Theses Doctoral

Black Aged in Nursing Homes: An Application of the Shared Function Thesis

Morrison, Barbara Jones

This study had three main goals. The first was to describe the institutionalized Black aged in terms of their relevant demographic
characteristics and reasons for admission. The second was to explore the relative importance of ethnic and cultural factors in service delivery to this population. The third was to examine the role which the Black family plays within the institutional setting as measured by patterns of visiting and task performance.

The application of the Shared Function Thesis to the situation of aged Blacks in nursing homes resulted in the formulation and testing of eight hypotheses. These hypotheses put forth possible explanations as to how the family and the nursing home work together as a Shared Function and how this cooperative relationship affects resident satisfaction with care and resident morale.

Data on these areas were obtained in structured interviews with nursing home administrators, residents, and family members. The sample was drawn from five selected voluntary nursing homes in New York City. A combination of random and purposive sampling resulted in the selection
of 93 residents who were interviewed as part of the study between January and September 1978. Sixty-four of the 93 residents in the study sample had family available. Twenty-seven of these family members were
interviewed. In addition, data on resident physical and mental health
status, as well as corroborative data on family involvement were collected in questionnaires completed by the nursing home staff.

Several major findings emerged in each area. Data on the demographic characteristics of this population were compared to existing norms for Black aged in the community. The institutionalized persons in the study sample were significantly older and there were many more widowed and never married persons. These findings would seem to indicate that lack of spouse or other familial supports in the face of advancing age and impairment is a major reason for admission to the nursing home. It was also found that availability of family was significantly related to sex of the older person. Black aged males in the study sample were less likely than aged females to have family available.

On the question of ethnic factors in service delivery, two major findings emerged. The nursing homes which serve a majority of Black residents and were therefore defined as "ethnic" were more likely than the non-ethnic nursing homes to include cultural components in routine
activities. These components included the celebration of holidays important to Black aged, the regular provision of ethnic foods and the
inclusion of Black music and art in social activities. The second finding was that consumer attitudes were related to the ethnic orientation of the host facility. This was especially true for issues of matching provider and consumer on the basis of ethnicity than for the inclusion of cultural components in routine activities for which there was ample support from most residents and family members.

With reference to the third area, the role of the family within the nursing home, data were obtained on patterns of visiting and patterns of task performance by family members and friends. On both indicators of shared function, visiting and task performance, there was evidence that family continue to play a meaningful role in the lives of their aged members even after institutionalization. Findings indicate that friends also visit frequently. Resident and family reported levels of visiting were very high and were above established norms for all Blacks in nursing homes. The reported level of visiting was also significantly higher than that reported for a sample of predominantly white, middle-class institutionalized aged in a similar study in the same locale.

With respect to task performance by family and friends, the most commonly reported tasks performed were the provision of food treats, shopping and running errands, and the provision of clothing. Both the level of visiting and task performance were significantly related to resident and family satisfaction with care in a positive direction.


More About This Work

Academic Units
Social Work
Thesis Advisors
Jenkins, Shirley
Ph.D., Columbia University
Published Here
May 26, 2015