Interventions en promotion de la santé auprès des personnes aînées LGBTQ : réalités québécoises.

Research on LGBTQ older adults reveals persistent accessibility problems with health and social services specific to this segment of the population as well as the need to develop inclusive approaches to remove accessibility barriers. In Quebec, governmental measures (such as public policy, action plans and reports) have prioritized actions to improve the accessibility of resources, raise staff awareness and encourage the establishment of safe and welcoming environments for LGBTQ older adults. This article focuses on two health promotion interventions for LGBTQ older adults: a training program developed by a community group and an online training tool targeting employees within the healthcare and social services network. In the light of these experiences, this article proposes recommendations.

Inclusive Practices toward LGBT Older Adults in Healthcare and Social Services: A Scoping Review of Quantitative and Qualitative Evidence.

Objectives: To determine what constitutes inclusive practices toward LGBT older adults in healthcare and social services and the supportive competencies of these practices. Methods: A comprehensive scoping review of the existing literature was conducted.Results: To be competent when addressing LGBT elder needs, personnel must have knowledge on LGBT realities, openness and be able to put certain skills into practice.Conclusions: Given the limited powers conferred on them by their respective positions, institutions must also play a role in encouraging the inclusion of LGBT older adults. Beyond the importance of taking into account the three dimensions of competence in staff training, changes must be made at all levels of the organizational structures.Clinical implications: Inclusive practices require 1) Educating personnel on the diversity of the life journeys of LGBT older adults; 2) Promoting relational and communication skills and open, friendly attitudes toward the diversity of LGBT identities; 3) Developing policies and procedures to create and maintain inclusive and safe environments for LGBT older adults.

[The mental health issues among gay and lesbian elders]. / Les enjeux de santé mentale chez les aînés gais et lesbiennes.

Most gay and lesbian elders have experienced discrimination and stigmatization related to their sexual orientation in their life trajectory. These negative experiences may have had an impact on their life course and on their mental health. Even if the majority of gay and lesbian older adults actually have and maintain good mental health, studies show that non-heterosexual people are at a greater risk of developing certain difficulties, such as anxiety, depression, suicidal thoughts and excessive consumption of alcohol and other substances. This article presents the factors that may weaken the mental health of older gay and lesbian people, such as victimization and the exposure to various forms of prejudice in their life course, the continuous management of the disclosure or dissimulation of their sexual orientation, the degree of internalized homophobia, as well as loneliness; and also presents the potential protective factors, such as building resilience, social networks and social support. This article concludes by illustrating the implications concerning the specific needs of the gay and lesbian elders. Some recommendations are also formulated with regards to recognizing the issues affecting gay and lesbian older adults as well as improving the services that are offered to them.

[Le programme Participe-présent auprès d'aînés vivant avec une problématique de santé mentale ou des difficultés psychosociales affectant leur participation communautaire : résultats d'une étude pilote sur sa faisabilité].

Les aînés qui vivent avec des problèmes de santé mentale ou des difficultés psychosociales sont souvent isolés et marginalisés. Le programme Participe-présent a été développé dans le but de promouvoir leur participation communautaire. Les objectifs de cette étude étaient de 1) décrire la pertinence, l'acceptabilité, et la faisabilité du programme lors de sa mise à l'essai et 2) d'explorer les bienfaits et les effets à court-terme du programme pour les participants. Vingt-trois aînés, quatre animateurs et trois responsables provenant de quatre organismes ont participé à l'étude. Les aînés ont été satisfaits de leur expérience de participation au programme et ont rapporté une meilleure connaissance des ressources et une plus grande satisfaction à l'égard de leur vie sociale. Les animateurs et les responsables d'organismes ont souligné l'adaptabilité de Participe-présent aux besoins de leur clientèle et à leur contexte de pratique, et ont identifié les facilitateurs et les obstacles à sa mise en œuvre. D'autres études mèneront à des recommandations favorisant le succès de la mise en œuvre de Participe-présent dans différents contextes.

