Millions of older Latinos will face complex medical decisions over the course of advanced illness, yet most are unprepared. Preparation for decision-making, or advance care planning (ACP), has traditionally focused on making decisions about life-prolonging procedures (eg, cardiopulmonary resuscitation) by completing advance directives (ADs). Yet, ADs are difficult to understand; are often not completed, especially by minorities; and often fail to affect the quality of care received. Latinos account for 15% of the US population, a proportion projected to grow to 30% by 2050. Spanish-speaking patients face significant communication barriers, and literacy-appropriate ACP tools that address unique aspects of Latino culture (eg, familismo or strong family loyalty) are lacking. We created a patient-centered ACP website called PREPARE (www. prepareforyourcare.org), which improves ACP engagement and is easy for English-speaking seniors to use; however, we had never tested it on Spanish-speaking patients.
