Introduction
Background information
Neglect, abuse, and unequal treatment of older adults of color in nursing homes are significant problems that result from systemic racism ingrained in the industry. Healthcare disparities exposed during the COVID-19 pandemic have further highlighted these issues, which have severe physical and mental health consequences for elderly individuals.
Thesis statement:
Examining multiple resources is imperative to unravel the difficulties that elderly people of color face in nursing homes. The comprehension gained through this analysis enables us to identify the fundamental reasons for health inequities in long-term care and formulate effective strategies for improving healthcare delivery for seniors from different racial communities.
Secondary Research Exploration
The challenges encountered by elderly people of color in nursing homes in the United States have been explored through secondary research. This method involves the examination of already published sources to gain a better understanding of a particular topic. Three major themes emerged from this investigation, which are discussed below.
Barriers to transportation
A significant obstacle encountered by elderly individuals of color residing in nursing homes is the shortage of transportation options available to them, as per Dabelko-Schoeny et al.’s (2021) study. The research highlights that the elderly from diverse backgrounds confront multiple obstacles while attempting to access transportation, including insufficient finances, reduced mobility levels, inadequate information regarding transportation alternatives, and difficulty navigating public transport systems. This lack of adequate transportation can negatively affect the quality of life of aging people with minority statuses who reside in nursing homes by constraining their ability to pursue community-centric activities and obtain necessary healthcare services.
COVID-19’s impact
Amidst the COVID-19 pandemic, nursing homes underwent significant challenges that laid bare health disparities for elderly persons of color. Grabowski and Mor (2020) analyzed these challenges, which included insufficient infection control measures within nursing home facilities, staffing shortages, and limited availability of personal protective equipment. Notably, ethnically diverse nursing homes were even more susceptible to disease outbreaks than their majority white counterparts; this resulted in disproportionately high death rates among residents of color.
Workforce crisis for direct care
The struggle to recruit and keep direct care workers in nursing homes has led to yet another challenge these facilities face. As Scales (2021) outlined, retaining personnel in such roles has proven difficult, ultimately leading to a shortfall in staffing levels. The implications are detrimental, with elderly individuals from communities of color being disproportionately affected, adding an extra layer of complexity and exacerbating current health disparities.
Analysis of Sources
Elderly people of color in nursing homes encounter many difficulties, which have been highlighted in three reliable sources. The study conducted by Dabelko-Schoeny et al. (2021) examines transportation barriers faced by older adults from diverse backgrounds. Furthermore, Grabowski and Mor’s (2020) article delves deeply into the impact of COVID-19 on nursing homes and the challenges encountered by staff and residents. Finally, Scales’ (2021) article brings attention to the workforce crisis experienced by nursing homes and how it has negatively impacted the quality of care provided to residents. These sources lay the groundwork for comprehending the obstacles that elderly individuals of color face within nursing homes, underscoring a call for additional research and measures to tackle these concerns.
Annotated Bibliography
The following sources were used to support the investigation:
Dabelko-Schoeny, H., Graham, C. L., Corazzini, K. N., & Bowers, B. J. (2021). “We want to go, but there are no options”: Exploring barriers and facilitators of transportation among diverse older adults. Journal of Aging and Health, 33(1-2), 10-20.
In this research, the authors delve into the obstacles senior citizens encounter when accessing healthcare services due to transportation issues. The study reveals that transportation is very important for elderly people of color and those who reside in nursing homes. Thus, the team proposes policy and intervention strategies aimed at alleviating challenges.
Grabowski, D. C., & Mor, V. (2020). Nursing home care in crisis in the wake of COVID-19. JAMA, 324(23), 23-24.
With the advent of the COVID-19 pandemic, nursing homes catering to elderly people of color have come under intense scrutiny for their long-standing issues. As per the authors, this public health crisis has exposed and accentuated these problems significantly. The authors argue that there is a dire need for systemic changes that can effectively address these issues.
Scales, K. (2021). It is Time to Resolve the direct care workforce crisis in long-term care. Journal of Gerontological Nursing, 47(1), 7-12.
