?The following is a guest post by Susan Avello. Susan is a great resource in the elder care industry. Please see her contact information after the article.
I?ve been under the impression and for years that?minorities are more apt to bring an elderly or disabled loved one into their home as opposed to putting them in a nursing home or some kind of facility. In fact, I worked in a nursing home for a few years while in my twenties.
It appears that?most minorities have a real sense of ?family, values and sticking together? and they tend to want to take care of their elders out of respect. Now I?m not saying whites don?t. This may also have to do with the costs associated (residential facilities vs. in home care) and quite possibly new laws and?legislation in play for Medicare and Medicaid?recipients.
Stumbling across an article from the?Science Blog?yesterday, I read that?in the last decade, minorities have poured into nursing homes at a time when whites have left in even greater numbers. This data is according to Brown University suggests a?racial disparity in elder care options?in the United States. This analysis was found in the journal of?Health Affairs?dated July 7, 2011.
This study suggests that elderly blacks, Hispanics, and Asians are gaining greater access to nursing home care. But?the growing proportion of minorities in nursing homes is coming about partly because they do not have the same access to more desirable forms of care as wealthier whites do, said the study?s lead author Zhanlian?Feng.
?Seemingly, we are closing the gap in terms of minority access to nursing home beds, but I don?t think that is something to celebrate,? Feng said. ?They are really the last resort. Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to.? (Ask any senior citizen and they?re more than likely going to tell you this. My Mom to this day, continues to try and make me promise that I will not put her in a nursing home).
This new analysis shows that between 1999 and 2008 the nation?s nursing home population shrank by 6.1 percent to just over 1.2 million people. In that time period the number of whites in nursing homes decreased by 10.2 percent nationwide, while the number of blacks rose 10.8 percent, the number of Hispanics rose by 54.9 percent and the number of Asians rose by 54.1 percent. The study also looked at nursing home population changes in the top 10 metropolitan areas for each minority.
Prior research has shown that the?nursing homes in predominately minority areas are often of lower quality and are more likely to close, while assisted living facilities are more likely to be built in areas where residents have high incomes. The result, reflected in the figures in the new?Health Affairs?paper, is a disparity that plays out not only economically and geographically, but also racially.
Most care?alternatives are not equally available, accessible, or affordable to everybody, certainly not to many minority elders.
As policymakers look to ??re-balance? elder care from nursing homes to other forms of care, for instance with shifts in Medicaid funding to support home and community-based services, they should account for these disparities, Feng said. As it is,?whites are clearly more likely to be using more desirable alternatives; more concerted efforts may be required to promote minority elders? use of them too, he said.
One way Feng?and his co-authors have quantified the disparity in eldercare?is by grouping metropolitan areas into quartiles based on the proportion of whites, blacks, Hispanics or Asians 65 or older in each area. They found that the representation of blacks, Hispanics and Asians in nursing homes increased as their share of elderly in the total population increased. This did not hold for whites, who did not appear to be obliged to choose nursing homes as they age.
In New York, a top 10 metropolitan area for blacks, Hispanics and Asians, nursing home residents from these groups increased 22 percent, 84 percent and 40 percent, respectively.?With different rates in different cities,?the challenge facing policymakers is not only national, but also local.
In the end, it would be a fabulous world if we all could choose where we wanted to spend the remainder of our days, but somehow ? that isn?t reality.?Siblings, children, family members, government, and our money or lack of it, ?all play a part in end of life care.
Source: In addition to Feng, the paper?s other authors at Brown University are Mary Fennell, professor of sociology; Denise Tyler, gerontology?researcher; Melissa Clark, associate professor of community health; and Vincent Mor, the Florence Pirce Grant Professor of Health Services, Policy, and Practice.
The National Institute on Aging supported the research.
About the Author:
Susan Avello is Vice President and Partner of?Aging Info USA??based in Chicago,IL. Aging Info USA directly supports employee caregivers, HR and Executive Management by implementing creative approaches in education, resources and training in regard to eldercare?and family caregiving and work/life challenges. She is the author of two books as well as?The Working Caregiver?and HR Virtual Cafe blogs. You can connect with her on Twitter?@susanavello.
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