Socio-Economic Issues of Long-Term Care - PLG Nursing Home Abuse & Neglect Injury Attorneys in California

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Socio-Economic Issues of Long-Term Care

Socio-Economic Issues of Long-Term Care

When we place our elderly family members into long-term care (i.e. skilled nursing, retirement community, assisted living, etc.) we hope that they’re being treated fairly. But, for many in the elderly community, this is unfortunately not the case.

In fact, according to the National Institute on Aging (NIA), approximately 1 in 10 adults over the age of 60 are abused, neglected or exploited financially. And, even more alarming, the abuse is sometimes nearly double that rate among minorities and people of color.

In order to combat this issue, we first need to understand it. Here are some of the details that show how race, and the socio-economic factors associated with being Black and /or Hispanic, has affected neglect and abuse in long-term care facilities.

What is elder abuse?

Elder abuse is defined as:

(a) “Abuse of an elder or a dependent adult” means any of the following:

(1) Physical abuse, neglect, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering.

Types of abuse:

Physical abuse: When someone, usually a caregiver, or another resident, causes bodily harm by assaulting, battering, hitting, pushing, or slapping – or in some cases, restraining an older adult against his/her will.

Emotional or psychological abuse: When a caregiver shouts hurtful words, threatens or repeatedly ignores an older adult. Keeping an elderly person from seeing friends and relatives is also considered emotional abuse.

Neglect: includes, but is not limited to, all of the following:

(1) Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter.

(2) Failure to provide medical care for physical and mental health needs.

(3) Failure to protect from health and safety hazards.

(4) Failure to prevent malnutrition or dehydration.

Abandonment: When an older adult who needs help is left alone without the necessary plan for his or her care.


Sexual Assault: that means any of the following:

(1) Sexual battery;

(2) Rape;

(3) Rape in concert;

(4) Incest;

(5) Sodomy;

(6) Oral copulation;

(7) Sexual penetration;

(8) Lewd or lascivious acts.

Financial abuse: When money or valuable belongings are stolen from an older adult. This can occur when caregivers forge checks, use retirement or Social Security benefits, or use an older person’s credit cards and bank accounts without their permission. It also includes changing names on policies or a will, or a title to a house, without the elder person’s permission.

Elder Abuse in Black and Hispanic communities

Studies show that elder abuse is a serious issue across all races, sexes, religions and cultural backgrounds. However, some evidence suggests that abuse among adults aged 60+ is even more common in Black and Hispanic elders.

Latino Elder Abuse

A study cited by the National Center of Elder Abuse (NCEA) specifically looked at 198 Latino elders and found that 40 percent experienced at least one type of abuse, with 21 percent experiencing multiple types of elder abuse. And, of those that were abused, less than 2 percent of them actually reported the abuse to any authority, such as the APS.

African American Elder Abuse

Another similar study cited by the NCEA researched elder abuse in African American populations.

This paper notes research conducted by Beach, Schulz, Castle, and Rosen (2010), a population-based study on financial exploitation and psychological mistreatment among 210 African American and 693 non-African American adults aged 60 years and older in Pennsylvania.

Findings showed that 24.4 percent of African American elders and 13.2 percent of Non-African-American elders reported psychological abuse. Both studies also concluded that financial exploitation was more common among the Non-White elderly populations surveyed, as was physical abuse.

What’s unknown, however, is the cause of this increase in abuse in Black and Hispanic elder communities. There are theories as to why this is the case, and many of the causes are likely linked to the socio-economic situations of most people in these populations.

Socio-economic issues in African American elders

A wide range of issues for African American families in the U.S. stem from suffering through systematic racism and structural segregation.

The long-term effects of these discriminatory acts continue to plague the African American population, creating a divide in health and economic wellness throughout the country, especially when compared to the non-Hispanic white population.

Health disparities:

African American households are usually at higher risk for disease and death, stemming from economic hardships and lack of adequate health care.

The U.S. Department of Health and Human Services’ Office of Minority Health (OMH) notes that “the death rate for African Americans is generally higher than whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide.”

The prevalence of health issues in the African American population can lead to an increase in stress and financial strain, which can, in turn, also lead to a habit of internalizing pain and discomfort – increasing the risk of mental health concerns. This is likely a factor when considering why more African American elders are being abused in long-term care.

Economic disparities:

According to the OMH, in 2019, the U.S. Census Bureau reported that 21.2 percent of non-Hispanic blacks were living at the poverty level, compared to 9.0 percent of non-Hispanic whites. That difference means that finding satisfactory health care and long-term care may be difficult for many elderly African Americans – if they can afford it at all.

Without the proper funds to place a loved one in a highly rated long-term care facility, or to move them from one care facility to another, the elder family member or their financially responsible party could be forced to endure abuse in less-than-ideal situations.

Lack of External Support:

Because of the above-mentioned factors, African American elders and their families lack the support systems that are more commonly found in white families, and are usually reluctant to trust anyone outside of their family/community.

