Coming Out to Care: Caregivers of Gay and Lesbian Seniors in Canada

Purpose: This article reports on the findings of a study whose purpose was to explore the experiences of caregivers of gay and lesbian seniors living in the community and to identify issues that emerged from an exploration of access to and equity in health care services for these populations. Design and Methods: The study used a qualitative methodology based upon principles of grounded theory in which open-ended interviews were undertaken with 17 caregivers living in three different cities across Canada. Results: Findings indicated several critical themes, including the impact of felt and anticipated discrimination, complex processes of coming out, the role of caregivers, self-identification as a caregiver, and support. Implications:  We consider several recommendations for change in light of emerging themes, including expanding the definition of caregivers to be more inclusive of gay and lesbian realities, developing specialized services, and advocating to eliminate discrimination faced by these populations

An institutional ethnography of elder care: Understanding access from the standpoint of ethnic and "racial" minority women

grantor: University of TorontoThe current study addresses the problematic of access for ethnic and "racial" minority elderly women through an examination of the working processes of a publicly-funded organization which provides elder care services in Ontario, from the standpoint of these women. Using Institutional Ethnography methodology, the study explicates how state ideologies become infused into the operating policies and guidelines of elder care ideologies become infused into the operating policies and guidelines of elder care organizations, shaping the actual way access is both conceptualized and operationalized and the subsequent interactions between workers and their elderly clients. Interviews conducted with 43 participants (elderly women, agency staff, community agency and institutional staff) explicate how actors both reproduce relations of oppression and counter or resist those relations. Several problematic constructions have been identified which highlight the disjunctures between older women's expressed desires regarding access and the way access to services are operationalized in elder care agencies. These include: family involvement in care; prolonged engagement as a means of facilitating access; the influence of acute health care models on eligibility for and delivery of care; and, a focus on cultural competence and language in the delivery of ethno-specific services. Program and practice implications are highlighted in order to shift the dominance of state-orchestrated ideologies which operate to shape the experience of women who are multiply situated on the margins and who have been and continue to be oppressed within elder care institutions.Ph.D

A Framework for Enhancing Access to Equitable Home Care for 2SLGBTQ+ Communities

Canadian, US, and UK public health and clinical research has identified barriers to health service access for Two-Spirit, lesbian, gay, bisexual, transgender, queer, non-binary, and intersex (2SLGBTQ+) communities. While offering important insight into the health service experiences of 2SLGBTQ+ communities, this body of research only recently, and still only minimally, reports on home care access experiences. Drawing on key findings from the 2SLGBTQ+ Home Care Access Project, a mixed-methods, Ontario-wide study, this paper animates an Access and Equity Framework, using participant stories and perspectives to underscore the relevance and effectiveness of the Framework as a tool to support systematic organizational assessment, evaluation, and implementation of access and equity strategies. Home care organizations can use this tool to assess their programs and services along a continuum of intentionally inviting, unintentionally inviting, unintentionally disinviting, and intentionally disinviting care for 2SLGBTQ+ people. To support this process, the framework includes six indicators of access to care: community engagement, leadership, environment, policies and processes, education and training, and programs and services

Prendre soin en contexte d’immigration récente. Les limites aux solidarités familiales à l’égard des membres de la famille avec incapacités

Plusieurs recherches ont porté sur les solidarités à l’égard des proches avec incapacités chez les familles de minorités ethnoculturelles. Ces recherches ont permis de constater une grande valorisation des solidarités familiales, une prestation importante de soins et un faible recours aux services chez ces familles. Toutefois, la plupart des recherches ont porté soit sur des groupes d’immigration ancienne, soit sur des groupes mixtes, ce qui ne permet pas de saisir les dynamiques chez les familles d’immigration récente. La présente étude porte sur 15 familles d’immigration récente prenant soin d’un proche avec incapacités. De l’analyse des entretiens, il ressort qu’il n’existe pas une seule norme univoque de solidarité familiale et que les familles connaissent de nombreuses contraintes qui limitent la capacité et la volonté des familles de prendre soin de ses membres avec incapacités.A number of research projects have focused on ethno-cultural minority families and the solidarity they demonstrate towards incapacitated relatives. Such research has shown the great importance they attach to family solidarity, the significant amount of care they provide, and their low level of dependency on outside sources. However, most of this research has targeted either long-established immigrant groups, or mixed groups, thus debarring any grasp of the dynamics that influence recent immigrant families. The present study looks at 15 recently immigrated families who look after an incapacitated relative. An analysis of interviews with them indicates that there is no one single standard of family solidarity and that these families experience many constraints that restrict both their ability and their desire to take care of their incapacitated relatives

Prendre soin en contexte d’immigration récente. Les limites aux solidarités familiales à l’égard des membres de la famille avec incapacités

Plusieurs recherches ont porté sur les solidarités à l’égard des proches avec incapacités chez les familles de minorités ethnoculturelles. Ces recherches ont permis de constater une grande valorisation des solidarités familiales, une prestation importante de soins et un faible recours aux services chez ces familles. Toutefois, la plupart des recherches ont porté soit sur des groupes d’immigration ancienne, soit sur des groupes mixtes, ce qui ne permet pas de saisir les dynamiques chez les familles d’immigration récente. La présente étude porte sur 15 familles d’immigration récente prenant soin d’un proche avec incapacités. De l’analyse des entretiens, il ressort qu’il n’existe pas une seule norme univoque de solidarité familiale et que les familles connaissent de nombreuses contraintes qui limitent la capacité et la volonté des familles de prendre soin de ses membres avec incapacités.A number of research projects have focused on ethno-cultural minority families and the solidarity they demonstrate towards incapacitated relatives. Such research has shown the great importance they attach to family solidarity, the significant amount of care they provide, and their low level of dependency on outside sources. However, most of this research has targeted either long-established immigrant groups, or mixed groups, thus debarring any grasp of the dynamics that influence recent immigrant families. The present study looks at 15 recently immigrated families who look after an incapacitated relative. An analysis of interviews with them indicates that there is no one single standard of family solidarity and that these families experience many constraints that restrict both their ability and their desire to take care of their incapacitated relatives