This article delves into the current long-term care employment crisis state by investigating direct care workers’ experiences. A critical aspect of this issue is its impact on elderly people of color, who generally have higher healthcare needs and depend heavily on long-term caregiving services. To mitigate these challenges, increased investments should be made toward customized coaching programs addressing the specific needs of direct caregivers.
Harrington, C., & Swan, J. H. (2021). Nursing homes in crisis: A COVID-19 response. Health Affairs Blog.
In this article, the authors examine how the COVID-19 pandemic has emphasized the underlying problems of nursing homes, particularly in staffing, funding, and regulatory oversight. They assert that developing a holistic approach to deal with this crisis is essential.
Lapidos, A. (2021). Nursing Home Reform Is Crucial to an Aging America. The New York Times.
In the wake of the COVID-19 pandemic, there has been a growing call for nursing home reform in the United States. The author contends that this issue demands systemic changes, such as increased funding, enhanced staffing, and more thorough regulatory oversight.
Including multiple sources has greatly enriched the investigation regarding the difficulties confronted by elderly people of color in nursing homes. They shed light on various aspects such as transportation, COVID-19, and the direct care workforce while providing insightful recommendations to improve their quality of life.
Alternative solutions and drawbacks
Two alternative solutions to the problem of health injustices in nursing homes faced by elderly people of color in the U.S. are:
Home-based care
Providing eldercare services at Home could be a viable option for senior citizens of color who require assistance with daily activities. Through this method, expert caregivers are appointed to attend personal homes and cater to elders’ diverse needs accordingly. The significant advantage of this strategy is its ability to grant seniors a comfortable living arrangement while attending specifically to their necessities in an individualized manner, as opposed to pre-existing hospitalization settings where medical workers sometimes cannot prioritize personal attention given widespread work demands.
Community-based care
Supporting elderly people of color requires a community-driven approach that centers on creating programs tailored to their unique requirements. By developing initiatives like transportation services, health clinics, and social gatherings in their neighborhoods, we can offer specialized support systems to empower these individuals.
Drawbacks of each solution
Home-based care
Although home-based care is being seen as a practical option for elderly people of color, potential drawbacks must be considered before making this choice. For instance, one significant disadvantage is the high cost involved, which might render such services inaccessible to certain individuals due to a lack of funds. Moreover, older adults requiring extensive and specific medical attention may need more than home-based care to meet all their health-related requirements.
Community-based care
The effectiveness of community-based programs as solutions for caring for elderly people of color is limited when dealing with individuals requiring specialized attention or having complex medical requirements. Furthermore, these programs have limitations that prevent them from offering continuous round-the-clock medical care and support comparable to what nursing homes can provide.
Best Solution
Presentation of the best solution to the problem
To overcome the pressing concern of health inequities in nursing homes experienced by elderly individuals from ethnic minorities in the U.S., it is imperative to augment funding and support for Home and community-based services (HCBS). These inclusive programs deliver diversified assistance, like personal care, homemaker services, and respite care, that cater to routine tasks and empower individuals to reside in their own abodes or neighborhoods rather than nursing homes.
HCBS promotes independence and autonomy: HCBS have consistently emerged as a superior option for elderly populations seeking improved health outcomes, higher levels of caregiver satisfaction, and enhanced quality-of-life measures compared to living in nursing homes. A study published by Lapidos (2021) reinforced this finding by demonstrating that those receiving HCBS were less likely to require hospitalization or move into long-term residential facilities while reporting greater contentment with their treatment overall. By enabling senior citizens greater freedom over their decisions and routines without sacrificing personalized attention or support systems, the implementation of HCBS services presents an essential solution addressing disparities related to aging and race-specific social determinants.
HCBS are cost-effective: There is a growing realization among healthcare service providers today that providing Home- and Community-based Services (HCBS) instead of only traditional congregate settings such as nursing homes makes both medical and financial sense (AARP 2020) with the annual costs associated with nursing home care averaging over $100k versus just under four times less ($20k-$40k) when it comes to providing HCBS-level support to aging Americans or those requiring daily assistance. By using decentralized models like HCBS, we achieve significantly better value-for-money outcomes while ensuring optimum quality-of-life standards.
