LGBT elders face significant inequalities and gaps in healthcare as they age. Many feel they must go back in the closet or avoid seeking medical care due to a lack of cultural competence training for providers and a scarcity of LGBT-friendly elder services. Studies show LGBT elders experience more health issues and die younger than heterosexual elders. To improve care, policy changes are needed to better educate providers and make elder agencies more inclusive. Reducing health disparities and improving quality of care for LGBT elders requires greater awareness of their unique needs.
This document discusses LGBT health and healthcare disparities. It provides statistics showing that LGBT individuals make up a minority of the US population and are understudied. LGBT people face more barriers to healthcare access and are more likely to lack a regular provider. Without access to care, conditions like HIV can go undetected and spread. The document calls for efforts like increasing LGBT-inclusive data collection, education to reduce stigma, and policies protecting LGBT patients to help address healthcare disparities. An interdisciplinary, systemic approach is needed to improve health outcomes for LGBT populations.
The document discusses research on health care access disparities among Latino populations and their families. It notes that Latinos are more likely than other groups to have uninsured family members. Research shows socioeconomic factors play a role, but people of color experience different health care even with similar insurance and conditions. The document then outlines several research implications and opportunities for systemic interventions to address barriers Latinos face in accessing health care.
23 introduction to social worksecond edsmile790243
This document provides an introduction to the second edition of the textbook "Introduction to Social Work: An Advocacy-Based Profession" by Lisa E. Cox, Carolyn J. Tice, and Dennis D. Long. It includes information about the authors, a brief contents section, and details on ordering and copyright. The introduction to social work textbook covers topics such as understanding the social work profession, history of social work, generalist practice, advocacy, responding to needs like poverty and health challenges, and working in changing contexts.
1 suicidejocelyn s. barrioseh1020patti smithsmile790243
This document summarizes the pedagogical aids used in most chapters of the textbook "Role Development in Professional Nursing Practice, Fifth Edition" to drive student comprehension and engagement. It lists learning aids such as chapter objectives, key terms, case studies, and critical thinking questions. The purpose is to address different learning styles and ensure mastery of concepts. Additionally, it provides publishing information for Jones & Bartlett Learning including contact details.
- The document discusses a research project examining factors that influence poverty rates in America, specifically looking at incarceration, health, income, and race.
- The researchers hypothesized that ethnic minorities with low incomes who are incarcerated are more likely to experience poverty due to barriers to employment and healthcare access after prison.
- Analysis of 2012 GSS survey data found those with criminal records were more likely to come from low-income backgrounds, supporting the hypothesis. However, relationships between other variables like health were less clear. Overall, the findings confirm race and income influence recidivism and perpetuation of poverty.
Mass trans issue brief for Sept 17 2015 FINALLeah Shaw
Discrimination against transgender people in public accommodations like restaurants and health centers in Massachusetts has negative health effects. A 2013 study found 65% of transgender people experienced such discrimination, linked to increased negative mental health symptoms and stress-related physical problems. While Massachusetts law prevents discrimination in employment, housing, and public accommodations based on sexual orientation, it does not include gender identity for public spaces. Passing bills S. 735 and H. 1577 would amend the law to include gender identity and help address health issues from discrimination.
This document discusses LGBT health and healthcare disparities. It provides statistics showing that LGBT individuals make up a minority of the US population and are understudied. LGBT people face more barriers to healthcare access and are more likely to lack a regular provider. Without access to care, conditions like HIV can go undetected and spread. The document calls for efforts like increasing LGBT-inclusive data collection, education to reduce stigma, and policies protecting LGBT patients to help address healthcare disparities. An interdisciplinary, systemic approach is needed to improve health outcomes for LGBT populations.
The document discusses research on health care access disparities among Latino populations and their families. It notes that Latinos are more likely than other groups to have uninsured family members. Research shows socioeconomic factors play a role, but people of color experience different health care even with similar insurance and conditions. The document then outlines several research implications and opportunities for systemic interventions to address barriers Latinos face in accessing health care.
23 introduction to social worksecond edsmile790243
This document provides an introduction to the second edition of the textbook "Introduction to Social Work: An Advocacy-Based Profession" by Lisa E. Cox, Carolyn J. Tice, and Dennis D. Long. It includes information about the authors, a brief contents section, and details on ordering and copyright. The introduction to social work textbook covers topics such as understanding the social work profession, history of social work, generalist practice, advocacy, responding to needs like poverty and health challenges, and working in changing contexts.
1 suicidejocelyn s. barrioseh1020patti smithsmile790243
This document summarizes the pedagogical aids used in most chapters of the textbook "Role Development in Professional Nursing Practice, Fifth Edition" to drive student comprehension and engagement. It lists learning aids such as chapter objectives, key terms, case studies, and critical thinking questions. The purpose is to address different learning styles and ensure mastery of concepts. Additionally, it provides publishing information for Jones & Bartlett Learning including contact details.
- The document discusses a research project examining factors that influence poverty rates in America, specifically looking at incarceration, health, income, and race.
- The researchers hypothesized that ethnic minorities with low incomes who are incarcerated are more likely to experience poverty due to barriers to employment and healthcare access after prison.
- Analysis of 2012 GSS survey data found those with criminal records were more likely to come from low-income backgrounds, supporting the hypothesis. However, relationships between other variables like health were less clear. Overall, the findings confirm race and income influence recidivism and perpetuation of poverty.
Mass trans issue brief for Sept 17 2015 FINALLeah Shaw
Discrimination against transgender people in public accommodations like restaurants and health centers in Massachusetts has negative health effects. A 2013 study found 65% of transgender people experienced such discrimination, linked to increased negative mental health symptoms and stress-related physical problems. While Massachusetts law prevents discrimination in employment, housing, and public accommodations based on sexual orientation, it does not include gender identity for public spaces. Passing bills S. 735 and H. 1577 would amend the law to include gender identity and help address health issues from discrimination.
This research proposal aims to study factors that lead to higher rates of HIV/AIDS diagnoses among African American men ages 18-24 compared to other groups. The researcher will conduct surveys and interviews with at least 100 men who have sex with men, including those of various races and socioeconomic backgrounds. Key research questions include examining differences in access to healthcare, levels of risk behavior, and how cultural and educational factors may influence HIV transmission patterns between racial groups. The goal is to better understand disparities and empower communities through more effective education and prevention strategies.
MSc in Child Forensic Studies REDONE 19th Feb2015Gerry Linke
This document provides an abstract and introduction for a thesis exploring midwives' perceptions and experiences asking pregnant women about domestic violence. It discusses the historical context of domestic violence and how attitudes have shifted over time. It notes that midwives are expected to routinely ask about domestic violence but some are reluctant to do so. The study aims to understand this reluctance by interviewing midwives about their views and attitudes. It discusses themes that may emerge around the environment midwives work in, consequences of asking about domestic violence, and midwives' own experiences. The implications concern improving training and support for midwives on this issue.
The document summarizes research on health disparities faced by LGBT transition aged youth. It finds that LGBT youth experience higher rates of discrimination, rejection, bullying, mental health issues like depression and suicide attempts, drug use, and homelessness due to social stigma and lack of family and social support developing their sexual identities. The social determinants of health, including discrimination, access to healthcare, and social environment disproportionately impact the health of LGBT youth. Developing culturally competent healthcare professionals is key to addressing these issues and disparities.
This document provides an abstract and introduction for a thesis on midwives' experiences asking pregnant women about domestic violence. It discusses the historical context of domestic violence being viewed as a private matter. The study aims to explore midwives' views and attitudes towards routine confidential enquiries about domestic violence. Five hospital midwives and five community midwives were interviewed using semi-structured interviews. The analysis identified three main themes: the environment where midwives work impacts their ability to ask about domestic violence; midwives acknowledged their clinical responsibilities but also safety concerns for mothers and babies despite emotional issues; and midwives reported experiencing extreme reactions when asking about domestic violence though they wanted to offer support. The implications suggest training on available resources and regular reflective supervision with
This research project aims to examine the family burden of people living with AIDS receiving treatment at BPKIHS. It will use an exploratory research design and survey 30 primary caregiver family members using interviews and assessments of family burden. The study hypothesizes that there will be no association between family burden and caregiver characteristics or social stigma. It seeks to understand the demographic profiles of PLWAs and their families, problems faced by caregivers, and the relationship between family burden and demographics. The results could help develop strategies to better support patients and reduce caregiver burden through education and policy changes.
Prevention of Substance Abuse and Suicide in the Elderly PopulationSande George
Bill Fitzpatrick, Senior Services Coordinator, Lines For Life, presents at the OSRAA Fall Conference 2018.
