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​Boulé, J., Wilson, K., Kortes-Miller, K., & Stinchcombe, A. (2019). “We live in a wonderful country, Canada, but…”: Perspectives from older LGBTQ Ontarians on visibility, connection, and power in care and community. The International Journal of Aging and Human Development.

This research investigated the health and aging experiences of 21 lesbian, gay, bisexual, trans, and queer (LGBTQ) adults, aged 60 to 79 years, to identify their service and support needs. Participants engaged in focus groups in four locations in Ontario, Canada. Data were analyzed using inductive thematic approach. Participants anticipated age-related losses and expected a greater use of and dependence on health/social care services. Despite greater LGBTQ visibility and inclusive care, participants perceived care services and facilities as unsafe and without competent support. Participants described employing positive strategies to overcome discrimination, contributing to participants’ health and aging experiences.

​Wilson, K., Stinchcombe, A., Ismail, M., & Kortes-Miller, K. (2019). LGBTQ2+ aging in Canada: Building the evidence and informing action. The Canadian Journal of Human Sexuality, (aop), 1-14.

Within Canada, there has been an increased Federal recognition and support for lesbian, gay, bisexual, transgender, queer, 2-spirit (LGBTQ2+) individuals and communities. The recognition of previous systemic discrimination helps to illustrate the unique social and historical contexts those current older adults faced as they aged as members of LGBTQ2+ communities. Addressing the diverse and unique needs of LGBTQ2+ older adults is crucial to ensuring safety and well-being within formal and informal care settings yet, due to a lack of research evidence, this remains a challenge. In order to advance research and action on LGBTQ2+ aging in Canada, stakeholders were convened at a research-policy forum to establish a community of interest and catalyze activities to support a diverse aging population. Immediate concerns that were raised included: social isolation, healthcare, education and training needs for providers, stigma and discrimination, and housing. Other knowledge gaps included dementia care and the effects of cognitive impairment on sexual and gender identity, lived realities of older LGBTQ2+ ethnic minorities, and the experiences of older Two Spirit Canadians. Attendees highlighted the importance of showcasing success stories of aging among LGBTQ2+ communities in addition to describing experienced challenges. Considering that members of LGBTQ2+ communities who experienced systemic discrimination and in or approaching old age, action on these fronts is urgently needed.

Kortes-Miller, K., Boulé, J., Wilson, K., & Stinchcombe, A. (2018). Dying in long-term care: Perspectives from sexual and gender minority older adults about their fears and hopes for end of life. Journal of Social Work in End-of-Life & Palliative Care, 14(2-3), 209-224.

As lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities age, many individuals expect a need to enter the long-term care system toward the end of life. Not unlike most aging Canadians, this anticipation is met with concern and fear. However, previous research suggests that older LGBTQ + individuals have unique fears often related to personal safety and discrimination. This qualitative study examined the hopes and fears of older LGBTQ + adults considering long-term care as they face end of life. Data were collected from three focus groups in Ontario, Canada, and analyzed using inductive thematic analysis. Specific and frequent reference to fear of entering long-term care homes was common across all focus groups, as participants anticipated: social isolation, decreased independence and capacity for decision-making, increased vulnerability to LGBTQ+-related stigma as well as exposure to unsafe social and physical environments. The results from this study, therefore, emphasize the need for palliative care specialists and long-term care home staff to address the unique health needs of older LGBTQ + adults nearing the end of life in order to work toward allaying fears and creating supportive and inclusive long-term care environments.

Kortes-Miller, K., Wilson, K., & Stinchcombe, A. (2018). Care and LGBT aging in Canada: A focus group study on the educational gaps among care workers. Clinical Gerontologist, 42(2), 192-197.

Objectives: Educational interventions have the potential to equip healthcare providers to support diverse aging populations. The purpose of this research was to identify educational gaps hindering the provision of person-centered care to older adults who identify as LGBT. Methods: Three focus groups were conducted in urban centers in northern, southern, and eastern Ontario with healthcare professionals and frontline staff. Semi-structured focus group discussion guides were developed based on the literature identifying some of the knowledge gaps, attitudes, challenges, and barriers around providing care for older LGBT adults. Results: The focus group data revealed several key findings related to 1) lack of curricula within formal education; 2) the need to create safer physical and social environments; and 3) the need to build relationships with LGBT-focused groups/organizations. Conclusions: Care providers want to provide open space for sexual and gender diverse older adults but lack the knowledge to do so. Clinical Implications: There is an ongoing gap within formal education systems such that historically marginalized populations who are now aging may be systemically neglected within formal curricula.

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