The Complicated Dynamic of Racism in Long Term Care


Holding Hands with Elderly Patient

 

By:  Evelina Silveira, President,   Diversity at Work in London Inc. and author of  Diversity and Inclusion on A Budget:  How to have a more engaged and innovative workforce for little or no dollars.

Go to almost any long term care facility in the London, Ontario area and the racial divide will be very visible when it comes to who is a  front-line worker versus a resident.  Race and ethnicity become very pronounced.  British name plaques sprinkled with a few Southern European ones grace the corridors of the residence.  These facilities are home to a largely female population, and the leadership is usually comprised of women of British origin.

When we look more closely however, we will see that visible minorities form a good part of the staff involved in direct service delivery.  In London, this means primarily Filipino, Sudanese, Ethiopian, Eritrean, Latin American and Eastern European women.  For the most part, the residents have had very little contact with these groups and are unfamiliar with them, and consequently   deep-rooted racism, prejudice and stereotypes are not uncommon.

We have to remember that the cultural and racial demographics did not change much until the mid 1980’s in London, Ontario.  These residents probably did not grow up, live alongside and work with people who looked different, sounded different and did things differently.   It should be expected that they may have feelings of discomfort when they are in such a vulnerable position when they have to rely on these workers for so much of their basic care and sense of safety.

However, this lack of comfort can lead to racism causing devastating consequences for these workers.  False accusations, physical assaults against the workers and racial slurs can all be hurled at the people who are entrusted to look after them.  Feeling powerless, and afraid to report any problems for fear of losing their job, many minority workers have to face the additional brunt of racism while they go about their jobs caring for our family members in low paying positions with little opportunity for advancement.

Administrators will note that while many residents may keep their racial intolerance to themselves, if they are struck with dementia their filter is often lost.  It means that racial minorities who work in dementia services will deal with the effects of racism to an even larger degree.  It is a very slippery slope as we cannot punish people with dementia for what they say, so what do we do?

There is very little in the research about what might be the best solutions to the problem of racism against direct care workers in senior residences.  It can be challenging because long term care is a resident’s home. To complicate matters, residents who are hard of hearing report real challenges understanding those who have heavy accents.  But can long term care facilities be doing more to embrace the diversity of their staff?  The answer is yes.  Here are a few suggestions, but we need more.

 1.   Advertise languages spoken at your long-term care facility. –  Use your website, boast about it in your pamphlets and create a welcome sign for your front lobby that is multi-lingual and showcases the languages spoken.

 2.  Have multicultural displays.  Work with families, residents and employees to showcase various cultures in your lobby.  You might want to designate a multicultural week where you could have display tables that residents and family members could preside.  This is a great way to let everyone know that your home respects and celebrates culture.  Don’t forget to include posters that show respect for diversity and inclusion.  Include a few new food choices.

 3.  Solicit ideas for new recreational activities.  Do you have a resident who enjoys working on a craft project that is unique to     their  country of origin?  Would they be interested in teaching others how to do it?  Your multicultural staff could provide insight into some foods, outings, music and crafts.  The possibilities are endless; all the while learning about one another can be fun.

4.  Intake Assessments.   It is important to let residents and family members know about respect policies that you may have regarding your employees.  Depending on the resident’s health condition they may or may not be able to adhere to them. Ensure that you include some culturally based questions about:  values, end-of life decisions, language spoken.

 5.  Onboarding for New Employees – Ensure that all employees are told about the supports that are available to them when it comes to any bullying, harassment and racism.  Racism can take a toll on a worker’s mental health and performance, and they need to know what it looks like and where they can report it without jeopardizing their job security.   The leadership needs to take reports of racism seriously and be prepared to create a work plan that can protect them that is respectful to the worker and the resident’s rights.

6.  Take a Team Approach.  While little can be done to change the behaviour of elderly residents, a lot can be done to create a supportive team environment for the person who is experiencing the racism, reducing some of the negative effects.  Workers may be assigned to work in pairs to deal with difficult residents or be removed from dealing with the problematic client altogether.  Communication is the key.  Remember to involve the worker in the plan.   Leaders should also take a proactive approach to speak with the resident if they are coherent and finding out what their concerns are.  The resident may have some legitimate concerns that may be wrongfully dismissed as racism.  However, if racism is the issue this is an opportunity for the leaders to demonstrate to the resident that the worker is qualified to do the job just as the rest and should be treated with the same respect.  This is an important action the leader must take to demonstrate to the worker that their concerns are treated seriously and that while he/she may not have the confidence of the resident their boss believes in them.

If your organization has faced similar situations, please leave us your comments about what worked.

 

 

 

 

 

 

 

 

 

 

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