Plus, systematic racism, segregation and other race-related discrimination programs have led to a general distrust of institutions, so seeking external help seems like a risky endeavor for many African American families.

Socio-Economic Concerns Among Hispanic Elders

Like the African American population, the Hispanic (or Latino) population in the U.S. is diverse and is actually comprised of many different ethnicities and countries of origin. And, like the Black community, most evidence suggests that Hispanic elders are more likely to be mistreated in long-term care situations.

There are many reasons that elder abuse is more common for Hispanic elders – although less evidence is available for proof of the abuse disparity. It’s safe to assume that many of the abuse cases stem from cultural beliefs in Hispanic families and the differentiation in health and healthcare.

Health and Healthcare factors:

According to a population bulletin posted by the Population Reference Bureau (PRB), “the large majority of Latinos, especially in the case of Mexicans, Puerto Ricans, and Dominicans, lag significantly behind whites on all socioeconomic dimensions.”

Although some Hispanic cultures tend to show lower mortality rates than non-Hispanic white population, many families in this general race category lack health insurance. The aforementioned bulletin explains that the lack of health insurance among Hispanic families likely stems from low-paying jobs with little or no coverage as part of their employment package.

Unfortunately, Hispanics are about 50% more likely to die from certain dangerous diseases (diabetes or liver disease) than whites, but usually show lower percentages when it comes to cancers. Generally speaking, the health and healthcare situation among Hispanic families is turbulent, and may be cause for additional mental and financial strain. These stressors can cause a variety of issues and could be a factor for the noted increase in elder abuse in Hispanic populations.

Cultural factors:

Most Hispanic cultures place a great deal of emphasis on family and tend to care for their elders in-home rather than send them to long-term care facilities. However, when Latino elders are in care situations, language barriers and lack of cultural competency can impede services and create barriers between the caregiver and the patient, and these frustrations can lead to abusive situations.

According to a research brief published by NCEA, despite the high rates of reported mistreatment among Hispanic elders, only 1.5% of respondents indicated they had reported abuse of any kind to Adult Protective Services (APS) in the past year. This could be contributed to a variety of factors, but most likely stems from cultural norms in the Hispanic community.

The sense of family and community in many Latino cultures also comes with the burden of additional shame. When Hispanic elders are abused – whether by someone outside of the family or by a family member – its less likely that they’ll report it because they don’t want to embarrass themselves or their family, especially if the elder themselves is seen as a caregiver or provider to their own family.

Who is most at risk of elder abuse in long-term care?

Compared to non-Hispanic Whites, homicide is more common among non-Hispanic Black or African American persons, and Hispanic or Latino persons. When it comes to elder abuse, the same ethnicities tend to be at greater risk of being abused, too.

The evidence suggests that African American or Black elderly persons are at the greatest risk, but are also more likely to report incidents compared to Hispanic or Latino elders, so those numbers may be skewed.

In the end, elder abuse in long-term care facilities is a problem among almost every ethnicity and race, with African American and Hispanic populations likely at a higher risk than non-Hispanic whites. However, even non-Hispanic whites are at great risk, as they’re more likely to be placed in long-term care and are the largest race in the U.S. – so white elders who have experienced elder abuse may have the highest count among all other populations. 

Preventing elder abuse in long-term care

Several factors may decrease the risk of perpetrating and/or experiencing elder abuse.

To prevent elder abuse, everyone in contact with an elderly person in care should understand and address the factors that put people at risk. A few helpful steps include:

  • Listen to older adults to understand their challenges and provide support.
  • Educate yourself and others around you about how to recognize and report elder abuse.
  • Learn how signs of elder abuse differ from the normal aging process.
  • Check-in on adults in care facilities, especially those who have a limited number of friends and family members.
  • Provide support for caregivers, too, such as local relief care groups, adult day care programs, counseling, or other outlets intended to promote emotional well-being.
  • Report any abuse or suspected abuse to the police if in immediate danger. Otherwise, it can help to speak with the Peck Law Group, experienced attorneys toll free at 1-866-999-9085, or immediately Check with Peck to learn how you can protect your rights, receive just compensation for your injuries, and bring those responsible to justice so that it doesn’t happen to others in the future.


Even if you take all the above measures, elder abuse isn’t going away overnight. Knowing as much as you can about elder abuse and neglect can, however, help your loved ones stay at a lower risk.

Sources:

https://ncea.acl.gov/NCEA/media/publications/Mistreatment-of-Latino-Elders-(2014).pdf

https://www.prb.org/resources/social-and-economic-well-being-and-the-future-for-latinos-in-the-united-states/

https://ncea.acl.gov/NCEA/media/publications/Mistreatment-of-African-American-Elders-(2016).pdf

https://www.nia.nih.gov/health/elder-abuse#types

https://www.ojp.gov/ncjrs/virtual-library/abstracts/understanding-and-combating-elder-abuse-hispanic-communities

https://www.cdc.gov/violenceprevention/elderabuse/fastfact.html

About the Author

Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.


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