“…However, evidence indicates that the emergency department admission and hospitalization rate increases as individuals' cognitive impairment progresses (Chen et al, 2021). Sociodemographic characteristics (e.g., education, race, and ethnicity) and health factors (e.g., cognitive impairment, limitations in activities of daily living, and the number of chronic conditions, collectively known as frailty) are associated with disparities in ACP and healthcare utilization and the type of healthcare settings used, such as home or hospital (Mah et al, 2021;Pereira et al, 2022;Rahemi, 2019;Rahemi et al, 2019;Rahemi & Williams, 2016Suntai et al, 2022). For example, certain racial groups, including Black individuals with dementia, may have inadequate access to information to make informed end-of-life decisions (Bonner et al, 2021) and may underutilize ACP because of racism, discrimination, and/or inequitable treatment within the health system (Bonner et al, 2021;McDonnell & Idler, 2020).…”