Constructing Discrimination Rights: Comparisons Among Staff in Long-Term Care Health Facilities

Abstract

Abstract Background and Objectives Despite increased attention to racial and gender justice in the workplace in recent years, discrimination complaints remain vastly underreported. Building on legal consciousness theory―which explains how individuals invoke (or do not invoke) legal principles to define everyday experiences―this study examines how long-term care facility staff understand experiences of discrimination by residents and why staff fails to report discrimination. Research Design and Methods This qualitative comparative study uses in-depth semistructured ethnographic interviews to compare experiences among facility staff (n = 80) at three levels (floor staff, mid-management, and upper-management). The qualitative content analysis incorporated both inductive and deductive coding approaches. Results Findings reveal extensive unreported instances of discrimination from residents. Staff at all levels rarely invoked discrimination concepts to describe interactions between residents and staff. Floor staff framed residents’ discriminatory behavior as a condition of employment or attributed resident behavior to their health or cognitive status. Mid-management framed experiences around staff safety. Upper-management acknowledged staff rights without invoking discrimination rhetoric. Discussion and Implications By avoiding naming experiences as discrimination and blaming residents, most floor staff never reached the claiming process that would result in a report or complaint of discrimination. Managers’ framings also shaped how front-line staff and managers named, blamed, and claimed experiences of discrimination and help explain why staff may be hesitant to report discrimination by residents. These findings suggest the need for new and targeted policy and practice approaches that address the nuances accompanying how staff understands workplace experiences as discrimination.