Navigating the Challenge of Discrimination in Healthcare: A Call to Action
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Discrimination in older adult care is a pervasive issue, shaping the quality of care older adults receive based on their background rather than their health needs.
Consider a healthcare clinic visited by two individuals: One from a wealthy neighborhood and another from a less affluent area. Despite having similar health issues, they receive different levels of care due to biases, conscious or unconscious, held by healthcare workers. This isn’t just a one-off situation but a widespread issue, as a survey by the Commonwealth Fund and the African American Research Collaborative found that nearly half of all healthcare workers have seen patients being treated unfairly because of their race, where they live, their income, or other personal characteristics.?
This issue isn’t limited to one place or one group of people; it’s seen across countries and affects many different types of patients. To address this, we need a comprehensive strategy that encourages healthcare environments, especially those in older adult care, to welcome and treat everyone equally, no matter their background.?
For those caring for older adults, this means being vigilant about the treatment those in their care receive. For example, an older adult from a minority background might not get the same attention or quality of care as other older adults. Caregivers need to be aware of these potential biases to advocate effectively for the best possible care for the older adults they support.?
The Prevalence of Discrimination?
The Commonwealth Fund survey paints a grim picture of the healthcare sector, where 47% of healthcare workers have observed discrimination based on race, ethnicity, gender, socioeconomic status, or other factors. This phenomenon is not isolated to the United States; a study from France found that 3.9% of respondents reported experiencing discrimination in healthcare settings, with significant disparities among women, immigrants, and those with origins in Overseas France, Africa, and Turkey.?
Let’s put this into a more relatable context. Imagine you’re accompanying an older loved one to a doctor’s appointment. Now, according to the survey, nearly half of all healthcare workers have noticed that patients are sometimes treated differently because of their race, whether they are male or female, their income level, or other personal characteristics. This means there’s a good chance your loved one could be treated unfairly just because of who they are or where they come from.?
Now, to make this even more relatable, let’s explore what discrimination can look like for many older adults in our lives.? Imagine an older woman, Mrs. Lopez, who emigrated from Mexico and speaks limited English. She visits a local clinic because of a persistent cough. Upon arrival, she senses reluctance from the staff to assist her, possibly due to her accent or the fact that she struggles to communicate in English. During her examination, the doctor seems rushed and dismissive, not fully addressing her concerns or exploring her symptoms in depth. Instead of being offered a comprehensive examination or a referral to a specialist, which might be standard procedure for another patient, Mrs. Lopez is quickly prescribed a generic medication and sent on her way.?
This scenario exemplifies several layers of discrimination:?
In this case, Mrs. Lopez’s experience with the older adult care system is marred by barriers that prevent her from receiving equitable care. Such instances highlight the need for older adult care systems to adopt more inclusive practices, ensuring all older adults, regardless of their background or language proficiency, receive the care and attention they deserve.?
And, it’s important to note that this issue isn’t just happening here; it’s a worldwide problem. As we mentioned, in France, a study showed that about 4 out of every 100 people felt they were discriminated against when getting healthcare, especially if they were women, immigrants, or came from specific regions like Africa or Turkey. So, if your older loved one is an immigrant or belongs to a minority group, they may face more hurdles in receiving the care they need, not just in the U.S. but also in other countries.?
Understanding this can help you be more prepared to support and advocate for the older adults in your care, ensuring they receive fair and respectful treatment in healthcare settings.?
Discrimination in older adult care settings can have profound effects on care and outcomes. Older Adults who face discrimination are more likely to delay seeking care, leading to worsened health conditions. This dynamic perpetuates health disparities, particularly among marginalized communities, and erodes trust in the healthcare system.?
Imagine an older woman, Mrs. Smith, who lives in a low-income neighborhood. She’s been feeling unwell for a while but hesitates to see a doctor because she’s had bad experiences in the past. When she finally visits the clinic, she feels the staff treat her differently because of where she comes from or because she’s older. They don’t listen to her concerns as seriously as they might for someone younger from a wealthier area. Feeling discouraged and disrespected, Mrs. Smith decides it’s better not to bother seeking help the next time she’s unwell.?
This scenario illustrates how discrimination doesn’t just hurt feelings—it can have serious consequences for health. By delaying or avoiding medical care due to past discrimination, Mrs. Smith’s condition could worsen, leading to more severe health issues that could have been prevented with timely care. This cycle is especially damaging in marginalized communities, where such experiences can deepen existing health inequalities and undermine trust in the care system. For those caring for older adults, understanding these dynamics is crucial to advocating for and supporting their health needs effectively.?
Strategies for Change?
To combat discrimination in older adult care, several strategies have been proposed. A research article published in the National Library of Medicine (NIH) from StatPearls emphasizes the importance of cultural humility, awareness, and sensitivity among healthcare professionals (HCPs). It suggests that diversity education should not just be about acquiring a set of knowledge but should involve a continuous process of learning, self-reflection, and developing an attitude of curiosity towards each patient’s unique context.?
Published research offers practical guidance for educators and healthcare institutions. For instance, many researchers recommend integrating diversity education throughout the curriculum and highlight the importance of self-reflection in learning and teaching diversity-related concepts. Meanwhile, a systematic review on reducing HIV-related stigma in healthcare settings indicates a gap in research and the need for effective interventions that address both knowledge gaps and institutional factors contributing to stigma.?
