Older adults who have limited English-speaking ability may have difficulty accessing services that are available to fluent English speakers. The language barrier may prevent them from receiving transportation, medical, and social services, as well as limit employment and schooling opportunities. For older adults with limited English-speaking ability, prescription instructions may be difficult or impossible to follow for prescription medications. Cultural responses to caregiving may differ for those who speak a primary language other than English; a service provider may rely on family members to identify needs of the older adult, which may result in a discrepancy between perceived need and services actually provided. Identifying people who need help understanding English can be used to inform a variety of legislative, policy, and research applications. People who speak a particular language other than English and cannot speak English “very well” can benefit from translation services, education, or assistance in accessing government services.