{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T20:29:40Z","timestamp":1783542580009,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Family caregivers provide essential support to older adults, yet those caring for individuals who face language discordance may experience added challenges affecting their psychological well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize the existing literature on the psychological impact of caregiving in contexts of language discordance, focusing on stress, anxiety, depression, burnout, and coping strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review was conducted across six electronic databases from 2000 to 2025 to identify studies examining caregivers of culturally and linguistically diverse individuals in healthcare and community settings. Quantitative and qualitative study characteristics were summarized via frequencies, and qualitative studies were additionally analyzed using content analysis. Preliminary results were reviewed with patient and family partners to inform discussion, interpretation, and implications for optimizing caregiver supports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7590 citations were retrieved, with 53 full text reviews. Ten studies were included, primarily composed of qualitative studies. Key themes include the emotional and cognitive burden of acting as interpreters, advocates, and system navigators; filial obligations, gendered expectations, and stigma on caregiving experiences; and the protective role of language\u2010concordant or ethno\u2010specific services. Language\u2010discordant caregiving was closely tied to cultural norms. Fragmented and unilingual healthcare systems, unmet service needs, and system\u2010level barriers increased caregiver distress, whereas culturally tailored supports and coping strategies provided mitigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Caregivers supporting individuals who face language barriers experience significant psychological strain. Routine screening for caregiver burden, integration of professional interpreters, and expanded access to multilingual and culturally appropriate supports are recommended. Future research should employ quantitative and mixed\u2010method designs to quantify psychological impact, investigate the intersection of language, gender, and other aspects of identity, and evaluate interventions that reduce caregiver burden. Addressing both linguistic and cultural dimensions is essential for improving caregiver well\u2010being and promoting equitable healthcare delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70572","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:53:37Z","timestamp":1783540417000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological Impact of Caregiving When Navigating Language Barriers in Health Care: A Scoping Review"],"prefix":"10.1111","author":[{"given":"Kristina M.","family":"Kokorelias","sequence":"first","affiliation":[{"name":"Section of Geriatric Medicine, Department of Medicine Sinai Health System and University Health Network  Toronto Ontario Canada"},{"name":"Department of Occupational Science &amp; Occupational Therapy, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"KITE Research Institute, Toronto Rehabilitation Institute, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-5279","authenticated-orcid":false,"given":"Bijal","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Section of Geriatric Medicine, Department of Medicine Sinai Health System and University Health Network  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-1193","authenticated-orcid":false,"given":"Shail","family":"Rawal","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina E.","family":"Reppas\u2010Rindlisbacher","sequence":"additional","affiliation":[{"name":"Section of Geriatric Medicine, Department of Medicine Sinai Health System and University Health Network  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1093\/geroni\/igad104.0793","article-title":"Estimating the Economic Value of Family Caregiving at a National and State Level","volume":"7","author":"Caldera S.","year":"2023","journal-title":"Innovation in Aging"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1590\/1981-22562017020.160202","article-title":"Health Profile of Family Caregivers of the Elderly and Its Association With Variables of Care: A Rural Study","volume":"20","author":"Brigola A. G.","year":"2017","journal-title":"Revista Brasileira de Geriatria e Gerontologia"},{"issue":"1","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/237437431500200103","article-title":"Who Is Taking Care of the Caregiver?","volume":"2","author":"Sullivan A. B.","year":"2015","journal-title":"Journal of Patient Experience"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.arr.2023.102096","article-title":"Understanding the Health Effects of Caregiving Stress: New Directions in Molecular Aging","volume":"92","author":"Christian L. M.","year":"2023","journal-title":"Ageing Research Reviews"},{"issue":"11","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1080\/13607863.2020.1805722","article-title":"What's Eating You? Risk Factors for Poor Health Behaviors Among Family Caregivers","volume":"25","author":"Koumoutzis A.","year":"2021","journal-title":"Aging & Mental Health"},{"issue":"1","key":"e_1_2_11_7_1","article-title":"Relationships Between Caregiving Stress, Depression, and Self\u2010Esteem in Family Caregivers of Adults With a Disability","volume":"2017","author":"Kim D.","year":"2017","journal-title":"Occupational Therapy International"},{"issue":"2","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s12529-018-9753-9","article-title":"Caregiver