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Examining racial and ethnic disparities among older adults in long-term care facilities
- Authors:
- LEE Kathy, et al
- Journal article citation:
- Gerontologist, 61(6), 2021, pp.858-869.
- Publisher:
- Oxford University Press
Background and Objectives: The purpose of this project was to examine individual-level ethnic and racial differences and facility-level differences in types of complaints and rates of complaint resolution in a local long-term care ombudsman program. Research Design and Methods: We employed a mixed-methods sequential explanatory design. First, we analyzed secondary complaint data based on residents’ race and ethnicity (n = 464) and facility characteristics (n = 101). We then conducted 2 focus groups with ombudsmen (n = 12) to provide context for our quantitative findings and to explore the ombudsmen’s views on disparities in long-term care facilities. Results: Racial and ethnic minority residents were more likely to generate complaints related to residents’ rights than nonminority residents. Assisted living facilities were more likely to have complaints related to residents’ rights and outside agencies than nursing homes. The rate of complaint resolution increased among facilities with a higher proportion of minority residents, compared to facilities with a lower proportion of minority residents. However, an estimation of cross-level interaction revealed that non-Hispanic White residents in these facilities experienced faster complaint resolution than minority residents. Ombudsmen expressed concerns about communication barriers between minority residents and facility staff and discussed different complaint types and resolution rates according to facility types. Discussion and Implications: Our findings highlight disparities across long-term care facilities as well as disparities in care minority residents experience. Long-term care ombudsman program complaint data should be disaggregated by race and ethnicity of the residents to advocate for policy change at facility, state, and federal levels. (Edited publisher abstract)
Filipinas as residential long-term care providers: influence of cultural values, structural inequity, and immigrant status on choosing this work
- Authors:
- BROWNE Colette V, BRAUN Kathryn L, ARNSBERGER Pam
- Journal article citation:
- Journal of Gerontological Social Work, 48(3/4), 2007, pp.439-455.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This exploratory study investigated reasons why Filipinas in Hawaii have become the primary caregivers of elders in residential care homes and if they thought their children would follow them in this profession. A random sample of 173 Filipina care home operators (CHO), of which 95% were first-generation immigrants, was interviewed using telephone survey methods. Data were collected: to profile caregivers; to identify motivations for becoming a care home operator; and to gauge if they or their children would continue in this line of work. The sample was composed of middle-aged Filipina CHO with training and experience in elder care who concurred that the job fit their cultural values. About a third also felt that this job was open to immigrants and helped them buy a house. Twenty percent or less felt discriminated against because of this work. Although half the sample felt that women were better caregivers than men, only 38% felt that caregiving was primarily the responsibility of women. Almost 90% planned to continue with this work, but only 12% said it was likely that their children or grandchildren would become CHO, supporting the notion that choosing this profession had less to do with cultural values and gender expectations than with economic opportunities available to the current cohort of CHO. Given these findings, Hawaii's capacity to meet future residential longterm care needs is discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Developing extra care housing for black and minority ethnic elders: an overview of the issues, examples and challenges
- Author:
- GREAT BRITAIN. Department of Health. Health and Social Care Change Agent Team
- Publisher:
- Great Britain. Department of Health. Health and Social Care Change Agent Team. Housing Learning and Improvement Network
- Publication year:
- 2006
- Pagination:
- 36p.
- Place of publication:
- London
This Housing LIN (Housing Learning and Improvement Network) report on Ageing and Ethnicity focuses on issues around providing specific extra care housing to BME elders as well as improving access more generally. It also offers a self-assessment checklist for commissioners and providers to consider when developing their extra care housing strategies and delivery plans.
Supporting black and minority ethnic older people's mental wellbeing: accounts of social care practice
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, MANTHORPE Jill, et al
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2010
- Pagination:
- 82p., bibliog.
- Place of publication:
- London
The Social Care Workforce Research Unit, based at King’s College London, was commissioned to undertake a practice enquiry looking at how social care practitioners were supporting BME older people’s mental wellbeing in the four parts of the United Kingdom (UK). The report is based on interviews with over 80 participants who included practitioners (including social workers, commissioners, and workers in the voluntary and community sector), managers, volunteers, BME older people, and family carers. The report sets out some of the background to the enquiry, outlines the methods used and presents findings in seven chapters. Chapters cover: Promoting wellbeing: addressing risk and encouraging social interaction through preventive approaches; mental wellbeing in care homes; personalised approaches to promoting wellbeing and supporting people with depression; housing and housing with care solutions to maintain mental wellbeing; relationships with older people using services, their carers and practitioners; training and skills development; staff views on specialist and integrated support. At the end of each of these chapters, brief summaries and reflections are presented in the form of main messages.
