Advance care planning among older LGBT Canadians: Heteronormative influences
Advance care planning among older LGBT Canadians: Heteronormative influences
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DOI：
10.1177/1363460719896968
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发表时间：
2020-03-17
期刊：
影响因子：
1.5
通讯作者：
Chamberland, Line
中科院分区：
文献类型：
--
作者：
de Vries, Brian;Gutman, Gloria;Chamberland, Line
在北美，预先护理计划（ACP）通常发生在对死亡和垂死的巨大矛盾心理的文化背景下，这对讨论临终护理愿望和为死亡做准备的努力提出了挑战。对于性和性别少数的老年人来说，这种挑战更为严重，因为他们往往与传统的异性恋规范支持系统缺乏联系。ACP准备（完成的文件，讨论）和他们的预测因素的程度进行了检查之间的91个社区居住的加拿大LGBT老年人（平均年龄68岁）的国家样本。样本是不成比例的单身和独居;更多的跨性别参与者有孩子，大约一半的参与者报告了一个选择的家庭。大约三分之二的参与者有遗嘱，而不到一半的人有生前遗嘱和医疗委托书，四分之一的人做出了非正式的离婚安排。超过三分之一的受访者报告说，他们讨论了未来的护理和临终计划。完成ACP文件和进行ACP讨论的唯一重要预测因素是关系状态（处于关系中的人更有可能参与这两项）和子女数量（有子女的人不太可能完成文件）。鉴于大多数老年男女同性恋、双性恋和变性者都是单身，必须扩大努力，接触这些人，让他们为生命的结束做好准备。
Advance care planning (ACP) in North America often takes place in a cultural context of great ambivalence about death and dying, challenging efforts to discuss end-of-life care desires and preparations for death. Such challenges are amplified for sexual and gender minority older adults who often lack connections to traditional heteronormative systems of support. The extent of ACP preparation (completed documents, discussions) and their predictors was examined among a national sample of 91 community-dwelling Canadian LGBT older adults (mean age 68). The sample was disproportionately single and lived alone; more trans participants had children and about half of all participants reported a chosen family. About two-thirds of participants had a will, while less than half had a living will and power of attorney for health care, and a quarter had made informal caregiving arrangements. Just over one-third of respondents reported having discussions about future care and end-of-life plans. The only significant predictors of both ACP documents completed and ACP discussions undertaken were relationship status (those in a relationship were more likely to have engaged in both) and number of children (those with children were less likely to have completed documents). Given that most LGBT older adults are single, efforts must be expanded to reach and engage these individuals in preparing for end of life.