Racism Reported by Direct Care Workers in Long-Term Care Settings

This article focuses on reports of racism experienced by direct care workers (DCWs). These DCWs provide the majority of hands-on care to older residents/clients that need help with activities of daily living such as bathing and dressing in long-term care (LTC) settings. Interviews were conducted with 644 DCWs working in three types of LTC settings. Proportionate random sampling techniques were used to select 49 LTC agencies from a five-county area in northeast Ohio. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. Analyses reported include frequencies, chi-square tests, and analysis of variance. Hearing racial and ethnic remarks, particularly from residents/clients, was widely reported by DCWs. Despite this, DCWs were likely to believe that remarks from residents/clients were not intended to hurt their feelings. Although DCWs heard fewer racial/ethnic remarks from family members or other staff, they were likely to believe that such remarks were intended to hurt their feelings. At the organizational level, DCW reports of hearing racial/ethnic remarks in nursing homes were more frequent than those in other LTC settings. Further, DCWs in organizations in which racial differences between them and the residents/clients that they served was very large reported hearing significantly more racial/ethnic remarks. These findings have important implications for addressing racism in LTC agencies with anti-discrimination policies and programs.