“I Left There Crying”: Racial Microaggressions and Implications for Caregiver Retention in Long-Term Care

Abstract

This exploratory study addresses racial microaggressions in long-term care (LTC) settings in the United States to address and better understand the impact of racial dynamics on Black/African American direct care workers. Drawing from ethnographic research and interviews with LTC administrators, paraprofessional healthcare workers and other support staff as part of a larger National Institute on Aging (NIA) funded study, narratives indicate that while minoritised LTC workers are encouraged to be understanding of residents of LTC settings prejudices, they are also acutely aware of the harm that repeated, racially charged labels and negative comments by residents can have on their social and emotional well-being. Implications include: (1) More LTC research needs to be done through the lens of direct care staff. (2) LTC needs targeted policies and practices including training for administration on how to prevent, recognize and navigate racially charged behaviour such as racial microaggressions. (3) Leadership must provide minoritised staff members with appropriate support and follow-through. Together with improved wages and benefits, addressing microaggressions may offer a critical tool to solving the LTC challenge of retaining direct care workers by improving worker well-being and job satisfaction and by extension, improving the quality of care for older adults.