Incidences of substance abuse and suicide are rising in the older adult population. Learn to identify the warning signs. Discover how you can help. Know where to get help.
The breach between what we know and what we do is lethalRodney Berg
Men die by suicide at a rate over three times higher than women in Australia. Close to 80% of all suicides are men, with the highest rates occurring in men aged 35-49. Psychological factors that contribute to the disparity include men being less likely to recognize or address negative emotions, seek help, or communicate feelings of despair. Prevention strategies should focus on building resilience, social support networks, coping strategies, and addressing issues like relationship problems, depression, alcohol abuse, and financial stressors. Public health campaigns that engage men and encourage help-seeking are also important.
This document summarizes a presentation about structural inequities and their disproportionate impact on children. It discusses key concepts like disparities versus inequities, equality versus equity, and race versus racism. It also examines how COVID-19 disproportionately affected minority groups. The presentation identifies gaps in current approaches, such as an overemphasis on personal responsibility. It outlines future directions, like how to better track disparities, close the research-to-practice gap, and make equity a priority from the beginning. Barriers to achieving equity are discussed, along with parting words of wisdom for community members.
The document discusses health concerns and considerations for LGBT communities, including bisexual, gay, lesbian, and transgender individuals. It outlines higher rates of substance abuse, mental health issues, and certain medical conditions within these groups. It also describes barriers to healthcare such as discrimination, lack of provider knowledge, and economic challenges faced by LGBT individuals.
CONSIDERING CONTEXTUAL VARIABLES IN ASSESSING INTELLECTUALLY DISABLD SEX OFFE...ccookman
This document summarizes a presentation about assessing risk in intellectually disabled sex offenders and applying a new assessment tool called the ARMIDILLO-S. The presentation encouraged recognizing contextual factors, learning about this emerging alternative to traditional risk tools for this population, and providing a template for further research. It discussed the state of research, characteristics of intellectually disabled sex offenders, common interventions, and lack of assessment measures normed for this group. The presentation aimed to promote using this new tool as a viable option and inspire additional validation research.
Information-seeking Behaviour of LGBTQ health professionalsMartin Morris
LGBTQ health professionals have information needs that may not be fully addressed by current online medical resources. The researchers conducted an online survey of 120 LGBTQ health professionals to understand their perspectives and information seeking behaviors. The survey found that over half believe online resources lack accurate LGBTQ health coverage. While attitudes have improved, many respondents still prefer discussing LGBTQ health topics with LGBTQ librarians due to perceived greater understanding. The researchers aim to continue analysis and interviews to improve library services and resources for this community.
This document discusses the need to create supportive spaces for transgender youth. It notes that transgender youth face unique challenges, such as lack of role models, victimization, and family rejection. The document outlines how community centers can help by providing resources to address basic needs, support identity development, and foster connections. Focus groups with transgender youth found that centers helped them access services, counseling, and social support networks. Centers should receive training to better understand transgender issues and support the well-being of these youth.
Treatment Considerations with Older LGBT AdultsMagamet Ruslan
The document discusses Knight and McCallum's Model (CCMSC) for understanding LGBT older adults. The model examines context, cohort, maturity, and specific challenges. Context refers to living situation (e.g. with family, alone). Cohort explores generations and their experiences (e.g. post-Stonewall). Maturity analyzes education and coping skills. Challenges include stigma, health issues, and lack of rights. Research on LGBT older adults is limited but shows they may need more assistance and experience greater stress, mental health issues, and discrimination. Affirming therapies like cognitive behavioral therapy are recommended.
This presentation includes summaries of research projects completed by Lauren Surprenant on topics related to youth and the elderly. The projects cover a range of issues including role reversal between Alzheimer's parents and children, teen pregnancy risk factors, eating disorders in gay males, ageism and sexism against the elderly, and the experiences of daughters caring for parents with Alzheimer's. The presentation provides titles, abstracts, and dates for each completed research project.
This document analyzes the effects of age stereotyping. It discusses how negative aging stereotypes are prevalent in society and internalized by older adults, leading to a cycle where stereotypes influence treatment and self-perception. The stereotypes impose unnecessary limitations and negatively impact health. While some stereotypes are harmless, widespread acceptance can lead to ageism. The paper examines how positive stereotypes may extend life and proposes recognizing and addressing ageism to improve quality of life for older populations.
This document summarizes a research paper about the negative effects of age stereotyping. It discusses how negative aging stereotypes are commonly held in society and internalized by older individuals, leading to negative self-stereotyping. Negative self-stereotyping is shown to have physiological impacts and can become a self-fulfilling prophecy, imposing unnecessary limitations. The paper examines ageism and negative stereotypes of elders in the media, among children, and in the medical field. It discusses the concept of self-stereotyping and the harmful effects of negative self-stereotypes on elders' health based on previous research studies. The purpose is to show how acceptance of positive aging stereotypes can benefit elders' physical and mental health.
Methodological Questions in Childhood Gender Identity ‘Desistence’ ResearchKelley Winters
A presentation to the 23rd World Professional Association for Transgender Health Biennial Symposium, Feb. 16, 2014, Bangkok, Thailand, by Kelley Winters, Ph.D., of GID Reform Advocates.
It is frequently repeated in mental health literature and popular media that the vast majority of children whose gender identity differs from their assigned birth-sex, or who are severely distressed by their birth-sex, will "desist" in their gender identities and gender dysphoria by adolescence. As a consequence, gender dysphoric children are pressed to remain in their birth-assigned roles throughout the world. But are gender dysphoria and diverse gender identities just a phase?
This presentation reexamines research in Canada and The Netherlands that underlies the "desistence" axiom, with respect to methodological rigor and validity of claims.
Conclusions:
(1) Evidence from these studies suggests that the majority of gender nonconforming children are not gender dysphoric adolescents or adults.
(2) It does not support the stereotype that most children who are actually gender dysphoric will "desist" in their gender identities before adolescence.
(3) These studies do acknowledge that intense anatomic dysphoria in childhood may be associated with persistent gender dysphoria and persistent gender identity through adolescence.
(4) Speculation that allowing childhood social transition traps cisgender youth in roles that are incongruent with their identities is not supported by evidence.
(5) These studies fail to examine the diagnostic value of Real Life Experience in congruent gender roles for gender dysphoric children.
This document discusses issues facing LGBT seniors. It notes that approximately 3.5% of U.S. adults identify as LGBT, with at least 1.5 million being over age 65. However, many LGBT elders avoid medical care due to fears of discrimination. As a result, LGBT seniors often receive inadequate care and have worse health outcomes than non-LGBT seniors. The document calls for policy changes like mandatory LGBT cultural competency training for all medical professionals, in order to improve healthcare access and quality for the aging LGBT population.
Casey Starrenburg has over 45 years of experience in the construction industry, specializing in financial reporting, project forecasting and reviewing, and cash management. He held several finance and administration management roles over his career with major construction companies like John Holland, Transfield Construction, and Royal Brisbane Hospital. In his most recent role as Financial Performance Manager at John Holland, he was responsible for project forecasting, reviewing at-risk projects, and conducting organizational reviews.
This research proposal aims to study factors that lead to higher rates of HIV/AIDS diagnoses among African American men ages 18-24 compared to other groups. The researcher will conduct surveys and interviews with at least 100 men who have sex with men, including those of various races and socioeconomic backgrounds. Key research questions include examining differences in access to healthcare, levels of risk behavior, and how cultural and educational factors may influence HIV transmission patterns between racial groups. The goal is to better understand disparities and empower communities through more effective education and prevention strategies.
MSc in Child Forensic Studies REDONE 19th Feb2015Gerry Linke
This document provides an abstract and introduction for a thesis exploring midwives' perceptions and experiences asking pregnant women about domestic violence. It discusses the historical context of domestic violence and how attitudes have shifted over time. It notes that midwives are expected to routinely ask about domestic violence but some are reluctant to do so. The study aims to understand this reluctance by interviewing midwives about their views and attitudes. It discusses themes that may emerge around the environment midwives work in, consequences of asking about domestic violence, and midwives' own experiences. The implications concern improving training and support for midwives on this issue.
The document summarizes research on health disparities faced by LGBT transition aged youth. It finds that LGBT youth experience higher rates of discrimination, rejection, bullying, mental health issues like depression and suicide attempts, drug use, and homelessness due to social stigma and lack of family and social support developing their sexual identities. The social determinants of health, including discrimination, access to healthcare, and social environment disproportionately impact the health of LGBT youth. Developing culturally competent healthcare professionals is key to addressing these issues and disparities.
