Monday, September 26, 2016

Race and Class Biases Among Nurses and Doctors (Research, Video 2:34)

Have you ever become so accustomed to an odor, even a bad one, that you stopped noticing it at all? Sometimes race and class biases are like that. Unfortunately, men, women, and children can be harmed, even killed, as a result. Many people don’t realize how embedded racism and classism are in our society, particularly when they are not victimized regularly themselves. Overt acts are intended, meant to be hurtful. Covert acts are implied, often done unconsciously, but still do damage because the recipients of these actions are mistreated. 

The healthcare industry, like many others, consists of workers who make decisions about people’s lives on a daily basis. Consistently high numbers of disparities related specifically to race and class have existed over many years. Still, most healthcare workers continue to say they treat all patients equally. Ongoing disparities impact, not only patients, but also their families, communities, and ultimately our nation. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity. 

This post is based on race and class bias research in which implied preferences for a specific social group are shown that can have adverse consequences for patient care of other groups.  Clinical stories were used and analyzed to determine whether implicit race or class biases among registered nurses influenced their decisions in managing patients. Performed at the Johns Hopkins Hospital, the study involved nurses who were given 8 multi-stage clinical stories to read in which patients' race or social class were randomly altered. In addition, nurses were given implicit association tests about race and social class.

Results of this study involving 245 mostly white and female registered nurses were the following:
1)   Most nurses stated that they had no explicit race or class preferences.

2)   Only 36 nurses demonstrated no implicit race preference as measured by implicit association tests for race and social class.

3)   Only 16 nurses displayed no implicit class preference on the implicit association tests for social class and race.

This research, along with many other examples, concluded that the majority of registered nurses displayed implicit (unconscious) preferences toward white race and upper social class patients. However, unlike published data on physicians, implicit biases among registered nurses did not correlate with clinical decision-making.

In this video, Michelle van Ryn, Ph.D., a researcher at the Mayo Clinic, describes implicit bias in health care and future research underway to understand and further address this critical issue. Keep in mind that this is not only a healthcare issue, but also a moral one.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Implicit and Overt Racism, Overt and Implicit Classism, Nurses and Doctors Racism-Classism, Dr. Michelle van Ryn, Bias in Healthcare Research

Monday, September 19, 2016

Hospital Wine for Terminally Ill (Research, Video 1:40)

Quality of life for the terminally ill can be defined in innumerable ways. Depending on the person, it could mean something as extravagant as winning the largest lottery or something as simple as being hospitalized and having a glass of wine with dinner or visiting loved ones. The idea of being hospitalized and having a glass of wine is already being implemented by the palliative unit at a hospital that has a bar serving wine, whisky, and champagne.

Clermont-Ferrand Hospital, located in France where wine is a staple, provides additional quality end-of-life care for patients by serving medically supervised wine provided by local residents living in the area. After all, shouldn’t the pleasantries of living be available all the way through final days of our death journey? Patients are invited to drink wine at mealtimes. Caregivers are even encouraged to learn the basics of oenology, the science and study of wine and winemaking. A Roman playwright name Plautus said, “Let us celebrate the occasion with wine and sweet words.” Here’s to happy endings for all who are terminally ill! Cheers!

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Monday, September 12, 2016

Financial Abuse and Older Adult Trust (Research, Video 2:36)

Are there people you really trust? Who are they, and why do you trust them? When mutual trust is achieved successfully in relationships, the experience can be beautiful and very beneficial to well-being. Unfortunately, knowing whom, when, and why to trust can be very difficult nowadays for anyone, especially older adults. Too often, their trust in social relationships goes unreciprocated and becomes exploitive.

Experts say older adult financial abuse will be the crime of the 21st century. Trust will play a major role. This became evident in a repeated trust game involving older adult financial abuse and including young adults investing real money with people they trusted at various levels (close, neutral, distant). Older adults were more likely than young adults to invest with all trustees. Older adults correlated higher intelligence with larger financial investments with the most trustworthy trustees. Better subjective financial untrustworthy well-being was associated with increased investing in the most untrustworthy trustees. Clearly, this presents potential dangers for older adults in the area of finance.

Are there ways for professionals who work with older adults, such as attorneys, law enforcement officials, and people who work at financial institutions to determine those at risk for being victims? Dr. Peter Lichtenberg, Director of the Institute of Gerontology at Wayne State University in Detroit, MI, is creating the Lichtenberg Financial Decision-Making Rating Scale for that purpose. This person-centered assessment will determine whether older adults are at risk for being victims of financial abuse and their ability to manage their money and other assets. The professionals would determine whether those surveyed are experiencing undue outside influence and whether they are competent in making good financial decisions. With this knowledge, they can better protect those most at risk for being exploited.

The National Adult Protective Services Organization website is a resource to help protect older adults from financial abuse while still allowing them their dignity. This website explains many common scams that are financially abusive to this population. Scammers include strangers, professionals, friends, and family members. Advice on the effects of financial exploitation and ways to address the abuse are also shared.

The rate of financial exploitation of the elderly is extremely high with millions indicating some form of perceived financial mistreatment occurring in the recent past. Dr. Natalia Tapia, Assistant Professor of Justice, Law and Public Safety Studies at Lewis University located in Midwest America, defines and discusses common forms of older adult financial abuse in this video: 

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.