LGBTQ people often invisible in home care, research project reveals
Ontario's LGBTQ communities face barriers to finding high quality home care that meet their unique needs, a five-year study by York University researchers reveals.
This research, the first study to comprehensively examine home care access for LGBTQ people in Ontario, was conducted by a team led by School of Social Work Professor Andrea Daley and School of Nursing Professor Judith MacDonnell, in collaboration with Rainbow Health Ontario and the Toronto Central Community Care Access Centre (CCAC).
"The LGBTQ community faces discrimination in health care services and barriers in finding responsive and relevant care," says MacDonnell in the School of Nursing. "While this has been well documented in hospital and other clinical settings, this study shows similar findings, highlighting the unique concerns that affect home care access for LGBTQ people across Ontario. We were also able to identify what's working well with examples of caregivers who provide affirming care"
The research focus on home care is important, according to Daley. "We can think of the 'home' as taking on great significance as a place where LGBTQ people can be themselves and live their identities and relationships with a greater level of freedom. However, that is likely to be affected by the discriminatory reactions and unpredictable support of service providers."
The findings showed that LGBTQ people often anticipate they may face overt or subtle hostility, as seen in other healthcare settings, and that home care providers require more training on health issues that are important to LGBTQ communities. Trans people especially may avoid seeking home care.
Among the study participants, one in three home care providers believed they had never worked with an LGBTQ client. Ninety per cent of home care service providers reported having never received continuing education while employed in home care that focused on a client's sexual and/or gender identity as it pertained to high quality care.
According to the researchers, these findings were of particular interest to the Toronto Central CCAC whose participation and staff involvement is part of an overall commitment to improve LGBTQ access, awareness and communication.
"Our staff work with likely the most diverse group of patients anywhere in the country and we pride ourselves in looking at the whole person - who they are and what their care needs are," says Anne Wojtak, Chief Performance Officer. "We've worked extremely hard at breaking down barriers for people who experience any form of inaccessibility: colour, race, religion, sexual orientation, financial status, and so on We're excited that with these findings we can continue to explore new ways to support better training, communication, and ultimately access to care."
The study shone a light on the many home care services users in the LGBTQ community who are under the age of 50, single and in the lower income group, while the study participants ranged from 19 to 86 in ages.
"The importance of our research also lies in the community-based approach taken to explore home care access for LGBTQ communities. Our research process brought together Ontario's LGBTQ community members as well as their supporters, and home care-related organizations," says Daley.
The study aimed at filling gaps in awareness of home care need for LGBTQ people to bring about policy change. MacDonnell adds "As we have undertaken the research and shared findings with diverse LGBTQ communities, service providers, decision makers and policy makers over the last five years, it is clear that there is significant interest across stakeholder groups in taking steps to improve care for LGBTQ home care service users, care givers, their chosen families and communities of care."