This document provides an abstract and introduction for a thesis on midwives' experiences asking pregnant women about domestic violence. It discusses the historical context of domestic violence being viewed as a private matter. The study aims to explore midwives' views and attitudes towards routine confidential enquiries about domestic violence. Five hospital midwives and five community midwives were interviewed using semi-structured interviews. The analysis identified three main themes: the environment where midwives work impacts their ability to ask about domestic violence; midwives acknowledged their clinical responsibilities but also safety concerns for mothers and babies despite emotional issues; and midwives reported experiencing extreme reactions when asking about domestic violence though they wanted to offer support. The implications suggest training on available resources and regular reflective supervision with
This research project aims to examine the family burden of people living with AIDS receiving treatment at BPKIHS. It will use an exploratory research design and survey 30 primary caregiver family members using interviews and assessments of family burden. The study hypothesizes that there will be no association between family burden and caregiver characteristics or social stigma. It seeks to understand the demographic profiles of PLWAs and their families, problems faced by caregivers, and the relationship between family burden and demographics. The results could help develop strategies to better support patients and reduce caregiver burden through education and policy changes.
Prevention of Substance Abuse and Suicide in the Elderly PopulationSande George
Bill Fitzpatrick, Senior Services Coordinator, Lines For Life, presents at the OSRAA Fall Conference 2018.
Incidences of substance abuse and suicide are rising in the older adult population. Learn to identify the warning signs. Discover how you can help. Know where to get help.
The breach between what we know and what we do is lethalRodney Berg
Men die by suicide at a rate over three times higher than women in Australia. Close to 80% of all suicides are men, with the highest rates occurring in men aged 35-49. Psychological factors that contribute to the disparity include men being less likely to recognize or address negative emotions, seek help, or communicate feelings of despair. Prevention strategies should focus on building resilience, social support networks, coping strategies, and addressing issues like relationship problems, depression, alcohol abuse, and financial stressors. Public health campaigns that engage men and encourage help-seeking are also important.
This document summarizes a presentation about structural inequities and their disproportionate impact on children. It discusses key concepts like disparities versus inequities, equality versus equity, and race versus racism. It also examines how COVID-19 disproportionately affected minority groups. The presentation identifies gaps in current approaches, such as an overemphasis on personal responsibility. It outlines future directions, like how to better track disparities, close the research-to-practice gap, and make equity a priority from the beginning. Barriers to achieving equity are discussed, along with parting words of wisdom for community members.
The document discusses health concerns and considerations for LGBT communities, including bisexual, gay, lesbian, and transgender individuals. It outlines higher rates of substance abuse, mental health issues, and certain medical conditions within these groups. It also describes barriers to healthcare such as discrimination, lack of provider knowledge, and economic challenges faced by LGBT individuals.
CONSIDERING CONTEXTUAL VARIABLES IN ASSESSING INTELLECTUALLY DISABLD SEX OFFE...ccookman
This document summarizes a presentation about assessing risk in intellectually disabled sex offenders and applying a new assessment tool called the ARMIDILLO-S. The presentation encouraged recognizing contextual factors, learning about this emerging alternative to traditional risk tools for this population, and providing a template for further research. It discussed the state of research, characteristics of intellectually disabled sex offenders, common interventions, and lack of assessment measures normed for this group. The presentation aimed to promote using this new tool as a viable option and inspire additional validation research.
Information-seeking Behaviour of LGBTQ health professionalsMartin Morris
LGBTQ health professionals have information needs that may not be fully addressed by current online medical resources. The researchers conducted an online survey of 120 LGBTQ health professionals to understand their perspectives and information seeking behaviors. The survey found that over half believe online resources lack accurate LGBTQ health coverage. While attitudes have improved, many respondents still prefer discussing LGBTQ health topics with LGBTQ librarians due to perceived greater understanding. The researchers aim to continue analysis and interviews to improve library services and resources for this community.
This document discusses the need to create supportive spaces for transgender youth. It notes that transgender youth face unique challenges, such as lack of role models, victimization, and family rejection. The document outlines how community centers can help by providing resources to address basic needs, support identity development, and foster connections. Focus groups with transgender youth found that centers helped them access services, counseling, and social support networks. Centers should receive training to better understand transgender issues and support the well-being of these youth.
Treatment Considerations with Older LGBT AdultsMagamet Ruslan
The document discusses Knight and McCallum's Model (CCMSC) for understanding LGBT older adults. The model examines context, cohort, maturity, and specific challenges. Context refers to living situation (e.g. with family, alone). Cohort explores generations and their experiences (e.g. post-Stonewall). Maturity analyzes education and coping skills. Challenges include stigma, health issues, and lack of rights. Research on LGBT older adults is limited but shows they may need more assistance and experience greater stress, mental health issues, and discrimination. Affirming therapies like cognitive behavioral therapy are recommended.
This presentation includes summaries of research projects completed by Lauren Surprenant on topics related to youth and the elderly. The projects cover a range of issues including role reversal between Alzheimer's parents and children, teen pregnancy risk factors, eating disorders in gay males, ageism and sexism against the elderly, and the experiences of daughters caring for parents with Alzheimer's. The presentation provides titles, abstracts, and dates for each completed research project.
This document analyzes the effects of age stereotyping. It discusses how negative aging stereotypes are prevalent in society and internalized by older adults, leading to a cycle where stereotypes influence treatment and self-perception. The stereotypes impose unnecessary limitations and negatively impact health. While some stereotypes are harmless, widespread acceptance can lead to ageism. The paper examines how positive stereotypes may extend life and proposes recognizing and addressing ageism to improve quality of life for older populations.
This document summarizes a research paper about the negative effects of age stereotyping. It discusses how negative aging stereotypes are commonly held in society and internalized by older individuals, leading to negative self-stereotyping. Negative self-stereotyping is shown to have physiological impacts and can become a self-fulfilling prophecy, imposing unnecessary limitations. The paper examines ageism and negative stereotypes of elders in the media, among children, and in the medical field. It discusses the concept of self-stereotyping and the harmful effects of negative self-stereotypes on elders' health based on previous research studies. The purpose is to show how acceptance of positive aging stereotypes can benefit elders' physical and mental health.
Methodological Questions in Childhood Gender Identity ‘Desistence’ ResearchKelley Winters
A presentation to the 23rd World Professional Association for Transgender Health Biennial Symposium, Feb. 16, 2014, Bangkok, Thailand, by Kelley Winters, Ph.D., of GID Reform Advocates.
It is frequently repeated in mental health literature and popular media that the vast majority of children whose gender identity differs from their assigned birth-sex, or who are severely distressed by their birth-sex, will "desist" in their gender identities and gender dysphoria by adolescence. As a consequence, gender dysphoric children are pressed to remain in their birth-assigned roles throughout the world. But are gender dysphoria and diverse gender identities just a phase?
This presentation reexamines research in Canada and The Netherlands that underlies the "desistence" axiom, with respect to methodological rigor and validity of claims.
Conclusions:
(1) Evidence from these studies suggests that the majority of gender nonconforming children are not gender dysphoric adolescents or adults.
(2) It does not support the stereotype that most children who are actually gender dysphoric will "desist" in their gender identities before adolescence.
(3) These studies do acknowledge that intense anatomic dysphoria in childhood may be associated with persistent gender dysphoria and persistent gender identity through adolescence.
(4) Speculation that allowing childhood social transition traps cisgender youth in roles that are incongruent with their identities is not supported by evidence.
(5) These studies fail to examine the diagnostic value of Real Life Experience in congruent gender roles for gender dysphoric children.
This document discusses issues facing LGBT seniors. It notes that approximately 3.5% of U.S. adults identify as LGBT, with at least 1.5 million being over age 65. However, many LGBT elders avoid medical care due to fears of discrimination. As a result, LGBT seniors often receive inadequate care and have worse health outcomes than non-LGBT seniors. The document calls for policy changes like mandatory LGBT cultural competency training for all medical professionals, in order to improve healthcare access and quality for the aging LGBT population.
Casey Starrenburg has over 45 years of experience in the construction industry, specializing in financial reporting, project forecasting and reviewing, and cash management. He held several finance and administration management roles over his career with major construction companies like John Holland, Transfield Construction, and Royal Brisbane Hospital. In his most recent role as Financial Performance Manager at John Holland, he was responsible for project forecasting, reviewing at-risk projects, and conducting organizational reviews.
