Long-Term Residential Care and Racism: A Scoping Review

J Am Med Dir Assoc. 2026 Apr 21:106209. doi: 10.1016/j.jamda.2026.106209. Online ahead of print.

ABSTRACT

OBJECTIVES: To systematically map and synthesize literature on racism experienced by staff in long-term residential care (LTRC) settings.

DESIGN: Scoping review of peer-reviewed articles.

SETTING AND PARTICIPANTS: Any staff member in LTRC.

METHODS: A scoping review conducted using Joanna Briggs Institute methodology, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. A comprehensive search of 7 electronic databases and gray literature was performed. Included peer-reviewed studies of any methodology reporting on racism experienced by LTRC staff. Findings were synthesized narratively using a framework examining interpersonal, institutional, and structural racism.

RESULTS: From 1647 studies, 28 were included, published between 1989 and 2025, mostly in the past decade in the United States. Interpersonal racism involved overt behaviors like slurs, accusations, rejection, and violence, as well as microaggressions questioning competence. Institutional racism appeared through inconsistent responses and a lack of antiracism policies. Structural racism was seen in wage gaps, limited mobility, and disadvantages for staff with intersecting identities.

CONCLUSIONS AND IMPLICATIONS: Racism in LTRC is widespread, affecting interpersonal, institutional, and structural levels. Addressing it needs more than individual resilience or leadership; understanding multilevel dynamics is crucial for future research and creating safe, inclusive environments.

PMID:42019924 | DOI:10.1016/j.jamda.2026.106209