"She's Dying and I Can't Say We're Married?": End-of-Life Care for LGBT Older Adults
"She's Dying and I Can't Say We're Married?": End-of-Life Care for LGBT Older Adults
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DOI：
10.1093/geront/gnaa186
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发表时间：
2021-11-15
期刊：
影响因子：
5.7
通讯作者：
Cloyes, Kristin G.
中科院分区：
文献类型：
--
作者：
Candrian, Carey;Cloyes, Kristin G.
女同性恋、男同性恋、双性恋和变性者（LGBT）老年人特别容易接受不公平的临终关怀。他们的医疗保健愿望可能被忽视或忽视，他们选择的家庭不太可能参与他们的决策，他们可能会经历更多的孤立，欺凌，虐待或虐待，最终导致接受低质量的医疗保健。这一点在沿着临终关怀的敏感过渡时期尤为重要; 2018年对865名临终关怀专业人员进行的调查中，43%的受访者报告说，他们直接观察到了对LGBT患者的歧视行为。缺乏可见度和问责制使脆弱性和歧视性待遇的可能性长期存在。不幸的是，虽然其他卫生保健领域已经优先考虑和规范性取向和性别认同（SOGI）数据的收集，临终关怀不定期评估患者的SOGI在生命结束的愿望和决定的背景下。本文通过对31位年长的LGBT成年人的深度访谈，重点关注了一位参与者的故事--埃斯特的故事。我们选择她的故事是为了说明，如果避免与患者公开讨论在生命结束时对他们最重要的是什么和谁，那么在生命结束时护理可能会受到损害。
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.