This document discusses GSS Infotech's automated approach to migrating organizations from older versions of Windows to Windows 7. It begins by outlining the challenges of large-scale Windows migrations. The approach involves 4 steps: 1) Analysis and planning to understand user environments and applications, 2) Engineering including automated compatibility testing to determine if applications will work, 3) Deployment using imaging and automation to minimize downtime, 4) Ensuring steady state like training and support after migration. Automation is key to efficiently handling large migrations with minimal human intervention.
El resumen clasifica los equipos participantes en un torneo de fútbol de peñas en Guadix según su rendimiento en las primeras dos fechas. El C.F. Graena lidera la tabla con 6 puntos tras ganar sus dos partidos con un saldo de goles de +9. El Disco Sweet y el Dehesas comparten el segundo puesto también con 6 puntos.
Este boletim de inscrição é para um clube esportivo e contém espaços para o nome do atleta, data de nascimento, gênero, número, nome do responsável, contato e forma de pagamento da taxa de inscrição.
El documento define una ciudad inteligente como aquella que utiliza intensivamente las tecnologías de la información y la comunicación (TIC) para crear y mejorar los sistemas que componen la ciudad, permitiendo recopilar, procesar y transformar información para hacer los procesos y servicios más eficientes y mejorar la calidad de vida. Se habla de ciudades inteligentes porque la dinámica actual de las ciudades requiere aumentar la eficiencia en el uso de recursos para mejorar la calidad de vida a través de la implementación de TIC. La int
Las operaciones de conectores en Mule Cloud permiten la conectividad con sistemas externos e invocar APIs remotas de forma similar a los transportes. Los argumentos simples de la API se representan como atributos de la operación, mientras que argumentos más complejos como colecciones u objetos se representan como tipos complejos anidados. Los atributos pueden ser opcionales u obligatorios y proporcionar valores predeterminados.
Eventos Científicos Online sob a Perspectiva da Pesquisa-Formação Multirrefer...Alice Costa
Este documento discute eventos científicos online sob a perspectiva da pesquisa-formação multirreferencial. Ele analisa como a dinâmica desses eventos ocorre na cibercultura e como criar uma ambiência formativa neles. A pesquisa qualitativa observa interfaces online, desenho didático, atores sociais e pesquisa-formação nesses eventos por meio de observação participante, entrevistas e documentos eletrônicos.
LGBT Older Adults: The invisible minority. Ivanob10
This document discusses issues facing LGBT older adults. It notes that the population of LGBT older adults is growing due to aging Baby Boomers. However, LGBT older adults face invisibility in research on aging populations. They also experience stressors such as lack of protections for housing and healthcare decision making for same-sex partners. Clinical implications include considering generational and cohort effects when providing psychotherapy. More research and clinical attention is still needed to fully address the needs of the growing LGBT older adult population.
This document provides information about LGBT aging and concerns. It begins by defining LGBT acronyms like lesbian, gay, bisexual, and transgender. It then discusses key events in the gay rights movement, such as the Stonewall riots. Statistics are presented showing the growing number of LGBT older adults and their unique concerns, like isolation, discrimination in healthcare and housing, and caring for aging partners. Specific needs of transgender elders are also reviewed. The document concludes by offering best practices for supporting LGBT elders.
LGBT Discrimintion in Health Care by Melissa MunozMelissa Munoz
This document provides a proposal for implementing mandatory cultural competence training for healthcare professionals focused on working with the LGBT community. The problem is that LGBT individuals often face discrimination in healthcare settings, resulting in avoidance of care. The proposed solution is a 3-month training program where staff will be required to attend sessions conducted by an LGBT advocacy organization. Data will be collected through pre-and post-tests to measure changes in attitudes, and observational data of the sessions. The goal is to increase LGBT cultural competence, reduce perceived discrimination, and increase LGBT individuals seeking healthcare.
LGBT seniors face discrimination, stigma, and lack of trust in the healthcare system due to their experiences growing up when homosexuality was considered a mental illness and crime.
Interviews with LGBT seniors and professionals revealed fears of discrimination, loneliness, and not being understood by healthcare providers.
Existing phone tree programs pair LGBT seniors with supportive volunteers for weekly contact, aiming to alleviate isolation and build trust in the system through empathetic communication.
The route to success in end of life care – achieving quality for lesbian, gay, bisexual and transgender people
21 June 2012 - National End of Life Care Programme
This guide has been developed following consultation with stakeholders at a series of discussion groups held around the country. It offers guidance and advice for those working with lesbian, gay, bisexual and transgender (LGBT) people, and for LGBT people themselves, whether giving or receiving end of life care.
It provides case studies, key recommendations and issues for health and social care professionals to consider, such as:
The importance of avoiding the assumption that someone is heterosexual.
The enhanced privacy rights for transgender people provided by the Gender Recognition Act (2004).
Avoiding the common misunderstanding that a next of kin needs to be a person related by blood or marriage.
Challenges faced if a person has not previously 'come out' - the need for end of life care can mean private domestic arrangements are subject to wider scrutiny.
Recognising that 'coming out' may result in LGBT people being isolated from their families of origin and therefore relying on other support networks.
The danger of not recognising the significance of a relationship, which may result in a bereaved person's grief going unrecognised.
The report calls for organisations and the people within them to have an LGBT-friendly culture and use education and training to positively address communication skills and attitudes. It urges organisations to have a clear confidentiality policy, involve LGBT people in services and promote the use of inclusive language at the end of life, with phrases that do not inadvertently make someone feel like they must reveal their sexual orientation and gender identity.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Sexual Orientation, Gender Identity And Adolescent Health 10.6.07Knoll Larkin
This document provides an overview of key terms and definitions related to sexual orientation and gender identity, with a focus on the experiences and health issues faced by LGBT youth. It discusses concepts like coming out, preferred language, challenges LGBT youth face in schools, homes, and healthcare settings, and health concerns including substance abuse, violence, HIV risk, and mental health issues. The document concludes with standards of care recommendations and resources for creating inclusive environments and supporting LGBT youth.
LGBT: Retirement Preparations Amid Social ProgressAegon
This report highlights how the legacy of discrimination and worries about social acceptance mean that LGBT people still fall behind in important areas when it comes to preparing for retirement.
This is an opportunity to learn about families by interviewing oneGrazynaBroyles24
This document discusses ways that nurses can advocate for improved healthcare for the LGBTQ community. It recommends that nurses participate in political actions like campaign groups and demonstrations to fight for LGBTQ rights and equality. As frontline providers, nurses are well positioned to identify problems in the healthcare system and advocate for policies that protect LGBTQ patients, such as promoting non-discriminatory language and collecting data on LGBTQ health needs. The document suggests that nurses can serve as leaders to implement programs and support political leaders who will pass policies promoting equality and access to culturally competent care for LGBTQ individuals.
LGBTQ Discrimination
Lamar Collins
Eng 122
Professor: Leah Hamilton
5/4/2020
Although many scholars think significant progress has been made in the LGBTQ community, I argue that there is still a lot more work to be done than they realize because of growing trends in anxiety and depression. This is partly due to acceptance and hate and can clearly be seen at home, school, work and in the community.
The LGBTQ community should not have to worry about losing their job or means of support as part of being discriminated. One part of The Equality Act is supposed to protect persons and their sexual orientation just as it is supposed to protect Religion and Belief. Yang (2019) “Title VII of the Civil Rights Act bans employment discrimination “because of [an] individual’s race, color, religion, sex or nation origin.” Sexual orientation and transgender status are not listed as specific protected categories, but no such language is required. The beauty of our nation’s civil rights laws is that they protect everyone-including lesbian, gay, bisexual and transgender people-who faces discrimination based on sex.” With the Equality Act under question, members of the LGBTQ community now fear of losing their jobs or being discriminated in the work place. This is due to the wording for the Policy/Act.
The increase in anxiety and depression from the hate can be unbearable at times. This has been causing an increase in suicide attempts for the transgender and non-binary community. There has been a great number of youth that are now referring to themselves as “non-binary”, which means they do not identify as either male or female. Halliwell (2019) “Almost 30% of transgender women reported attempting suicide. Almost 42% of gender non-binary youth reported attempting suicide in 2018”. This is a public health crisis, with suicide attempt rates 4 times higher than those of straight youth. When you identify as transgender, you normally feel emotional pain due to not being happy with is checked on your birth certificate. Most try to keep their family happy but this normally brings depression and a disconnect. Even still we there are youth coming out at earlier ages than what was seen in the 80s and 90s.
