Neurological Impairment Among Elderly African-American Nursing Home Residents

Objective: This article examines differences in nursing home use and quality among Medicare beneficiaries, in both Medicare Advantage and fee-for-service, newly admitted to nursing homes with Alzheimer’s disease and related dementias (ADRD). Method: Retrospective, national, population-based study of Medicare residents newly admitted to nursing homes with ADRD by race and ethnic group. Our analytic sample included 1,302,099 nursing home residents—268,181 with a diagnosis of ADRD—in 13,532 nursing homes from 2014. Results: We found that a larger share of Hispanic Medicare residents that are admitted to nursing homes have ADRD compared with African American and White beneficiaries. Both Hispanics and African Americans with ADRD received care in segregated nursing homes with fewer resources and lower quality of care compared with White residents. Discussion: These results have implications for targeted efforts to achieve health care equity and quality improvement efforts among nursing homes that serve minority patients.

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Patterns of preference importance ratings among African-American and White nursing home residents

Innovation in Aging ◽

10.1093/geroni/igaa057.3063 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 836-836

Author(s):

Nytasia Hicks ◽

Katherine Abbott ◽

Allison Heid ◽

Kendall Leser ◽

Kimberly Van Haitsma

Keyword(s):

African American ◽

Nursing Home ◽

Nursing Home Residents ◽

Test Group ◽

Preference Assessment ◽

Group Differences ◽

Test Results ◽

Importance Ratings ◽

Preference Ratings

Abstract Background: The Preferences for Everyday Living Inventory (PELI) was developed to assess the psychosocial preferences of older adults receiving home care (PELI-HC) and then revised for nursing home residents (PELI-NH). While the PELI-HC has been tested to identify patterns in preference ratings by race, the PELI-NH has not. We sought to explore whether the PELI-NH tool captures differences in preference ratings of African-American and White NH residents. Methods: Preference assessment interviews were conducted with NH residents (n = 317). Analysis via a Mann-Whitney U test, results show that 46 of 72 (63.88%) a preference importance items were not statistically different between African-American and White NH residents. Additionally, African-Americans reported greater importance than White older adult NH residents in 26 of 72 (36%) preference importance items. Conclusion/Implications: It appears that the PELI-NH can test group differences in preference importance among African-American and White NH residents; implications for practice will be discussed. Part of a symposium sponsored by the Research in Quality of Care Interest Group.

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Religious Activities, Strength from Faith, and Social Functioning Among African American and White Nursing Home Residents

Journal of Religion Spirituality & Aging ◽

10.1300/j496v19n04_02 ◽

2007 ◽

Vol 19 (4) ◽

pp. 3-20 ◽

Cited By ~ 4

Author(s):

Kenneth J. Branco

Keyword(s):

African American ◽

Nursing Home ◽

Social Functioning ◽

Nursing Home Residents ◽

Religious Activities

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RACIAL BIAS IN STAFF OPTIMISM ABOUT ADL IMPROVEMENT AMONG NURSING HOME RESIDENTS

Innovation in Aging ◽

10.1093/geroni/igz038.928 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S247-S247

Author(s):

Kenneth J Branco

Keyword(s):

African American ◽

Nursing Home ◽

Racial Bias ◽

Nursing Home Residents ◽

Assessment Instrument ◽

American Resident ◽

Resident Assessment ◽

And Gender ◽

Provision Of Care ◽

Resident Assessment Instrument

Abstract Research on bias in health care has shown disparity in provision of care to and health outcomes of African Americans. Patient optimism was associated with improved physical and psychosocial outcomes, and nurse optimism was correlated with patient perceptions of care. We estimated effects of race using logistic regression, controlling for ADLs, cognitive impairment, and gender on both staff optimism and resident optimism about capacity for improvement in ADLs in a probability sample (n=2604) of nursing home residents who were evaluated with the resident assessment instrument (RAI). We found no difference between African American and White residents’ optimism about their own capacity for improvement. Staff findings were quite different. Staff were most optimistic about the potential of residents who needed ADL assistance OR=1.82; 95% CI [1.42-2.32] over those who were ADL dependent or those who only needed oversight. Most importantly, it was in the oversight category of ADL impairment where the greatest indication of racial prejudice occurred. Staff were much less likely to be optimistic about African American residents (16%) compared to White residents (30%). With all control variables entered, staff were still less willing to be optimistic about African American resident improvement (AOR=0.65; 95% CI [0.44-0.96]. The implications of these findings are troubling. It is unlikely that staff would expend energy on improving the functioning of the African American residents whom they believe cannot improve. Further research is needed on the extent to which prejudice in nursing homes is accompanied by discrimination and how the bias can be overcome.

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