Case Western Reserve researcher suggests social workers need to play a bigger role in skilled-nursing facilities as baby boomers age
America is expected to become a “majority-minority” nation by 2045, according to the U.S. Census Bureau. By 2030 alone, racial and ethnic minorities are expected to make up almost 30% of the older adult population in the United States.
And with that shift, growing disparities in how minority populations are cared for in nursing homes are only likely to worsen, according to a new study by social work researchers at Case Western Reserve University.
Tyrone Hamler, a doctoral
candidate at the Jack, Joseph and Morton Mandel School of Applied Social
Sciences, co-authored an article about nursing-home care for elderly African-Americans
and Latinos, published in a recent issue of Social Work in Health Care.
In it, Hamler and co-author
Vivian Miller, an instructor and researcher at the University of Texas at
Arlington, contend that social workers need to take on a bigger role within interdisciplinary
teams at nursing homes.
Minority older adults need
extra attention for a few reasons. According to the research, they often have one
or more additional medical conditions co-occurring with a primary condition; higher
levels of cognitive impairment as they age; impairment in activities of daily
living; and lower socioeconomic status.
Hamler and Miller suggest
social workers are in the best position to help improve care.
“Trained social workers are
educated and armed with the knowledge and tools to best assess for cultural and
ethnic components of individualized resident care,” according to the study.
Minority older adults—particularly blacks and Latinos—experience more preventable diseases in general, Hamler said. The National Institutes of Health reports a “consensus of existing literature” highlighting the disparities in nursing homes nationally.
Improving nursing-home care
has been on the legislative radar since the 1980s. The effort to address
reports of poor care was first met with federal legislation in 1987, the
Nursing Home Reform Act (NHRA), meant to enforce quality care and the provision
of certain services to nursing home residents. Despite more minorities
entering nursing homes, standards for care have remained relatively unchanged,
“We need to make sure that
practitioners and researchers alike consider the role that society has with our
aging population,” he said. “We can have a direct and active role in lessening
inequities for older adults.”
Hamler and Miller’s research identified
several ways to improve nursing-home care, including training nursing home
staff in culturally appropriate assessments, interventions and care delivery;
gaining a better understanding of the variations in caregiving needs among
ethnic minority groups; and providing better assessment tools to focus on the gaps
“Nursing-home care is
something that’s difficult for people to talk about,” Hamler said, “but it’s
something we need to talk about.
These folks at the end of their lives need to be treated with dignity and
respect. And, as a society, this is one of our roles.”