Healthcare Fears of Being Stereotyped: Older Adult Concerns (Research, Video 3:40)

Stereotypes have a way of showing up in all kinds of circumstances, including those related to healthcare. It’s shocking how threats of numerous stereotypes can impact so many areas of people’s lives. Think about all the stereotypes that can be drawn from just looking at a person (age, race, ethnicity, weight, disability, mannerisms, etc.) or listening to a person (word choices, accents, evasiveness, humor, etc.), and it becomes clearer that many people carry extra burdens with them that present real threats to the kinds of experiences they have in healthcare situations. Too many times, the threats of stereotypes are real. But, even when the threats are not real, do they still impact patient care?

No one should be reduced to being viewed as a group stereotype. Unfortunately, older adults have been blanketed with many negative stereotypes by society. Ageism is alive and well, and they experience it. In addition to other numerous stereotypes, older adults may fear being judged in healthcare contexts on several characteristics. A research study with older adults in the Health and Retirement Study was done to assess the impact of threats of being stereotyped in healthcare situations. 

This study included 1,479 individuals. They were tested on whether healthcare stereotype threats were associated with self-rated health, reported hypertension and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with healthcare, and preventative care use. These were the results:

1)  Seventeen percent of respondents reported threats of healthcare stereotypes with respect to one or more aspects of their identities.

2)  Healthcare stereotype threats were associated with higher physician distrust and dissatisfaction with healthcare, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine.

This study is the first of its kind. It reveals that people do experience healthcare stereotype threats on the basis of various stigmatized aspects of social identity and that these experiences can be linked with larger health and healthcare-related outcomes. In terms of disparities, keep in mind that the impact of the stereotype threats may be experienced in addition to the impact of real stereotypes they actually do experience in the healthcare arena. The healthcare industry must educate and monitor staff regarding stereotypes in general to improve healthcare-related outcomes and achieve person-centered care for everyone.

In a society where younger people are idolized, many have come to perceive old people as invisible, dependent, and not as valued as the young. This video describes the roots and consequences of ageism in America.

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.

Hospice and Nursing Homes Blog

Older Adult Health, Friendships: Horse Lessons (Research, Video 4:48)

Although it’s well known that social relationships and trust are associated with psychological well-being and physical health, a researched-based reminder and video can still be helpful. This study on older adult social health included 149 community-dwelling adults aged 65 years and older (68 men, 81 women). Activities of daily living, social cohesion and trust, depression, subjective quality of life, current medical status, past medical history, and health behaviors were assessed in face-to-face interviews. Even neurobehavioral physical functions were assessed.

What were the research results?

As expected, scores for activities of daily living and Geriatric Depression Scale were significantly correlated with social cohesion and trust. Social cohesion and trust were significantly correlated with all subjective quality of life items. In addition, a strong correlation was observed between social cohesion, trust, and relationships with friends. Values for social cohesion and trust were significantly associated with both subjective sense of health and subjective happiness.

How does this influence our assessment of older adults?

Social cohesion and trust are important variables that influence self-rated health and happiness, independently of activities of daily living, age, and sex. When assessing geriatric psychological function, social cohesion and trust should be examined more carefully, given the association with a subjective sense of health, happiness, depression, and physical function.

What do horses have to do with this?

Plenty. If you’re like I am and don’t know jack about horse relationships, this video is a great introduction. Meet Arthur, William, and Harry in this delightful video. Savor what they teach us about friendship and trust at any age.

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.
Hospice and Nursing Homes Blog

Recruiting Older Adults, Caregivers for Research (Research, Gerontology Video 1:57)

Recruiting older adults for research can get complicated if those being recruited can’t drive, have no transportation, don’t feel well, are easily confused, have busy caregivers, and distrust strangers asking them certain questions. One place to start is to decide on the best way to deliver a recruitment appeal that would entice them to respond and cooperate. Letters and phone calls come to mind.

This study on recruiting older adults for research compared the results of using two versions of a letter followed by two versions of a phone call with the cooperation rate of their doing face to face surveys. A total of 2,014 caregiving units (composed of an older adult, a family member and a home care worker) were randomly sampled from a list of long-term care insurance beneficiaries. Of this group, 74.32% of the sampled caregiving units were eligible to participate in the study. These are the three types of appeals used:

1)   Group 1 received formal written and oral appeals and an advanced letter followed by a recruitment phone call.