Even though a good number of LGBTQ youth are being accepted, there are some that may not be accepted by their families and will be told to leave. Rhoades (2018) “homelessness among LGBTQ youth specifically is a major public health concern, with estimated rates of past-year homelessness among LGBTQ youth as high as 30–45% and evidence of a clear link between homelessness and poorer mental health for these youth.” The suicide rates for homeless LGBTW youth is 9-20 points higher of ono-LGBTQ homeless youth. These homeless youth also have to find ways of making money, most turn to selling their bodies and this takes a toll on their mental health. There are times where they are taken under the wing of a house “mother or father”. This is an older LGBTQ person who run.
This document provides an overview of a symposium on culturally effective care for LGBT populations. It begins with an agenda that includes differentiating key terms, defining intersectionality, identifying health disparities and social determinants of health, and applying concepts through a case study. The document then defines various terms related to gender identity, sexual orientation, sex, and development. It reviews the history of pathologization of LGBT identities in medicine and mental health. Statistics on demographics and health disparities experienced by LGBT populations are presented. Strategies for providing culturally effective care include creating an inclusive environment, building trust, ensuring confidentiality, and using inclusive language. Local and national resources for LGBT care are also listed.
Dalhousie Nursing : Cultural Competency "GLBTI" Presentation Febuary 2011Jonathan Veinot
This document discusses cultural competency in providing care to the GLBTI (gay, lesbian, bisexual, transgender, intersex) population. It outlines key social and cultural aspects of the GLBTI community, health risks they face, and implications for nursing practice, including using a culturally competent model of care. Barriers to healthcare access for the GLBTI population are also examined, such as fear of stigma or lack of provider knowledge.
The document discusses challenges faced by youth aging out of foster care in the United States. It notes that foster care is meant to provide substitute care for children placed away from parents/guardians, and can include family homes and group homes. However, research shows that many youth who age out struggle with independence, education, employment and health. The document calls for occupation-based programs to help equip youth with skills for independent living, and for occupational therapists to play a greater role in foster care systems given their training in skills relevant for transition.
This document provides information on creating inclusive practices for transgender and gender nonconforming clients. It begins by noting the lack of research and literature on serving TGNC individuals, couples and families in marriage and family therapy. It emphasizes using accurate terminology, addressing personal biases, and making the therapy space safe and respectful for all genders. The document recommends understanding gender as a continuum rather than a binary, being mindful of language, and normalizing gender diversity and exploration.
This document summarizes an academic article about transgender children and youth from a child welfare perspective. The article argues that gender variant children should be nurtured for who they feel they are, rather than treated as mentally ill. It discusses how transgender youth were previously pathologized and subjected to harmful medical treatments due to being classified as having Gender Identity Disorder in the DSM-III. However, whether gender variance truly constitutes a disorder or is a result of social and familial influences remains an open question according to the document.
This is the Abstract Presentation of of Dr Saritha P Viswan. This presentation was part of the 14th session of #APCRSHR10 Virtual, on the theme of "Sexual orientation and gender identity and SRHR in Asia Pacific".
Chair: Dr Chivorn Var, Convener of APCRSHR10 and Executive Director of Reproductive Health Association of Cambodia (RHAC)
Plenary Speaker: CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) | "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia"
ABSTRACT PRESENTERS:
* Saroj Tamang | Male-to-Female Transgender Community barrier and challenges in access of Sexual Health Services
* Saritha P Viswan | A review of transgender issues in India
* Sobo Malik | Limited Access to Health Rights Resulting in Increase Self Medication
* Ciptasari Prabhawanti | Sexual Identity, Sexual Orientation, Sexual Risk and Condom Use Behaviors of Clients of Transgender Sex Workers in Jakarta, Indonesia
For further information, visit www.bit.ly/apcrshr10virtual14
Conference website: www.apcrshr10cambodia.org or check out www.bit.ly/apcrshr10virtual
Thanks
This document provides guidance for working with LGBTQI2-S youth and young adults. It discusses the unique challenges they face, including higher rates of bullying, violence, suicide, and risky behaviors. It emphasizes the importance of acceptance and support from families and professionals. It defines key terms and recommends professionals enhance their cultural competence, promote safety and communication, and address the emotional and physical health needs of this population.
1) The document presents a curriculum aimed at improving cultural competency around LGBTQ health for healthcare providers at a university. It defines key terms like sex, gender, sexual orientation and gender identity.
2) It discusses how historical stigma has created health disparities for LGBTQ individuals, including higher rates of mental/behavioral health issues, STIs, obesity, and cancer screenings.
3) The curriculum provides case studies to demonstrate how to take a sensitive sexual history and provide a welcoming environment for LGBTQ patients to discuss their health needs.
Promoting Sexual Health Final PresentationLindsey Lewis
This document summarizes a research project proposal on promoting sexual health for individuals with intellectual disabilities. It finds that this population faces barriers to sexual education, risks of exploitation and health issues, and restrictions on their rights. The proposal recommends: 1) Implementing sex education programs for clients to increase knowledge and healthy behaviors. 2) Educating caregivers to reduce stigma and discuss clients' sexuality. 3) Advocating for clearer policies to prevent discrimination and support clients' sexual wellbeing through review of agency policies, rallies, and collaborative advocacy efforts. An evaluation plan includes testing clients and caregivers before and after interventions to measure changes in behaviors, attitudes, and knowledge.
1. Running Head: Health Care Inequalities Surrounding LGBT Elder Care 1
Health Care Inequalities Surrounding LBGT Elder Care
Shelley Ware
Springfield College School of Social Work
2. LGBT Elder Care 2
Abstract
As the world watched on June 26th, 2015, the U.S. Supreme Court ruled that states can no
longer ban gay marriage. This was a historical moment for LGBT individuals in gaining
equality. However, there is still a crisis with our aging LGBT population, many of whom are
going back into the closet as they become dependent on others for care. There are minimal
programs for aging LGBT individuals. This study sought to explore the gaps in medical care
that is resulting in LGBT persons feeling as if they have to hide their orientation or choose not to
seek medical care at all, resulting in health disparities. The author explored this issue through
literature review and face to face interviews. Findings showed that there is a need for policy
changes in elder care agencies in order to improve education and cultural competence as well as
to minimize health disparities of LGBT individuals and provide an increased quality of care.
Introduction
Dr. Nancy Orel (2013) published an article in the Journal of Homosexuality examining
the needs and concerns of LGBT older adults. Dr. Orel pointed out that, since January 1, 2011,
approximately ten thousand “Baby Boomers” (those born between 1946 and 1964) have been
turning 65 every single day (pp 54). Between 2000 and 2010, the population of Americans 65
years and over increased by 15.1%; a faster rate than that of the total U.S population at 9.7%
(Werner, 2011). Recent population-based surveys also indicate that approximately 3.5% of
adults in the U.S. identify as lesbian, gay or bisexual and 0.3% of adults identify as transgender.
This equates to nearly 9 million people (Ard & Makadon, 2012) and at least 1.5 million of them
are over the age of 65 (Sage general facts & discrimination, 2012-2015).
3. LGBT Elder Care 3
The purpose of this study was to explore the social crisis that surrounds our lesbian, gay,
bisexual and transgender (LGBT) older adults. Studies are showing that these elders are fearful
for their safety as they age and require more care. LGBT Baby Boomers, also referred to as
“Stonewall Seniors,” who fought for gay rights and equality in the 1960s, are being considered
the first “out” generation in LGBT history (Fitzgerald, 2013). Stonewall Seniors are now
retiring, becoming frailer and starting to think about their aging needs, including the possibility
of having to depend on others for care. However, many of them are not seeking that care out of
fear that direct care workers who come into their homes for the purpose of providing personal
hands-on care might discriminate against them. Other fears include possible abuse or the force
of religious prayer with the purpose of asking forgiveness for the choice of engaging in
homosexuality.
There is also a disturbing trend of LGBT elders avoiding their doctor’s office altogether
because the staff may not have had the sensitivity training necessary to manage the diverse needs
of this culture (Fitzgerald, 2013). As a result, these individuals are either feeling the need to hide
their sexual identity and appear “straight” or they are altogether avoiding seeking critical medical
care (Maddux, 2010). If needing care in a nursing home (NH), there is the added fear of having
to leave a loved one under the care of the NH staff, not knowing if that staff may be
discriminatory or abusive.
LGBT individuals are more likely to age alone as opposed to heterosexual elders
(Thurston, 2009)(Brennan-Ing, Karpiak, & Seidel, 2011). They often have a minimal support
network and may have lost many family members and friends after choosing to reveal their
sexual orientation or gender identity. These frail elders are often dying younger due to lack of
support and proper medical care. What is even more troubling is that one study in England
4. LGBT Elder Care 4
revealed that some transgender individuals are planning to commit suicide before getting to the
point of requiring care from medical professionals who do not understand their needs or are
uncomfortable due to lack of diversity training (Ward, Rivers, & Sutherland, 2012).