A study of the housing, care and support needs of African Caribbean older people living in Chapeltown, Leeds. A report by MHA Care Group in partnership with the Leeds black Elders Association and the Mary Seacole Nurses Association
- Author:
- HYLTON Tracey
- Publisher:
- MHA Care Group
- Publication year:
- 2001
- Pagination:
- 56
- Place of publication:
- Derby
This report details the results of a research study to identify the housing, care and support needs of African Caribbean older people living in the Chapeltown area of Leeds. It was undertaken between November 2000 and April 2001 and seeks to inform the development of services in the area. Key findings include: over 33% of the population in Chapeltown come from BME groups compared to 6% of Leeds as a whole, and 12.69% are Black Caribbean (1991 Census); service providers expressed the view that dementia care should be one of the top priorities for service development for African Caribbean people; there is a great sense of disempowerment among African Caribbean community members in terms of making their needs known and having needs met, due partly to institutional racism, lack of information, lack of awareness of the decision-making process; the majority of African Caribbean elders in the study want to carry on living independently in their own homes – with increased support if necessary; a large number of individuals want some form of aid or adaptation in their home; there is evidence that some older African Caribbean community members are low level service users – due to inappropriate assessment of their needs and a high use of family help and community group services; the greatest resistance to moving into a care home came from people aged 85 and over while the majority of under 85 years were prepared to concede that they may re-evaluate accommodation due to declining health; all were opposed to culturally specific accommodation; all carers/relatives in this study were adamant that the older person would be cared for at home indefinitely; there was a strong view that a sole black resident in shared accommodation was not desirable; this was due partly to institutional and direct racism and the lack of cultural sensitivity to their needs. (Edited publisher abstract)
Unequal pandemic, fairer recovery: the COVID-19 impact inquiry report
- Authors:
- SULEMAN Mehrunisha, et al
- Publisher:
- Health Foundation
- Publication year:
- 2021
- Pagination:
- 94
- Place of publication:
- London
This report sets out the findings of the Covid-19 impact inquiry, exploring how the same factors contributing to this widening of health inequalities exposed the UK to a high death toll and reduced people’s ability to deal with the subsequent economic shock. Drawing on an extensive body of evidence, this report identifies what has driven such outcomes during the pandemic. The factors shaping the UK’s overall experience of the pandemic are complex and multifaceted, and the pandemic is still ongoing. The Covid-19 impact inquiry provides an initial assessment of the effects of the pandemic using evidence available up to May 2021. The report highlights that poor health and existing inequalities left parts of the UK vulnerable to the virus and defined the contours of its devastating impact. The pandemic has revealed stark differences in the health of the working age population – those younger than 65 in the poorest 10% of areas in England were almost four times more likely to die from Covid-19 than those in wealthiest. Recovery needs to prioritise creating opportunities for good health – a vital asset needed to 'level up' and rebuild the UK economy. Government restrictions, although needed to limit Covid-19’s spread, have had wide-ranging consequences: from unmet health needs and mental health problems to education gaps, lost employment and financial insecurity. Some groups – young people, disabled people, ethnic minority communities and care home residents – have been more affected than others. Prisoners, homeless people and people experiencing sexual exploitation have also faced particular challenges. Type and quality of work, housing conditions, and access to financial support to self-isolate all contributed to increased exposure to the virus among working age adults. The legacy of the financial crisis has had a direct bearing on our experience of the pandemic. Deep-rooted issues – poor health, increased financial insecurity and strained public services – left the UK more vulnerable to Covid-19’s health and economic impacts. (Edited publisher abstract)
A sense of place: retirement decisions among older black and minority ethnic people
- Author:
- KHAN Omar
- Publisher:
- Runnymede Trust
- Publication year:
- 2012
- Pagination:
- 32p.
- Place of publication:
- London
This report looks at what influences retirement decisions in the black and minority ethnic community and recommends ways in which local and national government should respond to this population. It draws together the views of more than 100 BME older people across the UK. The responses reveal that this is typically a very personal decision, with people weighing up how they can best sustain ties to their family and community while at the same time being financially secure and having good access to services. A major theme of the research is how the government’s “one size fits all” approach is proving inadequate for meeting the needs of BME older people and how targeted, as well as universal, policies are needed to include them more fully in British society. The notion that BME people seek to retire overseas, is becoming outdated, even if it was ever widespread, as an increasing proportion of BME people in Britain were born here. Among the recommendations, the author highlights the need for care homes to provide care that better caters to the needs of ethnic minorities.
The role of ethnicity in end-of-life care in care homes for older people in the UK: a literature review
- Authors:
- BADGER Frances, et al
- Journal article citation:
- Diversity in Health and Care, 6(1), March 2009, pp.23-29.
- Publisher:
- Radcliffe Publishing
Care homes for older people are major providers of end-of-life care. There are over half a million deaths a year in the UK, the vast majority occurring among older people, and one in five members of the population dies in a care home. Ensuring the provision of high quality end-of-life care in care homes for older people is an important healthcare issue, and has recently been scrutinised as part of an overall review of end-of-life care in the UK. It is acknowledged that little is known either about the numbers of people from black and minority ethnic groups who are resident in care homes, or about the extent to which their end-of-life care needs are addressed in line with their specific requirements. This paper summarises the current research evidence on cultural issues relating to ethnicity in end-of-life care in care homes, identifying the need for both monitoring and research data on the experiences and perspectives of residents from black and ethnic minorities, and their family carers.
Social work practice with ethnically and racially diverse nursing home residents and their families
- Editors:
- KOLB Patricia J., (ed.)
- Publisher:
- Columbia University Press
- Publication year:
- 2007
- Pagination:
- 259p.
- Place of publication:
- New York
This book is a companion for service providers who work with ethnically and racially diverse older people and their families in nursing homes and other care settings. It provides demographic, historical, cultural and practice information to facilitate understanding of and providing services to older adults and their families. Individual chapters cover each of the following groups: African American elders; American Indian elders; Chinese American elders; Italian American elders; Japanese American elders; Korean American elders; Mexican American elders; Puerto Rican elders.
The great care divide
- Author:
- HIRSCH Donald
- Journal article citation:
- Community Care, 7.12.06, 2006, pp.32-33.
- Publisher:
- Reed Business Information
The article considers two studies published this year by the Joseph Rowntree Foundation mapping the availability of informal care and of residential care homes in the UK. The studies identify an uneven supply of care, with deprived groups often better able to provide informal care but with inferior access to care homes. The article argues that a new funding regime should aim to provide greater consistency.