Some have contended that elderly blacks are underrepresented in nursing homes because they prefer care from family members and extended kin over institutional care. However, a recent study supported by the Agency for Healthcare Research and Quality (HS08779) does not support this presumption. It shows that more elderly blacks than whites made long-term care plans (60 vs. 40 percent) in the event they became unable to live in their homes, and they included institutional as well as family care in their plans. Elderly individuals with more education were significantly more likely to have made long-term care plans than those with less education.
Receiving help at home, living alone, Medicaid coverage, and income adequacy had little effect on whether older adults had made long-term care plans. Making such plans also was not influenced by the need for long-term care as indicated by a person's difficulty in performing daily tasks, chronic health problems, and mental health status. Once these other factors were considered, blacks were no more likely than whites to include care from family members as a long-term care option.
The presumed preference of elderly blacks for family rather than institutional care may result from observations of existing care patterns that stem from barriers to institutional care faced by blacks. Perhaps community-based and long-term care personnel need to change the way that they perceive care options among black elders to include options other than family and home care, concludes Jim Mitchell, Ph.D., of East Carolina University. The researchers analyzed data from in-home interviews with 604 blacks and whites aged 65 and older in North Carolina to explore whether differences by race in long-term care plans were due to greater preferences for family care by blacks than whites.
More details are in "Difference by race in long-term care plans," by Dr. Mitchell, Holly F. Mathews, Ph.D., and Kimberly A. Hack, M.A., in the December 2000 Journal of Applied Gerontology 19(4), pp. 424-440.