Advancement is critical in ensuring that all agencies serving the elder population are
LGBT friendly. It begins with raising awareness on this issue with elder care agencies.
Trainings also need to be provided to all medical and direct care staff in order to develop cultural
competence and sensitivity when dealing with the unique needs of the LGBT elder population.
These steps are crucial so that Stonewall Seniors can stop being afraid and can confidently seek
medical and in-home, hands-on care as they age. No elder should be alone and without the
compassion and quality care that is needed in the later years of life. In an attempt to resolve this
social crisis, this research paper will explore the following question: What are the primary
concerns of LGBT individuals related to perceived gaps in the healthcare system surrounding the
needs of aging members of their community?
Review ofLiterature
The purpose of this study was to identify gaps in care, where medical care and education
are lacking and what needs to be done within the healthcare system to better support the under-
served Lesbian, Gay, Bisexual and Transgender (LGBT) elder population. It is important to
point out that, although LGBT is inclusive of all individuals who identify as other than
heterosexual, the needs of each group are very unique to each other. Transgender people do not
identify with the gender assigned to them at birth; they feel they were born in the wrong body.
This has been known to cause feelings of contention among transgender people, who have
pointed out that gays and lesbians cannot possibly identify with the inner turmoil of being
5. LGBT Elder Care 5
transgender (Brydum, 2015). For the purpose of this study, however, we will examine LGBT
needs globally.
Several studies and articles were reviewed that examined elder care services surrounding
LGBT societies. All of the research reviewed had an alarming trend; indicating that all
disciplines within the medical field do not receive sufficient training in the unique care needs of
LGBT elders. This lack of education creates an unfortunate domino effect. Insufficient training
of medical workers results in inadequate services and staff that lack empathy and knowledge of
LGBT issues. Subsequently, this leaves LGBT individuals with limited clinics to go to for
informed, quality care. The deficiency of care, in turn, leads to healthcare avoidance behaviors
which eventually results in health complications, comorbidities and in many cases, premature
death.
Fredriksen-Goldsen, et al.(2014) studied the health disparities of LGBT elders. They
identified LGBT individuals as a marginalized population and identified that there are associated
risk factors for poor health, disability and untimely death. In 2012, LGBT individuals were
identified as an at-risk population with regards to not having access to quality healthcare.
Dr. Nancy Orel (2013) examined the needs and concerns of LGBT older adults through
the use of qualitative and quantitative methodology. She put together focus group discussions
with 26 LGB individuals (she was unable to employ any trans people to participate, despite her
efforts at recruitment and inclusion). Dr. Orel’s interviews identified seven areas of importance
to LGB individuals. The seven identified concerns included medical/health care, legal,
institutional/housing, spiritual, family, mental health and social (Orel, 2013).
Dr. Orel’s interview data was consistent with past studies showing that there are many
health disparities in the LGBT culture. These disparities typically result from discrimination,
6. LGBT Elder Care 6
which increases stress, resulting in a higher probability of poor health and limited access to care
(Orel, 2013). There is also a disproportionately higher risk for violent hate crimes, sexually
transmitted diseases and mental health issues (Orel, 2013)(2015 National LGBTQ Task Force,
2015).
Rogers, Rebbe, Gardella, Worlein, & Chamberlin (2013) completed a study “exploring
the impact that training panels given by older LGBT adults had on training participants, many of
whom were future service providers” (pp 584). Their trainings were offered through the Gay and
Gray Program (GGP) out of Portland Oregon. The GGP is an agency that provides LGBT elders
with services including advocacy, social and legal support, meals, companions, health and
wellness education and case management (Rogers, Rebbe, Gardella, Worlein, & Chamberlin,
2013).
Rogers et al explains that, as a result of past discrimination and insensitivity from service
agencies, LGBT elders are reluctant to disclose their sexual orientation/gender identity or access
services altogether from non-LGBT agencies. The panel trainings focus their education on a
variety of issues that LGBT senior citizens are faced with; the goal being “to help the
participants reflect on their biases and attitudes toward older LGBT adults” (pp 585). The
trainings are given by a group of LGBT volunteers. The study concluded that the panel
discussions were successful in raising awareness, putting a face on LGBT issues, facilitating
self-reflection, promoting deeper understanding and acceptance and garnering empathy (Rogers,
Rebbe, Gardella, Worlein, & Chamberlin, 2013).
Another study by Lim and Bernstein (2012) examined the need to promote awareness of
LGBT issues in aging in a baccalaureate nursing program. Not only did this study reiterate the
critical need for more training of medical professionals, but it also sought to answer the question
7. LGBT Elder Care 7
of how we gain back the trust of LGBT Baby Boomers. These ‘boomers’ came out of the closet
and fought for gay equality during a time of intolerance; a time when people were deemed
mentally ill because of their sexual orientation (Lim & Bernstein, 2012). Even today, Gender
Dysphoria, the inability to identify with the gender assigned at birth, continues to be a diagnosis
in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5).
Lim and Bernstein’s research revealed that, out of the 150 medical schools examined in
their study, the average number of hours dedicated to LGBT related topics in the medical
curricula was only five (Lim & Bernstein, 2012). In the height of the aging boom, there will be a
projected 88.5 million people over the age of 65. Five hours of medical training seems
inordinately disproportionate for a population that, in the year 2050, is estimated to comprise one
out of every 13 elders (Lim & Bernstein, 2012).
Wood and Conley (2014) reviewed the impact that being lesbian, gay, bisexual or
transgender has on one’s religious and spiritual (R/S) identity. This is an important factor to
consider because of the negativism that religion associates with being LGBT. The loss of one’s
religious identity can result in feelings of depression and anxiety and can have a negative impact
on one’s overall health and well-being (Wood & Conley, 2014).
Wood and Conley broke down the various types of R/S abuses that can occur by
members of the congregation, whether in a leadership role or as peers. The abuses identified
include Leadership Representing God, Spiritual Bullying, Acceptance via Performance, Spiritual
Neglect, Expanding External/Internal Tension, Manifestation of Internal States and Sexual
Microaggressions (Wood & Conley, 2014). All of these, in some way, cause the individual to
feel like they are going against God’s will because of their LGBT identity. As a result of the
8. LGBT Elder Care 8
R/S abuse, the LGBT individual may experience feelings of self-doubt, depression, anxiety and
suicidal ideation.
Hughes, Harold and Boyer (2014) conducted an exploratory study on the level of
awareness of LGBT aging issues among aging service providers. They developed a
questionnaire that they handed out at the 2010 AAA conference in Michigan; an annual
conference for providers employed by local aging services agencies. The 87 surveys that were
completed were done so primarily by Caucasian, heterosexual women with a mean age of 46.
Sixty-eight percent rated themselves as ‘very comfortable’ providing assistance to older
LGBT adults and 31 percent rated themselves as ‘very knowledgable’ on LGBT
Medicare/Medicaid issues. The majority (35% - 48%), however, rated themselves as only
‘somewhat knowledgable’ on LGBT issues, such as legal and financial issues,barriers to service
and medical issues (Hughes, Harold, & Boyer, 2011). When asked if they wanted further
training on LGBT issues, 50 agencies reported wanting additional training while 29 did not
(Hughes, Harold, & Boyer, 2011).
Porter and Krinsky (2013) examined whether LGBT trainings actually result in positive
change within elder service agencies. Their data, collected through pretests prior to a LGBT
training and posttests following it, showed an increase of knowledge surrounding public policies
and LGBT resources. The training also increased participants’ beliefs that intake paperwork
should include sexual orientation and gender identity as it can lessen the perception by LGBT
individuals that medical providers are not sensitive to their needs (Porter & Krinsky, 2013).
The training postively improved the participants’ comfort level if one of their patients
were to come out to them. The only decrease in comfort level from pretest to posttest was in
providing care to a transgender person. Porter and Krinsky surmised that the decrease might be a
9. LGBT Elder Care 9
result of a reduction in the confidence of the provider’s ability to meet transgender needs as they
learned more about what those needs consist of (Porter & Krinsky, 2013).
Lastly, Brennan-Ing, Karpiak and Seidel put together a comprehensive report through the
AIDS Community Research Initiative of America (ACRIA) in 2011. Their sample included just
over 200 individuals with a mean age of 60. Of the 200 participants, 71% were men, 24% were
women and 5% identified as transgender or intersex (Brennan-Ing, Karpiak, & Seidel, 2011).
