they may not receive optimal care if they don’tspeak the same language as their caregivers

The demographic landscape of Western countries has shifted to a more diverse one.

CLR care becomes especially clear in settings where day-to-day communication is central to daily care and decision-making, such as long-term care (LTC).

Therefore, high care dependency, residents' demographic shifts (cultural and linguistic diversity), together with disease progression, create conditions in which mismatches between residents' preferred language and the language used within care facilities are likely to occur.

While these studies highlight the urgent need for CLR care, what remains unclear is what types of CLR programs exist in LTC settings, how these programs are implemented, what their core components such as approaches, strategies, and evaluation are, and which cultural or linguistic groups they are designed to support.

For individuals from minority language communities whose primary language differs from that spoken by the majority, this creates a patient-facility language discordance that can affect communication and trust between patient and provider, and ultimately affect health outcomes and the quality of care [[10], [25]]. Delivering care in residents' preferred language is important to creating a culturally and linguistically appropriate environment and ensuring high-quality LTC services [[10]]. Reducing language discordance not only improves the effectiveness of communication but also demonstrates respect for residents' identities, culture, and values. Conversely, patient-facility Language discordance further emphasized the importance of developing CLR care programs as a critical component of patient-centered care for older LTC residents from official linguistic minority communities [[17]].

LTC, including nursing homes or assisted living facilities, is a distinct sector that helps to provide comprehensive care when older adults' needs exceed what can be met at home or in the community [[15]]. Therefore, LTC residents are often individuals with physical dependency, multiple chronic conditions, and a high prevalence of Alzheimer's disease or other dementias [[16]]. As cognitive impairment progresses, many residents have language decline and even language reversal, in which the less ingrained second language is lost and the dominant original mother tongue re-emerges [[18]–[20]]. This change further exacerbates the language barriers at a time when care needs are most intensive. At the same time, cultural diversity within LTC is growing, creating challenges of acknowledging and accommodating residents' cultural backgrounds and linguistic needs [[21]].

When healthcare is delivered in a language that is not the individual's preferred or most often used language, the communication barrier may affect the quality of care they receive and therefore impact their health outcome

Therefore, this scoping review will identify and categorise CLR programs within long-term care.

Similar trends were found in Australia, where more than 37% of older adults were born overseas, and 10.6% of permanent migrants are not proficient in English [[ 6 ]]. As linguistically diverse older adults age, their health and care needs increase and they are more likely to need support from formal healthcare systems

This scoping review will follow the Arksey and O'Malley methodological framework, which was further developed by Levac and colleagues [[29]]. The review procedure will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) statement

Cultural and linguistic responsiveness in long-term care: A scoping review protocol on programs for residents and staff.