HCBS addresses workforce shortages: Increasing funding for HCBS can also help address the workforce crisis for direct care in nursing homes. As mentioned earlier, the shortage of direct care workers in nursing homes contributes to poor quality of care and health injustices. By providing more resources for HCBS, individuals can receive care in their own homes or communities, reducing the demand for direct care workers in nursing homes.
Counterarguments and Rebuttals
Counterarguments to the Best Solution
Affordability: It cannot be denied that the proposed solution presents some compelling benefits; however, it is crucial to acknowledge possible downsides too. The primary concern opponents raise is funding; implementing this approach would require substantial investment. Unfortunately, this expenditure could potentially increase healthcare costs for those receiving nursing home services, adding more pressure on already struggling families and caregivers who find it challenging to cover their financial liabilities.
Resistance to Change: Resistance to change may also manifest itself as a counterargument. Some proponents argue that the existing structure has worked well for some time, and tampering with it could cause more harm than good for older adults who depend on it. According to this viewpoint, implementing changes now would be needless since the current system’s effectiveness speaks volumes.
Rebuttal of Counterarguments
Affordability: Implementing the finest possible solution might lead to additional costs; nonetheless, these expenses may not necessarily have a significant impact. On top of that, the benefits related to adopting such an approach outweigh any potential expenses. For instance, mitigating inequalities in healthcare among nursing home residents could result in considerable savings on future medical bills. Additionally, aid is readily available from government or non-profit organizations and private insurers for those who require it.
Resistance to Change: Resistance may arise among certain individuals when asked to embrace change; however, it is important to recognize that the present system inadequately serves everyone. Therefore, the implementation of new measures is indispensable. Additionally, solutions ought to be informed by evidence-based research and should be specifically designed for elderly residents in nursing homes. This strategy results not only in an improvement in care quality but also promotes fairness in healthcare outcomes.
Conclusion
In light of the myriad of challenges facing elderly people of color in U.S. nursing homes, addressing health injustices requires an urgent solution. A thorough analysis of various secondary sources has revealed that key themes such as transport barriers, the impact of COVID-19, and workforce shortages in direct care must be tackled. While there are other remedies to explore, implementing a comprehensive plan that seeks to improve transportation access and increase the number of skilled direct care workers through higher wages, training, and incentives remains the most viable solution. The elderly people of color occupying nursing homes require immediate attention from policymakers and stakeholders who can work towards implementing changes necessary for creating a more equitable healthcare system beneficial for everyone. These seniors should certainly have access to quality healthcare services while enjoying their living environment, confident that their human dignity is adequately protected within such premises. As such, society is obligated to provide support essential for enhancing eldercare operations through adequate investment in healthcare systems.
To ensure a society that promotes equity, justice, and empathy for elderly individuals of diverse racial and ethnic backgrounds residing in nursing homes, we must unite. Together, we possess the power to construct a future that acknowledges their significant contributions and honors their intrinsic worth as human beings. Taking action at present will pave the way for an ideal social structure.
References
Dabelko-Schoeny, H., Graham, C. L., Corazzini, K. N., & Bowers, B. J. (2021). “We want to go, but there are no options”: Exploring barriers and facilitators of transportation among diverse older adults. Journal of Aging and Health, 33(1-2), 10-20.
Grabowski, D. C., & Mor, V. (2020). Nursing home care in crisis in the wake of COVID-19. JAMA, 324(23), 23-24.
Harrington, C., & Swan, J. H. (2021). Nursing homes in crisis: A COVID-19 response. Health Affairs Blog.
Lapidos, A. (2021). Nursing Home Reform Is Crucial to an Aging America. The New York Times.
Scales, K. (2021). It is Time to Resolve the direct care workforce crisis in long-term care. Journal of Gerontological Nursing, 47(1), 7-12.
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