The purpose of their study was not only to identify health and psychosocial needs of LGBT
elders, but also to pinpoint similarities and differences between LGBT persons with and without
the HIV virus (pp 12).
Some of the more noteworthy findings surrounded mental health, substance abuse and
sexual activity. Their statistics showed that the rate of severe depression more than doubled for
HIV positive individuals (29%) as compared to those who are HIV negative (14%). In
measuring the rate of current use (within the last 3 months) of substances, rates were
significantly higher for those who are HIV+ than those HIV- with regards to the use of cigarettes
(49% vs. 13%), crystal meth (4% vs 0%), cocaine (13% vs 1%), crack (10% vs 1.5%), heroin
(3% vs. 0%), marijuana (31% vs. 10%) and poppers (20% vs. 7%).
Alcohol use was higher among HIV- (66% vs. 57%) and use of pain killers was almost
equal (29% HIV+ and 25% HIV-). Those with HIV were more likely to report sex as being very
important to them and to having unprotected sex than their HIV- counterparts (Brennan-Ing,
Karpiak, & Seidel, 2011). Given the pattern of data from the aforementioned studies, this study
will seek to answer the following questions: Are there perceived gaps in medical care for LGBT
persons? What is causing the avoidance behavior of LGBT individals regarding medical care?
What needs to be done to educate medical professionals on the needs of aging LGBT persons?
10. LGBT Elder Care 10
Methodology
Using a qualitative design, the researcher’s objective was to answer the question “What
are the primary concerns of LGBT individuals related to perceived gaps in the healthcare system
surrounding the needs of aging members of their community?” The qualitative approach taken
to explore this overarching question was Phenomenological Analysis. The researcher was
planning on purposive sampling, which is the deliberate process of selecting respondents based
on their ability to provide the needed information (Padgett, 2008).
Attempts were made at recruiting participants for this study by sending correspondence to
several agencies that service the LGBT elder population. These agencies included the Worcester
LGBT Elder Network (WLEN) at the Worcester Senior Center, Fenway Health in Boston and
The History Project in Boston. These agencies were each informed about the research study and
its purpose. In the interest of privacy laws, these agencies were not asked to refer people to the
researcher, but to provide the researcher’s contact information to anyone they felt would be
willing to participate.
Fenway Health and The History Project returned correspondence to the researcher
indicating that they could not assist in the study. They each referred the researcher to the
agencies that had already been contacted. WLEN did respond and invited the research to attend
their monthly LGBT luncheon that is hosted there. Although unable to make the luncheon, the
researcher made a flyer that was passed out at the LGBT luncheon by one of the volunteers there.
The WLEN volunteer reported to the researcher that several of the attendees at the
monthly luncheon took the flyer, however the researcher received no responses to this attempt at
recruitment. Convenience sampling then became necessary after attempts at recruiting LGBT
11. LGBT Elder Care 11
elders did not yield any voluntary participants. Snowball sampling was also utilized as
participants in the study were asked to refer people in their network for ensuing interviews.
The four participants in this study were all chosen because of their sexual orientation.
Two of the interviewees were a Caucasian male couple, ages 36 and 55, who are currently living
in Central Worcester County. They were married earlier this year. Although younger than the
original age-range being considered for this study, the researcher felt it important to seek the
experiences and opinions of this couple as they have a 19 year age difference and have had
discussions regarding future planning. They were recruited through text message. They are
friends of the researcher and were asked to refer the researcher to anyone else they know who
might want to participate in this study.
The other two participants were women who both identify as lesbians. One is 58 years of
age and has been in a relationship with her wife for over 25 years and they have been married for
approximately eight of those years. The other is 78 years of age and lost her wife earlier this
year after 30 years together. Both women also reside in Worcester County. The participation of
these women was valuable because, not only did they give a different perspective than the male
participants, but also, according to research, older lesbians are more likely to hide their
orientation (Fitzgerald, 2013). As one of the women was also the caregiver for her wife and took
care of her with the assistance of hospice and care providers in the home, she was able to give a
unique perspective to that experience. The participants will be referred to as P1, P2, P3 and P4.
Data collection for qualitative research typically consists of three modalities:
observation, interviews, and review of documents (Padgett, 2008). Each participant was offered
their choice of locale for the interview; being either their home, the researcher’s home or a public
venue. All of the interviewees chose to come to the researcher’s home. Each interview occurred
12. LGBT Elder Care 12
at the dining room table in the late afternoon. There was one meeting per interview and the
interviews were recorded, each lasting between 30 to 60 minutes.
To ensure protection of the rights and dignity of each participant, they signed an ethics
consent form outlining the purpose of the study and providing them contact information for the
researcher, the professor and a LGBT hotline (see appendix 1). Each participant was assured
that they did not have to answer any question that they were uncomfortable with and each was
offered a copy of the final research project. Each participant was also compensated for their
time.
Careful preparation was taken to allow for the interviewee to assist the researcher in entering
their world. The researcher asked the same-sex male couple to watch the documentary, Gen
Silent, by director, Stu Maddox (2010), to bring awareness on this social crisis. The researcher
also gave each interviewee some background on why this project has taken shape and why it is
critical to promote awareness to both elderly and younger LGBT persons.
The beginning of the interview focused on the participants’ sexual orientation and then each
was asked to describe when they came out to friends and family. These questions were designed
not only as a benevolent introduction to how they each identify, but also to better understand
whether their experience of coming out was a positive or negative one. Research has shown that
people that do not have a good support network are more inclined to experience health disparities
(Ard & Makadon, 2012)(Fitzgerald, 2013).
Subsequent interview questions explored whether the participants have any concerns or
discomfort when seeking medical care and whether they feel their doctor’s office is LGBT-
friendly. These questions were intended to illustrate any perceived gaps in the healthcare system
related to cultural competence and whether steps are taken at clinics to demonstrate inclusion.
13. LGBT Elder Care 13
Studies reviewed indicate that there is limited awareness of LGBT issues within the health care
system (Hughes, Harold, & Boyer, 2011), that clinics do not always promote inclusion
(Worcester LGBT Elder Network (WLEN) sponsored by ESWA; Brightstar Care, 2015) and that
there is very limited LGBT education provided in medical schools to prepare future care
providers for management of these issues(Lim & Bernstein, 2012).
Further questions moved on to the participants’ feelings related to nursing home placement
and whether direct care workers are equipped to deal with LGBT aging issues. As Stu Maddox
(2010) demonstrated in his documentary, Gen Silent, which focuses on aging issues related to
LGBT elder care, if a person’s perception is a lack of understanding or the potential for
discrimination, then they are less likely to seek medical care at all until a crisis occurs.
Concurrent studies have corroborated this and have also shown that LGBT persons are less
likely to be medically insured (Gates, 2015) and that these individuals are not receiving equitable
healthcare (Fredriksen-Goldsen, et al., 2014). Data analysis involved analyzing the recorded
interviews in order to gather themes and patterns. Other analysis included observation of the
body language of each participant during the interviews as well as review of peer-reviewed
scholarly articles and other studies conducted on this topic.
Findings
Several core themes emerged from the data analysis of the four interviews. The first
theme identified was emotional/coping. Within this theme, several issues were discussed
including addiction, depression, fear, courage and denial. The emotional distresses all
surrounded the realization of being gay and the eventual acceptance of it. Two of the
participants struggled with addiction while another dealt with their spouse’s addiction. The
14. LGBT Elder Care 14
fourth did not mention addiction. All four indicated that they had emotional difficulty after the
initial realization that they might be gay. Each participant also displayed remarkable courage
when making the decision to come out to family and friends, knowing that it may have resulted
in the loss of some of their closest relationships.
Another theme that emerged was the social impact surrounding the sexual orientation of
each study participant. This theme emcompassed religion, support network, romantic
relationships and/or marriage, family, friends, neighbors and career. Religion was not initially
part of the interview questions, but was subsequently incorporated after the first two interviewees
raised this as a significant area of focus (see appendix #2).
P1 struggled severely on a religious level, feeling that he was an “abomination” and
feared that God would hate him for being gay. He sought to be “cured” by attending church. He
hit a turning point in his journey, however, after experiencing what he described as the hand of
God resting on his shoulder and he heard God tell him “It is okay. You are my son and I love
you just the way you are”. He finally felt a sense of peace and no longer believed that God hated
him.
