A Guide for Palliative Medicine Clinicians Taking Care of Lesbian, Gay, Bisexual, and Transgender Patients Using a Whole Person Care Approach (SA516)

Abstract

•Understand the impact of spiritual and existential distress in LGBT patients with chronic medical illnesses.•Access tools and resources to support LGBT patients and families facing life threatening illnesses and uncertain legal protection state-by-state.•Assess the unique needs of transgender patients who are receiving care from faith-based organizations. In 2011, the Institute of Medicine report on the Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People cited lack of legal protections and lack of social support as significant barriers to the quality of palliative care. LGBT patients have achieved expanded rights and access to health care. State health policy and legislation varies widely across the country and many states offer little legal protection to LGBT patients. LGBT patients living with chronic illnesses experience higher rates of depression and anxiety and more likely to have lower rates of satisfaction with care that they receive from health care providers (Kamen C 2015). Healthcare providers receive little training on caring for LGBT patients and often are unaware of educational and patient support resources for LGBT patients. While LGBT patients and their families are reported to have higher preferences for advance care planning, palliative care, and hospice many palliative care and hospice organizations lack policies and educational resources in regard to care of LGBT patients and families. Our transdisciplinary team of co-presenters includes representatives from medicine, advance practice nursing, social work and chaplaincy. The presenters will use case-based teaching to highlight the role of chaplaincy in assessing LGBT specific spiritual and existential distress. We will address the role of chaplaincy in promoting psychological well-being in LGBT patients by chaplain led Dignity Therapy. We will address the role of social workers to proactively promote formalized surrogate decision makers of LGBT patients’ preference, psychosocial well-being and resources to address variability in state protection for LGBT patients. We will address the role of hospice and palliative medicine teams in caring for transgender patients with advanced illnesses who are receiving care from faith-based and long-term care organizations. We will present resources for providers to educate their teams on caring and advocating for LGBT patients. •Resources to Improve The Quality Of Hospice And Palliative Care For Sexual And Gender Minority Patients And Families•Center of Excellence For Transgender Health - http://transhealth.ucsf.edu/•Hospice Foundation of America LGBT Resources- https://hospicefoundation.org/End-of-Life-Support-and-Resources/Coping-with-Terminal-Illness/How-to-Choose/LGBT-Resources•Lambda Legal Tools for Life and Financial Planning- http://www.lambdalegal.org/publications/take-the-power•LGBT best and promising practices for cancer care for LGBT patients and families throughout the cancer continuum- http://www.lgbthealthlink.org/Cancer-Best-Practices•LGBT Hospice and Palliative Care Network – https://lgbthpm.org/resources/•National Resources Center on LGBT Aging - http://LGBTagingcenter.org/resources•Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders- http://sageusa.care/ Institute of Medicine: The Health of Lesbian, Gay, Bisexual, and Transgender People Building a Foundation for Better Understanding. Washington, DC: National Academy of Science, 2011. Kamen C, Mustian KM, Dozier A, Bowen DJ, Li Y. Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors. Psychooncology 2015 24(11):1384-91.