What happens when older adults with dementia don’t get the help they need to live at home? The answer may lie in the growing link between unmet needs and nursing home placement—especially among Black and Hispanic/Latino older people. Over the past decade, the United States has seen a 12% rise in nursing home use among Black older adults and a 24% rise among Hispanic/Latino older adults. Researchers believe this increase may not be due to medical necessity alone.
Instead, the study suggests older adults with dementia are being placed in nursing homes because essential home- and community-based services aren’t meeting their needs. The research, published in Alzheimer’s & Dementia and available through the Wiley Online Library, was also featured in McKnight’s Long-Term Care News. It involved interviews with 61 people—including residents, family caregivers, and long-term care professionals. What they uncovered were seven common categories of unmet needs that often trigger avoidable admissions.
These categories include:
- Gaps in home- and community-based services
- Limited healthcare access
- Cognitive and functional decline
- Caregiver burden
- Safety concerns
- Lack of respite care
- Cultural or language barriers
Even when services were available, many families couldn’t access them due to limited insurance coverage, high costs, worker shortages, or scheduling conflicts. As coauthors Jasmine L. Travers, PhD, RN, and Aasha Raval, MPH, of NYU Rory Meyers College of Nursing put it, people often “did not receive enough hours of care, or could not afford the help they needed.”
So what does this mean for your community? It’s time to take a close look at your cultural competency. Are you ready to meet the needs of a more racially and ethnically diverse population? The National Center for Cultural Competence offers excellent tools, including PDF assessments and a Cultural and Linguistic Competence Policy Assessment (CLCPA), to help you evaluate and improve your practices.
Whether a resident’s admission is avoidable or not, the responsibility to meet their needs—especially when shaped by culture, language, or systemic barriers—falls on your shoulders. Addressing unmet needs and nursing home placement is not just a medical issue. It’s a call for more compassionate, competent care planning.
Stay well and stay informed!