Burden and Work Productivity Among Japanese Working Family Caregivers of People With Dementia","volume":"26","author":"Fujihara S.","year":"2019","journal-title":"International Journal of Behavioral Medicine"},{"issue":"5","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.jval.2022.06.014","article-title":"Caregiving\u2010Related Work Productivity Loss Among Employed Family and Other Unpaid Caregivers of Older Adults","volume":"26","author":"Fakeye M. B. K.","year":"2023","journal-title":"Value in Health"},{"issue":"2","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"e122","DOI":"10.5001\/omj.2020.40","article-title":"Implications of Language Barriers for Healthcare: A Systematic Review","volume":"35","author":"Al Shamsi H.","year":"2020","journal-title":"Oman Medical Journal"},{"key":"e_1_2_11_11_1","unstructured":"E.Macias Frauzto \u201cLost in Translation (Perdidos en la Traducci\u00f3n): The Impact of Language Barriers in Healthcare \u201d(2025)."},{"issue":"6","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1007\/s40615-021-01161-x","article-title":"Communication Challenges Faced by Spanish\u2010Speaking Caregivers of Children With Medical Complexity: A Qualitative Study","volume":"9","author":"Nageswaran S.","year":"2022","journal-title":"Journal of Racial and Ethnic Health Disparities"},{"issue":"9","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1007\/s11606-019-05119-y","article-title":"Caregiving for Older Adults With Limited English Proficiency: Transitioning From Hospital to Home","volume":"34","author":"Semere W.","year":"2019","journal-title":"Journal of General Internal Medicine"},{"key":"e_1_2_11_14_1","first-page":"603","volume-title":"The Impact of Language Barriers on Patient Safety and Quality of Care","author":"Bowen S.","year":"2015"},{"issue":"3","key":"e_1_2_11_15_1","first-page":"49","article-title":"A Review of Patient Safety Communication in Multicultural and Multilingual Healthcare Settings With Special Attention to the US and Canada","volume":"4","author":"Horv\u00e1th \u00c1.","year":"2022","journal-title":"Developments in Health Sciences"},{"issue":"2","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S1526-9523(02)00218-0","article-title":"The Impact of Language Barriers on the Health Care of Latinos in the United States: A Review of the Literature and Guidelines for Practice","volume":"47","author":"Timmins C. L.","year":"2002","journal-title":"Journal of Midwifery & Women's Health"},{"issue":"1","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.35680\/2372-0247.1181","article-title":"Experiences of Communication Barriers Between Physicians and Immigrant Patients: A Systematic Review and Thematic Synthesis","volume":"4","author":"Ahmed S.","year":"2017","journal-title":"Patient Experience Journal"},{"issue":"2","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1007\/s10903-022-01442-5","article-title":"The Experience of Informal Newcomer Cancer Caregivers With Limited Language Proficiency: A Scoping Review","volume":"25","author":"Murong M.","year":"2023","journal-title":"Journal of Immigrant and Minority Health"},{"key":"e_1_2_11_19_1","unstructured":"E. L. C.Aromataris K.Porritt B.Pilla andZ.Jordan \u201cJBI Manual for Evidence Synthesis \u201dhttps:\/\/synthesismanual.jbi.global."},{"issue":"7","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA\u2010ScR): Checklist and Explanation","volume":"169","author":"Tricco A. C.","year":"2018","journal-title":"Annals of Internal Medicine"},{"issue":"3","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/XEB.0000000000000050","article-title":"Guidance for Conducting Systematic Scoping Reviews","volume":"13","author":"Peters M. D.","year":"2015","journal-title":"International Journal of Evidence\u2010Based Healthcare"},{"issue":"7","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/01.NAJ.0000451683.66447.89","article-title":"JBI'S Systematic Reviews: Data Extraction and Synthesis","volume":"114","author":"Munn Z.","year":"2014","journal-title":"American Journal of Nursing"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S1479-3709(07)11003-7","volume-title":"Empirical Methods for Bioethics: A Primer","author":"Forman J.","year":"2007"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2020.103632","article-title":"Abstraction and Interpretation During the Qualitative Content Analysis Process","volume":"108","author":"Lindgren B.\u2010M.","year":"2020","journal-title":"International Journal of Nursing Studies"},{"issue":"4","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1177\/1533317511411908","article-title":"Experiences and Perceptions of Culturally and Linguistically Diverse Family Carers of People With Dementia","volume":"26","author":"Boughtwood D. L.","year":"2011","journal-title":"American Journal of Alzheimer's Disease and Other Dementias"},{"issue":"6","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"e4492","DOI":"10.1111\/hsc.13853","article-title":"The Experience of Structural Burden for Culturally and Linguistically Diverse Family Carers of People Living With Dementia in Australia","volume":"30","author":"Gilbert A. S.","year":"2022","journal-title":"Health & Social Care in the Community"},{"issue":"2","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.5172\/jamh.5.2.132","article-title":"Issues Faced by Carers of People With a Mental Illness From Culturally and Linguistically Diverse Backgrounds: Carers' and Practitioners' Perceptions","volume":"5","author":"Rooney R.","year":"2006","journal-title":"Australian e\u2010Journal for the Advancement of Mental Health"},{"issue":"1","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-13-427","article-title":"The