scholarly journals PALLIATIVE AND END-OF-LIFE CARE TO THE LGBT COMMUNITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S623
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
Lgbt Community ◽  
And Gender

Abstract The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care – across cultures and countries. Health care providers may fail to recognize, acknowledge or address disparities in care. Providers and institutions may be uncomfortable with gender and sexuality issues, and often fail to inquire about sexual orientation and gender identity. It is estimated that there are approximately 2.7 million LGBT adults in the U.S. age 50 and older and approximately 1.1 million age 65 and older. In the UK, an estimated 5-7% of the population identify as LGBT; there are between 600,000 and 840,000 LGBT adults aged 65+. With the projected increased number of older adults and improved treatments that extend the life of seriously ill individuals, even greater numbers of LGBT older adults, and their families, will require palliative and end-of-life in the coming years. Researchers in the US and UK have found that LGBT older adults living in the community and in long-term care facilities experience inadequate, disrespectful, and abusive care due to their sexual orientation and gender identity status. They fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored by health care staff. This symposium will describe the experiences of LGBT individuals and their family members, and compare commonalities and differences faced by LGBT communities in the US and UK in accessing palliative and end-of-life care.

COVID-19 and the Long-Standing Vulnerabilities of Older Adults

2020 ◽  
Vol 119 (820) ◽  
pp. 323-325
Author(s):  
Deborah Carr
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Financial Resources ◽  
Life Care ◽  
Medicaid Reimbursement ◽  
The Us ◽  
Health And Mortality ◽  
Policy Solutions

The COVID-19 pandemic has taken a devastating toll on the lives of older adults, intensifying long-standing challenges in the US health care system. Persistent health and mortality disparities on the basis of race and socioeconomic status, staffing shortages and insufficient financial resources at some nursing homes, and a reluctance among Americans to make formal plans for their end-of-life health care are problems of heightened magnitude in the pandemic era. Policy solutions like extending Medicare benefits to younger people, increasing Medicaid reimbursement rates, and facilitating formal conversations regarding end-of-life care may help Americans to age and die with dignity.

scholarly journals Improving End-of-Life Care for People with Dementia in LTC Homes During the COVID-19 Pandemic and Beyond

2021 ◽  
Vol 24 (3) ◽  
pp. 164-169
Author(s):  
Sharon Kaasalainen ◽  
Lynn Mccleary ◽  
Shirin Vellani ◽  
Jose Pereira
Keyword(s):  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Task Force ◽  
Life Care ◽  
Term Care ◽  
Health Care Resources ◽  
People With Dementia

COVID-19 pandemic has resulted in a significant increase in deaths in long-term care homes (LTCH). People with dementia living in LTCHs represent one of the most frail and marginal­ized populations in Canada. The surge of COVID-19 cases in LTCHs and rationing of health-care resources during the pandemic have amplified the pre-existing need for improve­ments in palliative and end-of-life care in LTCHs. This pos­ition statement, created by a task force commissioned by the Alzheimer Society of Canada, provides recommendations for a multipronged coordinated approach to improving palliative and end-of-life care of people with dementia living in LTCHs during the COVID-19 pandemic and beyond.

scholarly journals Improving Quality and Access to Care in Long-Term Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Nancy Dudley ◽  
Nancy Dudley
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Workplace Violence ◽  
Independent Living ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care

Abstract Innovative delivery models that assure access to quality care in long-term care settings are needed for the diverse high-risk aging U.S. population. The 2008 National Academy of Medicine report, “Retooling for an Aging America: Building the Health Care Workforce” highlighted the need for changing the roles of health care providers in order to provide high-quality and cost-effective care to older Americans. Moreover, from the providers’ perspective, workplace violence in health care institutions, such as nursing homes, negatively affect the delivery, quality, and accessibility of health care. In this symposium, we identify needs and care provisions in the context of older adults aging in long-term care settings and discuss the implications for policy and health care transformation. This symposium comprises three distinct presentations: (1) identifying and addressing the needs of diverse older adults aging in low-income independent living facilities in community health practice; and based on pilot survey results from nurses in the State of New Hampshire, (2) reframing residents’ violence directed toward providers as self-protection and (3) proposing legislative and policy changes designed to meet the needs of staff and residents of long-term care facilities. These presentations represent efforts across long-term care settings to improve access and quality of care in the context of diverse older adults aging in the U.S.

scholarly journals “She’s Dying and I Can’t Say We’re Married?”: End-of-Life Care for LGBT Older Adults

2020 ◽  
Author(s):  
Carey Candrian ◽  
Kristin G Cloyes
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Poor Quality ◽  
Life Care ◽  
Quality Health Care ◽  
Quality Health ◽  
Bisexual And Transgender ◽  
And Gender

Abstract Lesbian, gay, bisexual, and transgender (LGBT) older adults are at particular risk for receiving inequitable end-of-life care. Their health care wishes may be ignored or disregarded, their families of choice are less likely to be included in their decision making, and they may experience increased isolation, bullying, mistreatment, or abuse, which ultimately contribute to receipt of poor-quality health care. This is particularly important during sensitive transitions along the care continuum to end-of-life settings; 43% of respondents of a 2018 survey of 865 hospice professionals reported having directly observed discriminatory behavior toward LGBT patients. Lack of visibility and accountability perpetuates vulnerabilities and the potential for discriminatory treatment. Unfortunately, while other areas of health care have prioritized and normalized collecting sexual orientation and gender identity (SOGI) data, hospices do not routinely assess patients’ SOGI in the context of end-of-life wishes and decisions. Drawing insight from a sample of 31 in-depth interviews with older LGBT adults, this paper focuses on one participant’s story—Esther’s. We chose her story to illustrate how care can be compromised at the end of life if an open discussion with patients about what and who matters most to them at the end of life, is avoided.

scholarly journals Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 201-201
Author(s):  
Leah Haverhals ◽  
Katie Cherry
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
The Impact ◽  
Hurricane Irma

Abstract The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.

scholarly journals Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 704-704
Author(s):  
Yuchi Young ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Systems ◽  
Long Term Care ◽  
The United States ◽  
World Population ◽  
Term Care ◽  
The Usa ◽  
Aged Society

Abstract The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture. This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

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