Frances Shani Parker, eldercare consultant and Detroit, Michigan author of Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes, writes this blog. Topics include eldercare, hospice, nursing homes, caregiving, dementia, death, bereavement, and older adults in general. News, practices, research, poems, stories, interviews, and videos are used often. In the top right column, you can search for various topics of interest to you. You can also subscribe to this blog or follow it by email.
There is no question that older adults who are lesbian, gay, bisexual, and transgender (LGBT) belong to a population subjected often to adverse discrimination in society and experience unique health needs. Approximately 2.7 million U.S. older adults self-identify as being members of this population. Many feel unsafe revealing their sexual orientation and may not be willing to reveal their sexual orientation to their medical providers. Institutions that focus on providing them with support must implement more staff development and dissemination of homophobia training and policy changes that positively impact older adult LGBT quality of life.
A research study was done to increase understanding of the experiences and needs of older LGBT adults when accessing healthcare. Results of the study included three major themes. The themes were "Outness," "Things are Different Now," and "Additional Resources." These themes describe participants comfort with being "out," how treatment they received changed over time, and needed services or other options from the community. Healthcare providers must be prepared to create trusting relationships with these individuals to deliver truly comprehensive care.
Aging adds another layer of concerns for those in the older adult LGBT community. Like millions of others in this quickly expanding population, they must think about where and how they will live. This includes serious concerns about discrimination and bullying targeting them in senior communities. This video features LGBTsenior issues related to discrimination in long-term care homes.
Lesbian, gay, bisexual, and
transgender (LGBT) youth have unique needs that need to be addressed on several
levels. A former school principal and current eldercare consultant, I write
this post with a focus on LGBT school practices and grandparent perspectives.
Compared to
heterosexual youth, research on LGBT school practicesindicates that
LGBT youth are targeted for bullying at school in disproportionate numbers. It
cannot be stressed enough that they, like all students, should be getting their
education in a supportive environment through a variety of practices and
professional inservices. Bullying of LGBT students is
far too common.
In terms of correctional
practices, school administrators reported the following for
creating a supportive LGBT environment in schools:
1)Having
a point person for LGBT student issues
2)Displaying
sexual orientation-specific content
3)Having
a gay-straight alliance
4)Discussing
bullying based on sexual orientation
5)Providing
professional development around LGBT inclusion and LGBT student issues
Not surprisingly, students attending
schools with caring LGBT climates reported lower odds of
relational bullying victimization, physical bullying perpetration, and sexual
orientation-based harassment compared to students in schools with
less caring LGBT climates. An added benefit was that these LGBTpractices may be protective for all students, regardless of their sexual
orientation.
Intergenerational family
experiences of the lesbian, gay, bisexual, transgender (LGBT) community are
often not represented during family discussions within the larger heterosexual
community. These relationships are important in order to understand better how
LGBT individuals function within family systems.
Beyond school, LGBT youth have family members to consider regarding their advocacy. What about relationships between gay grandchildren and heterosexual grandparents? Grandparents generally want good
relationships with their grandchildren, especially those who live near them and with whom they have frequent contact. Positive socialization
is helpful and healthy for everyone involved. Unfortunately, sometimes these relationships can be
difficult, even painful. But grandparents like Glen and Linda Marks demonstrate in this video that having a gay grandchild can be an opportunity for open acceptance of who he is. After
learning that their grandson was gay, they expressed their determination to "walk" with him with continuing love and support.
Most people will agree that their
sex and sexuality are core components of their human experiences. Lesbian, gay, bisexual, and transgender (LGBT)
people are no different in this regard. Unfortunately, they continue to be
discriminated against in society based on these important components that
reflect who they are as people. This discrimination exists in the healthcare
system and negatively impacts the kinds of treatment they receive.
Scholarly research on the sex
and sexuality of terminally ill lgbt people receiving palliative and hospice
care, especially those from minority populations, is very limited. LGBT sexual expressions may change with advancing age and
illness in ways that differ from more traditional concepts. While the U.S.
Supreme Court decision regarding marriage equality has further advanced LGBT
cultural views in society, much more research is needed to advance
understanding of this population’s unique healthcare challenges.
All healthcare
clinicians should focus on treating lgbt clients with patient-centered care
that respects who they are and enhances their quality of life.
Produced by the
American Academy of Hospice and Palliative Care Medicine, this video features
the palliative care insights of Dr.
Bruce Scott. He shares ways for healthcare professionals to improve their
relationships with lgbt clients and positively impact care.
Intergenerational family
experiences of the lesbian, gay, bisexual, transgender (LGBT) community are
often not represented during family discussions within the larger heterosexual
community. These relationships are important in order to understand better how
LGBT individuals function within family systems.
1)Close relationships with
grandchildren who lived near them and with whom they had frequent contact
2)Close relationships with
grandchildren whom they had informed of their sexual orientation
3)Social support associated
with better mental health
Although there are factors known to affect
intergenerational relationships and mental health among older people, the three variables above specific to gay
grandfathers are important predictors of the quality of their relationships
with their grandchildren and of their mental health. What about relationships between gay grandsons
and heterosexual grandfathers? The following video is a revealing discussion in
which a gay grandson starts off interviewing his grandfather. Eventually, the grandson ends up being interviewed and explaining his sexual orientation for the first time to his
conservative grandfather.
Discussions of the
LGBT older population and healthcare disparities often conclude with
recommendations for more education of healthcare service providers. But how
successful has that approach been? This research study on LGBT cultural competency training focused on the unique challenges of sexual and gender minorities provides evidence regarding
whether attitudes, beliefs, and intentions of service providers improved.
Included were data collected at four Massachusetts training events piloting a
cultural competency workshop using surveys about lesbian, gay, bisexual, and
transgender (LGBT) aging for mainstream older adult service providers.
Findings revealed significant improvement in
numerous aspects of service providers' knowledge, attitudes, and behavioral
intentions as a result of the training sessions. Benefits included these:
1)Awareness of LGBT resources
2)Policy disparities
3)Spousal benefits for same-sex couples
4)Intention to challenge homophobic remarks
Recommendations included long-term follow-up of participants,
the inception of agency-level surveys to appraise institutional culture change,
and increased curriculum on transgender older adults.
UC Davis Medical Center, formerly
known as Sacramento Medical Center, is a major academic health center located
in Sacramento, California. This video shows strategies used there to improve healthcare
and decrease national LGBT disparities:
