LGBT End-of-Life, General Healthcare Discrimination (Older Adult Research, Video 4:41)

America’s population continues to age, and that includes more older adults dying. Across the country, there are more than 2.7 million LGBT (lesbian, gay, bisexual and transgender) adults ages 50 or older living in our communities. Unlike many heterosexual and cisgender (sex assigned at birth) counterparts in their age groups, discrimination greatly threatens their health, wellbeing, economic security, and social connections, leaving them vulnerable to serious barriers in terms of support in meeting their end-of-life and general healthcare needs.

While the end-of life care of LGBT persons is understudied, we do know that in the absence of legal marriage or protective legal documentation which many LGBT people do not have, their problems increase. Researched articles on LGBT end-of-life barriers render the following information:

1) Discriminatory laws (e.g., prohibitions against same-sex marriage) and policies

2) Lack of decision-making capacity

3) Lack of knowledge regarding patient wishes

4) Lack of visitation rights

5) Challenges from biological next of kin

6) Discrimination and psychological distress.

Increased research on transgender persons, bisexual persons, and providers of end-of-life care is needed. Clearly, they need a supportive healthcare system that is educated to meet their unique end-of-life needs.

In this video, SAGE Care and the Center for Consumer Engagement in Health Innovation asked LGBT older adults and care providers why being "out" to healthcare providers is so important. The main thing we learned from them is that they want to be treated with respect based on who they are.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Lesbian, Gay, Bisexual, Transgender (LGBT) Patients: Research on Nursing Students (Doctors' Support Video 2:43)

Lesbian, gay, bisexual, and transgender (LGBT) patients have a history of being discriminated against in the healthcare system and society in general. Very little research is available on the attitudes of nursing students toward this marginalized population. The purpose of this research on LGBT nursing students’ attitudes was to appraise findings on this issue through an electronic search. Medical subject headings using search terms such as gay, lesbian, transgender, bisexual, LGBT, nursing students, etc. were used.

These were the results:

1) Fewer than 50 percent of the studies (5 out of 12) suggested more positive attitudes of nursing students toward LGBT persons.

2) Six studies reported negative attitudes, and one study reported neutral attitudes.

These studies indicate that nursing students' attitudes are becoming more positive. Studies published before 2000 reported a preponderance of negative attitudes toward LGBT patients. Negative attitudes impact disparities.

UC Davis Health System has incorporated a practice with doctors that provide LGBT support they believe can reduce LGBT healthcare disparities. Doctors ask patients sexual orientation and gender identity questions as part of the routine clinical assessment. By standardizing the collection of this information through the electronic health record, UC Davis officials believe this gives doctors a better understanding of each patient and helps them provide more well-informed medical advice and care. The following video explains the outcomes:

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog