End-of-life care for gay, lesbian, bisexual and transgender people

Abstract

There is little understanding in Australia of the particular issues faced by gay, lesbian, bisexual and transgender (GLBT) people in end-of-life care and advance care planning. This exploratory qualitative study aimed to achieve an initial understanding of these issues to compare with the international literature and inform the development of a larger study involving GLBT consumers. Consultations were carried out with 19 service providers and 6 GLBT community members located in the Northern Rivers and metropolitan Sydney areas of New South Wales (NSW), Australia. Participants reported barriers to health care service access due to discrimination, inappropriate care, and lack of knowledge among both consumers and health care workers of legal rights at the end of life. While advance care planning can assist with improving end-of-life care, respondents reported a number of obstacles. These included a lack of knowledge and absence of perceived need, and the additional obstacle of social isolation, leading to difficulties identifying alternative decisionmakers. The study highlighted the need for community education among GLBT people and health and aged care providers on the existing legal provisions available to prevent discrimination in end-of-life care.

It's Not All Darkness: Robustness, Resilience, and Successful Transgender Aging

“…7-10 Further, we observed that trans-aging is still most likely to be lumped together with LGB aging. [11][12][13][14][15][16][17] We also found a small international literature on the transgender population. [18][19][20][21][22] However, the international literature on trans-aging appears to be extremely sparse.…”

“…11,[41][42][43] Witten 44 examines the challenges at later-life and end-of-life stages. However, only anecdotal data are provided.…”

Developing Understanding of Same-Sex Partner Bereavement for Older Lesbian and Gay People: Implications for Social Work Practice

“…Even less is known about the experiences of older transgender or intersex individuals, as they get older and face the loss of their partners (Witten & Eyler, 2012). Recent explorative research in Australia suggests that LGBT individuals face barriers in accessing appropriate end-of-life care due to discrimination and lack of knowledge about LGBT needs and experiences (Cartwright, Hughes, & Lienert, 2012). Research exploring the needs of older lesbians and gay men highlights concerns about the experience of loss of a partner, and the lack of appropriate bereavement support available (Gay and Grey in Dorset, 2006;Smith, McCaslin, Chang, Martinez, & McGrew, 2010).…”

Experiences and perceptions of residential and home care services among older lesbian women and gay men in Australia

“…However, there is a lack of understanding of what these initiatives have meant for older lesbian and gay people in terms of their expectations for and experiences of aged‐care, and whether all people have been able to benefit from these initiatives. Studies conducted in Australia have examined experiences and perceptions of residential‐care, which broadly show a range of concerns and fears, including management of identity disclosure, lack of safe spaces for intimate relationships and the need for culturally safe and inclusive services (Barrett, ; Barrett, Crameri, Lambourne, Latham, & Whyte, ; Cartwright, Hughes, & Lienert, ; Chamberlain & Robinson, ; Crameri, Barrett, Latham, & Whyte, ; Harrison, ; Hughes, , ; Lovelock, ; Waite, ). Research has also found lesbian and gay people tend to have low awareness regarding their legal options, with most avoiding or not being given the opportunity to discuss the issue with healthcare providers (Hughes & Cartwright, , ).…”