Focus on the family: A case example of end-of-life care for an older LGBT veteran

Abstract

The Department of Veterans Affairs (VA) is likely the largest provider of health care for LGBT persons in US. However, histories of homophobia, stigma, discrimination, and past military policies have all had a lasting impact on the health of LGBT veterans. Effects can be seen across healthcare needs, disparities, access, and utilization for or by LGBT veterans. A case from a VA hospice unit is used to illustrate some challenges and opportunities when providing end-of-life care for an older, lesbian veteran. This veteran had been cared for by her wife who was struggling to meet care needs at home. Over time, it became clear that the wife was emotionally and financially dependent on the veteran, and would be facing many psychosocial and financial challenges when the veteran died. However the wife was reticent to accept referrals for help or services due to past negative experiences with social service agencies related to her sexual orientation. The interdisciplinary team collaborated to care for the veteran's medical needs, and the wife's emotional and psychosocial needs, until after the veteran's death. This case highlights many of the unique needs and challenges that may arise in caring for LGBT veterans and their families at end-of-life.

Mind the gap: Sex, gender, and intersectionality in military-to-civilian transitions

“…LGBT+ Veterans are at increased risk of experiencing housing instability, and their conjugal partners experience discrimination with services, such as end-of-life care and financial supports. 81 Health research dominates the literature, but health challenges are often intertwined with, or lead to, social, socio-economic, housing, employment, and criminal justice issues. [82][83][84][85] The literature on MST underscores the need to connect the dots between health and other domains of well-being; for example, MST poses a heightened risk factor for homelessness among women Veterans.…”

As Representações sociais da velhice LGBT entre os profissionais do Programa Estratégia da Família (PEF)

“…Nesse âmbito, estudos demonstram um maior nível de sofrimento psíquico nos idosos LGBT mais velhos em comparação com os idosos mais jovens (Fredriksen-Goldsen et al, 2015). Esse sofrimento pode ser refletido na acumulação de estresse vivenciada por grupos sexuais minoritários e que pode comprometer o bem-estar físico e psicológico (Hinrichs & Christie, 2019;Medeiros, Araújo, Santos, Souza & Monteiro, 2019).…”

Two, Four, Six, Eight, Don’t Assume Your Grandma’s Straight: The Intersectionality of Aging and Sexual Minority Status

“…In one, the intersection of stigma (drug use history, HIV status), culture/ethnicity status (Spanish speaking) and the needed social support to address it, emerge as themes based on a qualitative study of the experiences of older men with HIV who identify as gay, bisexual, or heterosexual (Johnson Shen et al, 2018). Three of the papers featured in this issue rest at the intersection of aging, sexual minority status, and Veteran status (Cortes et al, 2018;Donaldson et al, 2018;Hinrichs & Christie, 2018). The life experiences of Veterans can have unique features for consideration, including the military culture that actively kept Veterans from being "out" until recently, as well as combat or other life experiences that non-Veteran sexual minorities might not have.…”