Barriers to Effective Nursing Care in Elderly Patients

Barriers to nursing care are obstacles that either prevent people from getting nursing care or cause them to get inferior care compared to others. Many factors contribute to forming barriers to nursing care. Eliminating these barriers is an ongoing process that takes time and commitment. The first step in the process is identifying possible barriers.

Lack of Training

• Nursing programs often fail to prepare nurses for leadership roles in elderly care. The reasons for the lack of preparation are various and include curriculum deficiencies, lack of educator preparedness and lack of clinical experience. This is particularly true when it comes to end of life care and pain management. The situation is improving as research advancements provide insight into these areas of nursing care; however, it is a slow process. It takes time to change educational materials and guidelines. An additional hurdle is training the educators so they are comfortable teaching the new material.

Cost

• In a study of Medicare patients published in the October 2004 issue of the "American Journal of Public Health," almost 25 percent of the respondents cited cost of care as a barrier to health care. Aside from the cost of care, low income serves as a major barrier. In the study, people who reported an income of less than $12,000 per year were 2.6 times more likely to report a barrier to care than people earning $50,000 or more per year. The American Medical Association cites low socioeconomic status as an even greater barrier to health care than race.

Poor Communication

• Lack of communication between nurses and patients continues to be a major barrier to effective care. A busy nurse might misinterpret verbal or visual cues from a patient. Much of nursing work is task oriented and time spent talking is seen as wasted time. Changes in hearing and vision among the elderly also provide barriers to communication. A hearing-impaired patient may not answer questions appropriately simply because they did not hear the question. Overly task-oriented nurses may upset the patient, resulting in "uncooperative" behaviors.

Race

• Ethnic minorities face more barriers to care than Caucasians. The reasons for the disparity include lower average incomes, lack of government assistance, language differences, ethnic traditions, and discrimination. There are many repercussions of the increased barriers. For example, Caucasian women have the highest incidence of breast cancer, yet the death rates for breast cancer are highest among African American women. In fact, figures compiled by the American Cancer Society indicate that death rates for several common cancers are higher for African Americans than for Caucasians.