[Points de vue d'adultes vieillissants ayant une déficience intellectuelle à l'égard de leur participation sociale].

Au cours du vieillissement, les adultes ayant une déficience intellectuelle (DI) vivent de nombreux changements susceptibles d'influencer leurs possibilités d'exercer leurs activités quotidiennes et leurs rôles sociaux. Une bonne connaissance de leurs points de vue sur le sujet apparaît cruciale pour mieux adapter l'offre de services à leurs besoins. Cette recherche a pour but de mieux comprendre les points de vue des personnes ayant une DI à l'égard de leurs possibilités de participation sociale à travers l'avancée en âge. Des entrevues individuelles et un atelier participatif ont été réalisés avec des adultes âgés de 40 à 75 ans dans la ville de Québec. L'analyse de leurs propos a permis d'identifier leurs points de vue relatifs à trois thèmes, soit leurs capacités, les possibilités d'exercer leur participation sociale et les soutiens reçus. Pour conclure, des recommandations sont proposées afin que les pratiques soutiennent réellement leur participation sociale à travers l'avancée en âge.

Older Adults in Administrative Quagmire: A Scoping Review of Policy and Program Coordination Across 6 Marginalized Older Adult Populations.

BACKGROUND AND OBJECTIVES: Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on six groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual and transgender) community, and individuals living in a rural area. RESEARCH DESIGN AND METHODS: A five-stage scoping review methodology was followed, and 53 articles (published between 2000-2022) from five social science databases were analyzed. RESULTS: The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied, but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analysed in one specific policy area or within a clinical setting along the lines of facilitating care coordination. DISCUSSION AND IMPLICATIONS: This scoping review reveals a mutual neglect on the part of public administration and policy scholars towards marginalized older adults, and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults.

Palliative Care Professionals' Perceptions and Communication About Sexual Expression of Older Adults at End of Life: How Biases Compromise Holistic Care.

BACKGROUND AND OBJECTIVES: The sexuality of older people, which has historically been invisible, is increasingly represented and promoted in the media. However, the sexuality of the oldest older adults showing signs of frailty remains obscure and subject to ageist and ableist biases. Studies on sexual expression at the end of life have shown that sexuality and the need for support related to it remain important for many people. RESEARCH DESIGN AND METHODS: This article examines the perceptions and attitudes of professionals regarding the sexuality of older adults in palliative care, based on an exploratory qualitative study. Participants were recruited from several palliative care teams working either in hospital or in home settings in Canada. RESULTS: Professionals (n = 16) held two main views of sexuality: broad and holistic or narrow and genital-focused. Perceptions of sexuality in later life were either described as a continuation of or distinct from middle adulthood. No matter what views were held, most professionals did not discuss sexuality with their patients at the end of life. DISCUSSION AND IMPLICATIONS: The lack of communication about sexuality may be largely due to professional's ageist, ableist, and heterosexist views regarding the sexuality of this population group. Results confirm the relevance of providing palliative care training about diverse sexual experiences and the importance of supporting older adults at the end of life with respect to their intimate and sexual needs. Such an approach is in line with the holistic vocation of palliative care.

Une formation complémentaire et appliquée : un besoin pour la relève en recherche interventionnelle en santé des populations.

Population Health Intervention Research (PHIR) is an emerging and distinct field that combines scientific research and public health practice. However, traditional academic training in research, which is founded on specific disciplinary orientations, does not sufficiently inform and prepare new PHIR researchers. In this commentary, we advance the idea that PHIR requires a broader range of competencies and knowledge that must be developed through a complementary and applied training program. Drawing on our experience as 4P Strategic Training Program fellows, we identified key elements of the program that have helped prepare us in our careers as future and new PHIR researchers. We believe that complementary and applied training programs such as the 4P Program are a promising strategy in training and supporting the next generation of PHIR researchers in their efforts to improve population health.