P2 stated his belief that “God makes people who they are supposed to be. I don’t think I
ever struggled religiously with being gay”. P3 and P4 both stopped going to church; P3 because
the Catholic church has historically been against homosexuality and P4 became “turned off”
after she approached a Catholic priest, who appeared to have no interest in offering her support
or comfort and “did not seem to want to be bothered”. All four participants still have
faith/spirituality and P3 is considering committing to the Unitarian church, as they are accepting
of and welcoming to LGBT individuals.
15. LGBT Elder Care 15
Another theme identified was LGBT considerations, which was comprised of what age
the participants were when they realized they were gay, coming out, sexuality, LGBT in sports,
transgender, cross-dressers and Provincetown. One interesting finding within this theme
surrounded the age of coming out to family and friends. Though both males realized that they
were gay before the age of ten, neither came out until they were almost 30 and both came out to
the women in their family first. Both of the female participants realized they were lesbian during
teenage years; one came out around age 16 and the other around age 21.
Subsequent themes included Negativism, Advocacy/Resources, Future Planning and
Lifestyle. The theme, future planning, reflected on medical care, nursing home placement
(NHP), caregiving, long term care insurance and accepting help. An interesting and unexpected
finding was that none of the interviewees reported having concerns about going to their doctor’s
office. It was noted, though, that none of the medical offices are outwardly LGBT-friendly,
meaning literature, marketing materials, posters and other supplies that target the LGBT
population with the goal being inclusion and a welcoming atmosphere.
Additionally, the participants were evenly divided when asked whether they have
concerns related to NHP. P1 and P3 did express concerns related to having to live or put their
spouse in a nursing home, while P2 and P4 did not. Those that expressed concerns stated they
were troubled by the lack of education and sensitivity training for medical staff and direct-care
workers regarding LGBT issues. Those that did not express concern about NHP stated they have
“no qualms about it” and P4 stated “I try to joke with people…If they come aboard on my side,
then great, but if not, I would know my place, but would not let them walk over me.”
Finally, the theme of advocacy revealed issues such as death with dignity, housing for
LGBT, policy change, resources, and what is important for non-LGBT medical professionals to
16. LGBT Elder Care 16
know. An important finding here relates to three of the four interviewees acknowledging that
they would prefer to live in LGBT housing. The fourth was ambivalent about housing. The key
reasons for preferring LGBT housing were not just for inclusion and comfort, though that was
primary. Other reasons that surfaced had to do with activities of interest as well as providing a
“safe haven” for people from other cultures or countries which may imprison or execute a person
for being homosexual.
When asked if housing for LGBT would be isolating, one participant challenged the
researcher, asking “If a facility is not LGBT friendly, [that person] is already isolated. If I had to
go back into the closet, how much more isolated can you be? If the staff is either gay or
empathetic to the struggles these people have been through, then they will be in a place of love
and support and that will keep you free of isolation.” Two of the interviewees also made the
suggestion that this type of housing would not need to be exclusively for LGBT individuals and
that they would welcome integration of non-LGBT, but with the understanding that it would be
an open facility.
Some words of wisdom that the participants felt that non-LGBT medical staff should be
aware of included the following statements: “Being gay is not a disease that you catch; it’s
something that you’re born with.” “Just be aware and open and not so close-minded. Don’t
assume; it’s basic social work. We meet the clients where they’re at.” “We’re like everybody
else. Be sensitive to differences, whether they’re gay or a minority of some other type.” “Just be
yourself and let us be ourselves.”
Implications and conclusion
The findings of this study were consistent with other studies conducted over the past five
years. There are several changes that need to take place to improve care to the LGBT elder
17. LGBT Elder Care 17
population, which continues to be underserved (Lim & Bernstein, 2012). The first step to
minimizing discomfort among medical professionals is education. Policy changes are needed to
ensure that LGBT training is mandatory and recurrent (at least annually) for healthcare workers.
Education promotes awareness which, in turn, creates empathy and understanding (Rogers,
Rebbe, Gardella, Worlein, & Chamberlin, 2013).
Despite the finding that none of the study participants expressed discomfort when going
to see their medical doctor, what did emerge is that they all believe there is still a long way to go
regarding clinics adapting their outward appearance in order to create a more LGBT-friendly
atmosphere. Nancy Orel (2013) also concluded in her study that “one of the greatest obstacles
[continues to be] the level of homophobia and heterosexism within the culture” (pp. 70).
Additional consideration should be taken by clinicians about the impact that the loss of
religious and spritiual identity has on LGBT individuals. Religious impact was brought up by
each of the participants in this study and it clearly played a role in the ability for some of them to
cope with and come to an acceptance of their homosexuality. The loss of R/S identity can not
only negatively impact emotional and mental well-being, but LGBT individuals are at a higher
risk of experiencing R/S abuse (Wood & Conley, 2014).
Some limitations to the study was the small sample size of only four participants. Only
one interviewee was over the age of 65, which could account for why only half the sample
expressed concerns related to medical care. Younger LGBT individuals appear more open and
less concerned about conventionalism. The researcher was also only able to recruit individuals
who identify as gay and lesbian, and was not able to recruit a transgender individual. Due to
participants for this study being collected through convenience and snowball sampling, it is also
likely that they overrepresented people who are more open to talking about their experiences.
18. LGBT Elder Care 18
Further research should be done with health care agencies to explore why trainings on
LGBT issues are not regularly provided to staff. Studies on this topic have only spanned the last
five to ten years. Further studies of a longitudinal nature may be necessary to ascertain if
systematic LGBT trainings do effectuate positive change in the long term attitudes and empathy
of healthcare workers. Porter & Krinsky (2013) agree that supplemental trainings would be
necessary and should not be just a singular curriculum. It is again important to note that,
although the LGBT acronym globally considers all individuals that identify as queer, each
subcategory of the acronym carries its own unique needs and cannot be mistaken for a ‘one size
fits all’ philosophy. Their needs are shaped by many factors including race, ethnicity, age and
socioeconomic status (Lim & Bernstein, 2012).
Today’s youth appears to be playing a significant role in the shift in attitudes and biases
towards LGBT individuals. This shift has taken place over the last 12 years, since Massachusetts
became the first state to legalize gay marriage (Jones, Cox, & Navarro-Rivera, 2014). The
Millenial generation seems to be less accepting of the heteronormative codes of the late twentieth
century mainstream culture and more people now approve of gay marriage than ever before
(Jones, Cox, & Navarro-Rivera, 2014).
This shift, however, is still in its infancy. Until today’s youth begins taking care of our
seniors in the next 20-30 years, it is more important than ever to heed the words so eloquently
spoken by an interviewee from this study. When asked what is important for non-LGBT persons
to know, he responded “Do you really want to cause these people more pain than they have
already experienced? More understanding leads to more empathy, compassion and patience.
Understand my struggle and walk in my shoes before passing judgment on me.”
20. LGBT Elder Care 20
Orel, N. A. (2013). Investigating the Needs and Concerns of Lesbian,Gay, Bisexual, and
Transgender Older Adults: The Use of Qualitative and Quantitative Methodology.
Journal of Homosexuality, 53-78.
Padgett, D. (2008). Qualitative Methods In Social Work Research. Thousand Oaks, CA: Sage
Publications, Inc.
Porter, K. E., & Krinsky, L. M. (2013, August). Do LGBT Aging Trainings Effectuate Positive
Change in Mainstream Elder Service Providers? Journal of Homosexuality, 61(1), 197-
216.
Rogers, A., Rebbe, R., Gardella, C., Worlein, M., & Chamberlin, M. (2013, August). Older
LGBT Adult Training Panels: An Opportunity to Educate About Issues Faced by the
Older LGBT Community. Journal of Gerontological Social Work, 580-595.
Sage general facts & discrimination. (2012-2015). Retrieved October 31, 2015, from Sage-
Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders:
https://www.sageusa.org/issues/general.cfm
Thurston, C. L. (2009, March 15). We Don’t All Age the Same: The Unique Needs of LGBT
Seniors. 2009, Nevada, USA.
Ward, R., Rivers, I., & Sutherland, M. (2012). Lesbian, Gay, Bisexual and Transgender Ageing.
London/Philadelphia: Jessica Kingsley Publishers 2012.
Werner, C. A. (2011). The Older Population: 2010. Retrieved October 31, 2015, from United
States Census Bureau: http://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf
Wood, A. W., & Conley, A. H. (2014, April). Loss of Religious or Spiritual Identities Among
the LGBT Population. Counseling and Values, 59, 95-111.
Worcester LGBT Elder Network (WLEN) sponsored by ESWA; Brightstar Care. (2015).
Inclusive Services for LGBT Older Adults: A Practical Guide to Creating Welcoming
Agendas. Worcester.