (ACP).1–3 Abedini and colleagues found that among older adults with severe illnesses, limited English proficiency (LEP) was associated with higher rates of end-of-life healthcare utilisation and in-hospital death and lower rates of ACP.4 Potential drivers of these disparities could be language barriers, low health …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.