Care workers need to receive mandatory training to ensure that LGBTIQ+ people can access safe and inclusive palliative care, Community Care Review has been told.
“This needs to happen across all healthcare institutions, mirroring what has been done with cultural safety training for Aboriginal and Torres Strait Islander people,” said Dr Ashwin Kaniah – who has helped develop an e-learning program that offers professional advice on how to provide palliative care that fits the unique needs of LGBTIQ+ communities.
Accredited by the Royal Australian College of General Practitioners – and hosted by LGBTIQ+ Health Australia – the free four-module government-funded program is aimed at people working in palliative care or those with an interest in palliative care.
Developed in partnership with palliative care experts and co-designed with LGBTIQ+ communities across Australia, the LGBTIQ+ Inclusive Palliative Care eLearning program fills a much-needed gap identified by a national survey of healthcare professionals and LGBTIQ+ people about barriers and enablers to palliative care for LGBTIQ+ people.
The survey revealed that 94 per cent of LGBTIQ+ respondents were concerned about the lack of inclusivity or support in some institutional healthcare settings, such as aged care.
“It’s important that, when receiving end-of-life care, LGBTIQ+ people are allowed to be their authentic selves,” said Dr Kaniah. “To enable this, healthcare providers must be comfortable asking questions about sexual orientation and gender identity. When considering our transgender community members, it’s important to ensure there are discussions about their hormone treatment decisions as they enter their end-of-life phase.”
It’s also important that those delivering palliative care are able to welcome and respect the patient’s friends and loved ones “who, often,” said Dr Kaniah, “are their chosen alternative family.”
Dr Kaniah also highlighted the importance of advocating for LGBTIQ+ patient rights, especially regarding substitute decision-makers and power of attorney. “It’s about respecting a patient’s goals, values and wishes,” he said.
Dr Kaniah told CCR palliative care-givers also need to be cognisant of LGBTIQ+ histories. “Older LGBTIQ+ people have faced unique challenges, including decades of discrimination and the trauma of the AIDS epidemic – it’s important that people providing palliative care are aware of that history and the impact it has played on older people’s lives,” he said.
Acceptance is key, said Dr Kaniah.“Healthcare professionals must realise that because of the discrimination that LGBTIQ+ people have experienced during their lifetimes, they will be continually gauging whether they can trust their care givers.”
As well as framing LGBTIQ+ histories, the e-learning modules provide information about developing strategies to support loved ones, and how to create welcoming and inclusive environments.
The four modules cover:
- introduction to LGBTIQ+ communities
- barriers to providing and receiving palliative care
- enablers for LGBTIQ+ people in palliative care
- having end-of-life planning conversations.
Palliative care cannot be generalised, said Dr Kaniah. “Palliative care can’t be one size fits all – it must be customised to meet the unique needs of the many communities that exist in society.”
People interested in enrolling in the program can register here.
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