Abstract
Lesbian, gay, bisexual, and transgender (LGBT) older adults face a number of challenges with respect to access to healthcare especially towards end-of-life. Through a systematic search and scoping review of the literature, we sought to answer two related research questions. In particular, the purpose of this scoping review was to determine the healthcare needs of LGBT older adults nearing end-of-life as well as the factors that contribute to a good death experience among older adults who identify as LGBT. A systematic search of electronic databases for articles published between 2005 and 2016 as well as screening for relevance resulted in 25 results. The data were charted and grouped according to the themes of: social support and chosen family, intimacy, health status, fear of discrimination and lack of trust, lack of knowledge and preparedness, and cultural competence in the healthcare system. The results suggest a role for health and social service workers in contributing to a positive care experience for LGBT older adults by becoming knowledgeable about the unique needs of this population and being unassuming and accepting of individuals’ sexuality. Many of the articles reviewed collected data outside of Canada, limiting generalizability and highlighting a need for Canadian data on LGBT aging and end-of-life.
Highlights
Researchers have reported disparities in health between older LGBT individuals and their non-LGBT peers, including less access to healthcare and the negative effects of stigmatization [1]
From a policy and practice standpoint, the available literature highlights the importance of promoting inclusion at end-of-life and addressing the specific needs of LGBT individuals
Educational resources should be made available to healthcare providers, enabling them to provide culturally competent end-of-life care
Summary
Researchers have reported disparities in health between older LGBT individuals and their non-LGBT peers, including less access to healthcare and the negative effects of stigmatization [1]. In a sizeable US-based study, LGBT individuals reported concerns regarding social isolation, finances, and access to health services. Limited Canadian data suggest that older LGBT individuals are more likely to live alone and be socially isolated, and have a strong desire to avoid long-term care facilities (i.e., institutionalized care) [2]. LGBT individuals often experience stigma and discrimination, which can have a negative impact on their health and even their life expectancy. As well as experiencing health disparities, stigma, and discrimination, older LGBT individuals are less likely than their majority peers to have spouses and kin to serve as caregivers, provide guidance in Geriatrics 2017, 2, 13; doi:10.3390/geriatrics2010013 www.mdpi.com/journal/geriatrics
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