Black Patients With Dementia More Likely to Receive Aggressive Care in Nursing Homes
A recent study published in JAMA Internal Medicine shows that Black nursing home residents with advanced dementia likely receive more aggressive care than non-Black residents.
A team of researchers from Massachusetts, Tennessee, Georgia and North Carolina conducted the qualitative study with 169 staff interviews in 14 nursing homes in four states. Interviews included questions about physical environment, care processes, decision-making, and implicit and explicit values.
They found that Black residents in facilities in the southeast of the U.S. receive more aggressive care than non-Black patients, such as the use of feeding tubes. It also shows that facilities that provide low-intensity versus high-intensity care have more pleasant physical environments, standardized advance care planning processes, greater staff engagement in decision-making and staff who did not value tube feeding.
All surveyed staff expressed assumptions that proxies for Black residents were reluctant to engage in advance care planning and favored more aggressive care as a result.
The study suggests that there are issues surrounding equitable care for residents of nursing homes, especially when it comes to Black patients with advanced dementia.
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