End-of-life care in ICU may depend on English fluency, study finds

Patients with limited English proficiency in the intensive care unit may be less likely than native speakers to have orders for comfort care before they die, according to a study covered by Reuters.

The study, published in Mayo Clinic Proceedings, looked at data on more than 27,000 patients admitted to ICUs in a large academic hospital over a three-year period. The total included 779 people with limited English proficiency.

Although ICU death rates were the same regardless of what language patients spoke most fluently, patients with limited English proficiency were 62 percent less likely to have orders for comfort care before they died.

ICUs took an average of 19 days longer to transition these patients from getting active treatment to only receiving measures for easing pain and suffering. Patients with limited English proficiency were also 36 percent more likely to be put in restraints and 77 percent less likely to have an advance directive to say what kind of care they want.

"This study shows that the end-of-life care that patients with limited English proficiency receive is different than for those who do not have [a] language barrier," lead author Dr. Amelia Barwise told Reuters.

"This may be because more patients with limited English proficiency have an authentic desire to die with more aggressive medical therapies or that communication or other barriers prevent healthcare teams from optimally assessing and implementing a less aggressive approach for dying patients with limited English proficiency," she said.

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