Nursing Homes can't enforce patients bias

Well, the story continues: http://www.publicopiniononline.com/c...ce=most_viewed


Reacting to a federal court decision in Indiana, the county nursing home is striking out residents' racial preferences for caregivers.

Nursing homes have been sandwiched between balancing patient rights and employee civil rights. The federal ruling says that a home cannot enforce a patient's prejudices.

Five of the 171 patients at the Falling Spring Nursing and Rehabilitation Center have indicated a racial preference for the people who care for them, according to Nursing Director Alma Cullers.

Cullers said she had tried to make staff assignments so the patients would be comfortable with their caregiver. She noted in patient care plans when a resident complained about the race of a person treating them.

"We always try to accommodate the residents," nursing home Administrator Dr. Barry Parks said. "It is home to them."
With the federal ruling, nursing staff will have to explain to patients stating a racial preference.

"We have certain rules," Parks said. "We will try to accommodate those as far as we can, but we can't be in conflict with federal laws."

If a resident insists, he or she will be asked to find another home, according to Parks.

Cullers said that in eight years she has seen a significant decline in the number of residents complaining of a caregiver's race.

"This is a different century in which we are living," Franklin County Commissioner Robert Thomas said.
But the source of an elderly person's prejudice may not be as simple as saying he or she grew up in a different time.

"It is never too late to have a person learn tolerance," said Cynthia L. Pickett, Associate Professor of Psychology, University of California at Davis.

" However, we do know that aging brings with it certain cognitive declines, particularly in terms of executive brain function. It is more difficult for older adults to regulate and inhibit any racial biases that they might have. However, it is not impossible for them to do so, but you may see more 'slips.'"

Whites, 60 years and older, exhibit 5 to 10 percent more bias than younger whites, according to results from a decade-long sociological study called Project Implicit. Harvard University, the University of Washington and the University of Virginia run the study.

"I believe that it would be a mistake for people to excuse or accept racial bias among older adults as somehow inevitable," Pickett said. "Behaving and acting in egalitarian ways takes effort even for the young. It may require a little more effort for older adults. However, this does not mean that older adults should be allowed to follow a different set of rules or be somehow exempt from the same codes of conduct that the rest of society abides by."

Negative racial attitudes commonly are transmitted socially, she said.

"People are exposed to the attitudes of their peers, parents and family members," she said. "If they grew up in an environment where negative racial attitudes were prevalent, they may have adopted those attitudes as well."

People also have a tendency to prefer the groups to which they belong to groups to which they do not belong.

"That bias, often referred to as 'in-group bias', is difficult to eradicate and tends to occur in all age groups," she said.

The recent court ruling runs counter to the Nursing Home Reform Law, enacted by Congress in 1987. The law addressed evidence of widespread abuse of nursing home patients and led to state regulations about care of the elderly.

Patients have the right to refuse to be treatment by a caregiver of the opposite sex. Courts have cited privacy issues in allowing that.

Less than three percent of patients at the county nursing home have expressed racial preferences. The complaints did not dictate anything in the county's hiring practices, Commissioner Robert Ziobrowski said.

A nursing home confronted with a hostile resident has a range of options without resorting to discharging the resident, according to a recent federal ruling on resident discrimination of nursing home employees.

The employer can take these reasonable measures to avoid liability for work place harassment:

-- The home can warn residents before admitting them of the facility's nondiscrimination policy and secure the resident's written consent.

-- It can attempt to reform the resident's behavior after admission.

-- It can assign staff based on race-neutral criteria that minimize the risk of conflict.

Original story: http://www.ultimatenurse.com/forum/f...ed-race-93416/

Okay, so there is some rational thinking around this issue. While it's sometimes more difficult, effort is being put toward upholding higher socialized function rather than caving in claiming "patients' rights".

R

Well, we do all have rights, but are they being pushed to the extreme?

Extreme? In general as well as in the practice of medicine, it is my opinion that social "advocates" in their pursuit of "justice" have expanded the definition of extreme thereby, complicating social practices greatly. There's a lot of indulgence out there giving rise to manipulative behavior. I tire of hearing, "it's my right to have..." over minute or inconsequential issues or to be granted special priviledges or to be excused from certain behaviors that would be considered socially appropriate. Back to the original, cited example, I think there's a difference between the right to competent and compassionate nursing care and the right to choose the ethnicity, gender, faith practice, age range or whatever of the nursing care provider.

Just my two cents,

R

I just found this added to my OP:

To read a copy of the 7th U.S. Circuit Court of Appeals decision on Chaney vs. Plainfield Health Center see http://www.leagle.com/unsecure/page.htm?shortname=infco20100720145.

Here are highlights of the July 20 decision:

-- Plainfield Health Center in Indiana complied with a resident's racial preference by telling Brenda Chaney, a black certified nursing assistant, in writing everyday that "no black" assistants should enter this resident's room or give her care.

-- The racial preference policy created a hostile work environment and violated the Title VII of the 1964 Civil Rights Act. Plainfield's practice of honoring the racial preferences of residents was accompanied by racially-tinged comments and epithets from co-workers.

-- The comments stopped, but Plainfield's racial preference policy remained in place and continued to surface in conversations with other employees.

Researchers at Harvard University, the University of Virginia, and University of Washington run Project Implicit.
You can check your personal bias at https://implicit.harvard.edu/implicit/.

Most of the site's Implicit Association Tests examine thoughts and feelings that exist outside conscious awareness or control, according to the Web site. Researchers attempt to understand divergences between people "knowing their minds" and "speaking their minds."