Experiences of Culturally and Linguistically Diverse Family Caregivers in Utilising Dementia Services in Australia","volume":"13","author":"Xiao L. D.","year":"2013","journal-title":"BMC Health Services Research"},{"issue":"1","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1300\/J083v33n01_06","article-title":"Stress and Service Use Among Minority Caregivers to Elders With Dementia","volume":"33","author":"Ho C. J.","year":"2000","journal-title":"Journal of Gerontological Social Work"},{"issue":"7","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3390\/socsci13070378","article-title":"Dementia Care Decisions, Caregiving Situations, and Formal Service Use in Korean Immigrant Families: A Qualitative Application of a Sociocultural Model","volume":"13","author":"Jang Y.","year":"2024","journal-title":"Social Science"},{"issue":"3","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","DOI":"10.1177\/2158244020951261","article-title":"Language Related Difficulties Experienced by Caregivers of English\u2010Speaking Seniors in Quebec","volume":"10","author":"Sanderson D.","year":"2020","journal-title":"SAGE Open"},{"issue":"3","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/hex.12867","article-title":"Developing Education Materials for Caregivers of Culturally and Linguistically Diverse Patients: Insights From a Qualitative Analysis of Caregivers' Needs, Access and Understanding of Information","volume":"22","author":"Schaffer J. L.","year":"2019","journal-title":"Health Expectations: An International Journal of Public Participation in Health Care and Health Policy"},{"issue":"7","key":"e_1_2_11_33_1","doi-asserted-by":"crossref","first-page":"2785","DOI":"10.1080\/01434632.2022.2071428","article-title":"Caregiving and Flying Cars: Interactionally Mediated Practices of Care Through Language Brokering Within an Afghan Migrant Family in Denmark","volume":"45","author":"Ghandchi N.","year":"2024","journal-title":"Journal of Multilingual and Multicultural Development"},{"issue":"3","key":"e_1_2_11_34_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/hex.12867","article-title":"Developing Education Materials for Caregivers of Culturally and Linguistically Diverse Patients: Insights From a Qualitative Analysis of Caregivers' Needs, Access and Understanding of Information","volume":"22","author":"Schaffler J. L.","year":"2019","journal-title":"Health Expectations"},{"issue":"1","key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3233\/JAD-180957","article-title":"The Role of Care Navigators Working With People With Dementia and Their Caregivers","volume":"71","author":"Bernstein A.","year":"2019","journal-title":"Journal of Alzheimer's Disease"},{"issue":"2","key":"e_1_2_11_36_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.7326\/0003-4819-154-2-201101180-00012","article-title":"Lost in Translation: The Unintended Consequences of Advance Directive Law on Clinical Care","volume":"154","author":"Castillo L. S.","year":"2011","journal-title":"Annals of Internal Medicine"},{"issue":"2","key":"e_1_2_11_37_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5430\/jha.v6n2p21","article-title":"Meeting Demand: A Multi\u2010Method Approach to Optimizing Hospital Language Interpreter Staffing","volume":"6","author":"Chiam T. C.","year":"2017","journal-title":"Journal of Hospital Administration"},{"issue":"3","key":"e_1_2_11_38_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1558\/cam.26400","article-title":"Language Brokering in Multilingual Caregiving Settings","volume":"13","author":"Jansson G.","year":"2017","journal-title":"Communication & Medicine"},{"key":"e_1_2_11_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.pec.2025.108767","article-title":"Effectiveness of Interpreters and Other Strategies for Mitigating Language Barriers: A Systematic Review","volume":"136","author":"Lent L. G.","year":"2025","journal-title":"Patient Education and Counseling"},{"key":"e_1_2_11_40_1","unstructured":"N.Barrier \u201cCommunity Clinic NWA Saved 63% on Interpretation Cost \u201dhttps:\/\/www.nobarrier.ai\/case\u2010study\u2010federally\u2010qualified\u2010health\u2010center#:~:text=SointegratingNoBarriershowed costreductionininterpretation."},{"issue":"9","key":"e_1_2_11_41_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.32312","article-title":"Accuracy of Artificial Intelligence vs Professionally Translated Discharge Instructions","volume":"8","author":"Martos M.","year":"2025","journal-title":"JAMA Network Open"},{"issue":"1","key":"e_1_2_11_42_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1038\/s41746-025-02055-6","article-title":"Evaluating Human\u2010In\u2010The\u2010Loop Strategies for Artificial Intelligence\u2010Enabled Translation of Patient Discharge Instructions: A Multidisciplinary Analysis","volume":"8","author":"Brewster R. C.","year":"2025","journal-title":"npj Digital Medicine"},{"issue":"3","key":"e_1_2_11_43_1","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/s11606-023-08497-6","article-title":"Chatting Beyond ChatGPT: Advancing Equity Through AI\u2010Driven Language Interpretation","volume":"39","author":"Bakdash L.","year":"2024","journal-title":"Journal of General Internal Medicine"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70572","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70572","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:53:43Z","timestamp":1783540423000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":42,"alternative-id":["10.1111\/jgs.70572"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70572","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jgs.70572"}}