Silent Illumination

Abstract

With a growing population of transgender-identified elders in the United States, their unique spiritual end-of-life needs are coming to light. This article presents a case study of a hospice volunteer who used skillful means as an artist to help a transgender-identified woman express her spirituality in the last 6 months of her life. After data analysis, 4 themes emerged related to the expression of spirituality by lesbian, gay, bisexual, transgender, and queer (LGBTQ) elders at end of life. The themes that emerged included (1) the human element in advocacy for spiritual care, (2) the importance of safe spaces for reflection and meditation, (3) the importance of skillful means to work with LGBTQ people, and (4) acknowledgement of gender identity as a spiritual need. This case study serves as a springboard to advance research into the end-of-life needs of LGBTQ elders and the ways in which members of the hospice team can support spiritual care and alleviate suffering for this population.

Healthcare needs and assets of gender diverse older adults: A systematic integrative review

“…Resourcefulness and creativity represent another asset particularly applicable to resilience, empowerment and self‐expression. Campbell and Catlett (2019) described the creative works of a transgender older adult on hospice who, in collaboration with a volunteer, made a book of her life stories and messages of hope for her community. And Elder (2016) noted that gender diverse older adults found expression through visual art, film, music, and performance as a component of their resilience.…”

“…Spiritual expression was essential for the dying process of the transgender older adult in the case study by Campbell and Catlett (2019).…”

“…Campbell and Catlett (2019), the authors provide recommendations for meeting the transgender participant's spiritual needs, including advocacy for spiritual care, creation of safe spaces for spiritual expression, clinician development of skillful means through education, and affirmation of gender identity. And inLippe et al (2021), an outline for transgender-inclusive primary palliative care is provided integrating the concepts of cultural humility, moral archaeology, and a palliative communication framework.…”

The process of transitioning for the transgender individual and the nursing imperative: A narrative review

“…Parental support for access to transitioning is pivotal for young transgender people. Rejection also exists for people 65 and older who do not have support in transitioning (Campbell & Catlett, 2019). This age group faces a lifetime of health care refusal, discrimination, victimization and spiritual and emotional violence (Kattari et al, 2020).…”

End-of-Life Care for Transgender Older Adults

“…Addressing discrimination and improving care at EOL for transgender older adults require building a culture of inclusivity among healthcare providers; changing policies to support transgender rights; strengthening social and spiritual support; and emphasizing the assets of transgender elders ( Catlett, 2022 ). To build competency and inclusivity in EOL care for transgender older adult patients, several studies propose educational trainings for healthcare providers, especially clinicians in hospice and palliative care, a discipline that focuses on enhancing quality of life for persons with serious or terminal illnesses ( Adan et al, 2021 ; Bell & Johnson, 2020 ; Campbell & Catlett, 2019 ; Elder, 2016 ; Hughto & Reisner, 2018 ; Jones & Willis, 2016 ; Walker et al, 2017 ). In addition to educational initiatives, policy change has emerged in the literature from the USA and Canada as a strategy for mitigating discrimination, stigma, and elder abuse ( Carroll, 2017 ; de Vries et al, 2019 ; Hoy-Ellis & Fredriksen-Goldsen, 2017 ; Hughto & Reisner, 2018 ; Knochel & Flunker, 2021 ; Lowers, 2017 ).…”