LGBTQ2S+ people face several barriers to accessing healthcare. These barriers have a significant impact on the day-to-day health and well-being of these individuals as well as delaying the diagnosis and subsequent treatment of life-limiting illnesses. As a person’s health declines, these barriers may prevent a person from accessing palliative care support from community healthcare and can significantly delay entry to long-term care. These delays can decrease quality and quantity of life, and substantially increase the stress of caregiving for family and loved ones.
Barriers to Palliative Care for LGBTQ2S+
What are the barriers to accessing long-term care and palliative care for LGBTQ2S+ people and how can these barriers be reduced? Well, one barrier is that LGBTQ2S+ individuals may face discrimination from care providers. This can take the form of providers refusing to see LGBTQ2S+ patients, refusing to provide care for queer-specific health issues, or making LGBTQ2S+ patients feel unwelcome in their practice or care facility. Discrimination causes LGBTQ2S+ people to delay or avoid seeking care, and therefore the diagnosis and treatment of a life-limiting illness or access to long-term care may also be delayed.
Lack of knowledge about queer health issues among providers is another barrier to healthcare for LGBTQ2S+ people. Providers may not be familiar with the unique health needs of LGBTQ2S+ people, and this can lead to poorer quality of care. When LGBTQ2S+ people are diagnosed with life-limiting illnesses, they have the right to expect care providers who are knowledgeable about their unique healthcare needs.
As healthcare professionals, it is everyone’s responsibility to ensure that all patients feel safe and comfortable when accessing care. This includes ensuring that our LGBTQ2S+ patients feel cultural safety when interacting with our healthcare team.
Recommendations
Addressing these barriers to help improve the accessibility of palliative and long-term care for the LGBTQ2S+ community includes ensuring that the healthcare team is appropriately trained on LGBTQ2S+ healthcare needs and cultural sensitivity. Team training might include:
1. Developing LGBTQ2S+ health and cultural competency: Participating in comprehensive training on LGBTQ2+ health and cultural competency that addresses the unique needs and concerns of this community. This training should include topics like gender identity, sexual orientation, pronoun usage, and the use of inclusive language.
2. Creating LGBTQ2S+ inclusive spaces: Palliative care and long-term care providers should also strive to create an inclusive and welcoming environment for LGBTQ2S+ patients. This might include displaying LGBTQ-friendly signage, having gender-neutral restrooms, and providing LGBTQ2S+-specific resources and literature available.
3. Identifying and displaying non-discrimination policies: Palliative, residential and long-term care facilities should have non-discrimination policies that explicitly prohibit discrimination based on sexual orientation or gender identity. Such policies should be prominently displayed and communicated to all staff members.
4. Offering LGBTQ2S+-specific healthcare: Providers need to offer palliative care services that are specifically tailored to the LGBTQ2S+ community. Practitioners need to develop their awareness of, for example, physical diseases that occur at higher rates among LGBTQ2S+ populations, or the unique challenges of transitions at end-of-life for LGBTQ2S+ people.
5. Being affirming and validating LGBTQ2S+: Healthcare providers need to be able to affirm and validate the experiences and identities of their LGBTQ2S+ patients. This means using the correct language when referring to patients, respecting their pronouns, and always treating them with dignity and respect. In palliative care, this can help LGBTQ2S+ patients feel more comfortable seeking care, asking questions, and accepting the integration of a palliative approach when a life-limiting illness is diagnosed.
6. Providing support and resources for LGBTQ2S+: Supporting LGBTQ2+ patients means having LGBTQ2S+-specific resources available at your facility and connecting patients with LGBTQ2S+-friendly support groups or healthcare providers in the area, or other individuals in the care facility. For example, transitions that occur with declines in health can be more mentally difficult for LGBTQ2S+ individuals. Therefore, preparing to offer specific resources to help support the person and their loved once manage the transitions would be appropriate.
Taking these steps will help to ensure that the team is able to provide the best possible care to LGBTQ2S+ patients. And ensure that all members of the LGBTQ2S+ community have access to the care they to have the best quality of life as they face life-limiting illnesses and decline.
For more information on cultural safety for LGBTQ2S+ people, click here to register for the FREE Webinar – Creating Safer Care for LGBTQ2S+ People: A Focus on Personhood and Relationships with David K Wright
Resources
https://www.lgbtqiahealtheducation.org/
https://www.cdc.gov/lgbthealth/index.htm
https://www.goodreads.com/book/show/32784376-lgbtq-inclusive-hospice-and-palliative-care
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Creating Safer Care for LGBTQ2S+ People: A Focus on Personhood and Relationships