Think of a nurse, John, who regularly cares for a diverse group of older adults, including Mr. Lee, who immigrated from China, and Mrs. Rodriguez, who grew up in Mexico. To provide the best care, John needs more than just medical knowledge; he needs to understand and respect the cultural backgrounds and personal histories of his patients. This is where the concept of cultural humility comes in. It’s about John being open to learning from his patients about their cultures, reflecting on his own cultural biases, and continuously striving to improve his interactions with each unique individual he cares for.?
For professionals in older adult care, one of the best ways to facilitate change is to strengthen the soft skills for caregivers, frontline nurses, and professionals that can have a direct and positive impact in reducing discrimination of older adults: empathy, respect, and effective communication.??
Incorporating a focus on skills-based training is essential for fostering an environment that prioritizes the dignity and equitable care for older adults. Enhancing soft skills such as empathy, respect, and effective communication among older adult care professionals is not just beneficial—it’s transformative. These skills enable caregivers to connect with older adults on a human level, seeing beyond medical charts and diagnoses to the individual’s unique experiences and needs.?
For instance, a caregiver with developed empathy skills can better understand the fears and concerns of an older adult who is anxious about a new diagnosis. By showing genuine respect and listening actively, the caregiver can make the patient feel valued and heard, which can significantly improve the older adult’s willingness to engage in the treatment plan from their care team and follow medical advice.?
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Effective communication goes beyond just conveying information clearly; it involves ensuring that the message is received and understood by the older adult, taking into account language barriers, cultural differences, and varying levels of health literacy. This approach not only improves outcomes for older adults, but also builds a stronger, more trusting relationship between older adult care providers and those in their care.?
Incorporating these soft skills into professional training programs requires a deliberate effort. It means moving beyond traditional medical education that focuses heavily on technical knowledge and procedural skills to include comprehensive training in interpersonal communication, cultural competence, and emotional intelligence. By embedding these elements into continuing education, professionals are better equipped to navigate the complexities of older adult care in a diverse society, ultimately leading to a more inclusive, understanding, and effective care system. This shift is particularly crucial in the care of older adults, where empathy and respect can significantly impact their quality of life and overall health outcomes.?
A Call to Action?
The evidence is clear: discrimination in older adult care is a pervasive issue that requires urgent attention. Older adult care providers, professionals, educators, and policymakers must work together to implement strategies that address this challenge head-on. This involves not only providing education on cultural humility and sensitivity but also creating policies that promote equity and inclusion in older adult care settings.?
One practical approach involves training older adult care professionals in cultural humility and sensitivity. This means teaching them to recognize and respect the diverse cultural backgrounds of their patients. For example, a caregiver might learn the best ways to communicate with an older adult patient who speaks a different language or follows cultural practices unfamiliar to the caregiver.?
Additionally, older adult care centers can implement policies that promote fairness and support for all older adults. This could include setting up a system where older adults and staff can report discrimination anonymously, without fear of repercussions.?
Older adult care centers might also hold regular meetings or workshops for staff and older adults to discuss issues related to discrimination, offering a safe space for sharing experiences and learning from one another. Imagine a scenario where older adult care professionals and older adults come together in a workshop to share their experiences with discrimination and learn how to support each other better.?
Creating an inclusive environment where every older adult, including those from various backgrounds, feels respected and valued is the goal. By educating older adult care professionals, revising policies to promote equity, and encouraging open dialogue, we can make significant strides toward eliminating discrimination in older adult care settings.?
Conclusion?
Creating an older adult care system that treats everyone fairly, regardless of their background, is a work in progress. There are still obstacles to overcome, but the willingness of older adult care professionals to make positive changes is a crucial step toward a more accepting and inclusive environment.?
First, recognizing there is a problem is key. Imagine a scenario where a home health aide, Mark, notices that his colleague seems to treat older adult patients from minority backgrounds differently, perhaps not spending as much time with them or not being as patient. By acknowledging this behavior as a problem, Mark and his colleagues can start to make changes.?
Embracing diversity means understanding and valuing the differences between us all, including older adults in our care. For example, a physical therapist might take the time to learn a few words in the native language of an older adult immigrant to make them feel more comfortable and valued during their sessions.?
Implementing concrete strategies involves taking specific actions to fight discrimination. This could look like an older adult care center adopting a skills training program for its staff focused on cultural sensitivity, ensuring that all older adults, including those from diverse backgrounds, receive compassionate and respectful care.?
By taking these steps—acknowledging the issue, valuing diversity, and putting specific measures in place—we move closer to an older adult care system that lives up to its promise: to care for everyone equally, without letting biases or stereotypes get in the way. This approach not only improves the quality of care for older adults but also builds a foundation of trust and respect between older adult care professionals and the communities they serve.?
About the Author: Patrice Woodard
Patrice Woodard, Director of Customer Operations for Engage with? Skills Training Programs, boasts over a decade in project management, process improvement, and accounting. With a diverse background spanning social services to sales, Patrice is dedicated to crafting environments that champion both team and customer success. She orchestrates the seamless administration and coordination of Engage with? training endeavors.
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