2)   Group 2 received the original formal letter, but a revised, more personal recruitment phone call that included broader and more positive information.

3)   Group 3 received both a revised advanced letter and a revised more personal recruitment phone call.

What were the results in terms of cooperation?

1)   Group 1: The cooperation rate for the formal written and oral appeal was about 50% for the entire caregiving unit.

2)   Group 2: The revised advanced letter and revised, more personal recruitment phone call yielded an increase of 20-25% in the cooperation rate for the entire caregiving unit.

3)   Group 3: Using the original advanced letter and the revised, more personal recruitment phone call yielded an increase in the cooperation rate only among migrant home care workers.

    Conclusion: By changing the format of appeal, the cooperation rate of older adults and their caregivers in a research survey can be increased. This study also pointed out the importance of sending an advance letter.

The Institute of Gerontology at Wayne State University in Detroit, Michigan brings together science and service to advance the cause of aging research. Its multidisciplinary faculty, post-doctoral fellows, and pre-doctoral trainees focus on the social and behavioral aspects of lifespan health and cognitive development. Dedicated to promoting successful aging, the Institute of Gerontology combines research and outreach to make life better for older adults everywhere. This video features many fine aspects of the program.

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.
Hospice and Nursing Homes Blog

Older Adult Support: Do They Want or Need It? (Research)

Have you noticed that the older people get, the more they are viewed as being in need of support? The problem with this generalized way of thinking is that support can be a very complex consideration. First of all, how do older people really feel about being receivers of support? Researchers of older adults set out to find that answer by interviewing community-dwelling, childless, older adults who were perceived by many to be “at risk” of lack of support.

The real meaning of support became more evident when the level of receiving support had to be defined. When researchers and assessors asked participants if they had enough support, responses regarding support and the experience of receiving it were explained in diverse ways:

   1) Some participants received support resulting from particular circumstances such as illness. They  viewed this kind of support as acceptable due to qualities of the support giver, and/or by being part of  reciprocal exchanges across time.

   2)  Participants resisted support, however, when associated with difficult interpersonal dynamics or the  giver’s assumptions about the receiver’s incapacity.

   3)  Some expressed concerns about wanting to be independent and not needing support.

   4)  Some felt the idea of being old and the equivalent of being in need of support was negative in terms of  being a support receiver.

Where do these responses leave researchers, needs assessors, and potential support givers? These responses emphasize the importance of examining how support receivers view themselves and their particular support needs before attempting to fulfill them. Support givers must not make misleading assumptions about “at-risk” groups. Although childless participants were perceived to be unsupported, many of them had a lifetime of self-support or an intentionally developed  “web of contacts” that satisfied them just fine.

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.

Hospice and Nursing Homes Blog

Older Adult Religion and Spirituality (Research, Hospice Nurse Video 2:51)

Are most religious older adults spiritual? Are the most spiritual ones religious? Topics related to spirituality and religion can get very personal. That’s why many people avoid them. As hospice volunteers, we are advised not to impose our personal religious or spiritual beliefs on patients. Some people have daily spiritual experiences that are a core part of their lives. At the same time, they may have varying levels of praying or attending formal religious services.

When older adults come together and live in a community, they bring all their varied personal religious and spiritual beliefs and practices, including no beliefs and practices. Rush University Medical Center researchers studied the levels of daily spiritual experiences of 6,534 older adults living in biracial communities. These are the reported results of that study:

1)   Most participants had daily spiritual experiences. African Americans and women had more than Whites and men.

2)   Prayer and worship were moderately connected with daily spiritual experiences.

3)   African American race, older age, female gender, better self-rated health, and greater social networks were associated with higher daily spiritual experiences scores. Higher levels of education and depressive symptoms were associated with lower daily spiritual experiences scores.

Overall, these findings are consistent with other research findings on religion and spirituality in the lives of older adults.

As eleven-year-old Jayna Brown demonstrates in this video, many of these spiritual connections begin in childhood. She sings "Take Me to the King" by Tamela Mann:

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog