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.

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.

Sexuality and ageing in palliative care environments? Breaking the (triple) taboo.

BACKGROUND: Ageist perceptions continue to constrain the choices available to older adults in terms of their sexual expression. OBJECTIVE: This paper discusses the last stage of life, when older adults may be progressing through a terminal disease, dying and in palliative care environments. Are they (or is anyone, at any age) interested in remaining intimate when they are dying? If yes, how is this interest accepted/facilitated within such environments?. RESULTS: This article does not claim to be definitive, but provides a broad, preliminary sketch of this neglected research area. It suggests that, for many, sexual expression and intimate connection continue to be important until the very end of the lifespan. CONCLUSIONS: As such, this important topic deserves recognition as part of an overall response to sexuality and ageing by policy makers and health professionals. Its importance will only become more significant due to greater longevity and population ageing.

[Not Available]. / Vivre à l'intersection du VIH et du vieillissement : quelles répercussions sur les liens sociaux significatifs?

This research examines obstacles faced by older people living with HIV in maintaining their significant social ties (family, friends) in the light of a double theoretical framework, inter-sectionality and the course of life. Favoring a qualitative methodology, this research is based on in-depth, semi-directed interviews with a diverse sample of 38 people living with HIV, aged 50-73 years. Analysis reveals that a significant proportion of participants have experienced ruptures or deterioration of close ties with intimates at the level of family or friends. The principal factors behind these difficulties are the past and present stigma associated with HIV and /or other social positions, long-term effects of HIV, issues related to aging and crosscutting effects of HIV and aging.

Talking about Sexuality and Intimacy with Women Spousal Caregivers: Perspectives of Service Providers.

This article reports the findings of an exploratory study examining service provider perceptions and experiences of addressing sexuality and intimacy with women spousal caregivers. The caregiver-provider encounter is examined, and challenges faced by service providers in addressing sexuality are considered. Themes identified include ambivalence and discomfort, personal and institutional barriers, meanings attributed to sexuality and intimacy, and lack of opportunities to discuss experiences. Strategies to overcome silence and invisibility on the part of service providers in the health and social services system are considered.

[Specialized mental health services for the elderly: a pilot study of the evaluation process]. / Services spécialisés en santé mentale pour les personnes de 60 ans et plus. Étude pilote de l'évaluation du processus.

In Quebec, the Centre de santé et services sociaux (CSSS) Cavendish offers specialized services for the elderly with mental health problems (SSSM 60+) (Nour et al., 2011a). This article describes a targeted segment of the population reached (considering the exclusion criteria, only 50% of the elderly receiving services from the SSSM 60+ were followed). The article presents the model of individual changes relating to services, and explores the psychosocial mediators that influence the efficiency of services. This population experiences various psychosocial problems, the most important being mild to moderate symptoms of depression. Services and interventions by the SSSM 60+ team appear to increase significantly the therapeutic alliance and the feeling of empowerment in this clientele. Prioritizing these two concepts during service delivery appears to be an avenue to consider.

[Palliative care practices at home: instead of social exclusion of older people in later life?]. / Les pratiques de soins palliatifs à domicile: lieu d'exclusion sociale des personnes âgées en fin de vie?

The understanding of palliative care practices at home (PCH) is limited by the lack of available scientific knowledge. This is explained by the fact that its practices are relatively recent and they question our relationship with death and dying individuals. This study aims to contribute to the advancement of knowledge about PCH with the elderly. More specifically, with a perspective of social exclusion, it aims to understand how practices either do or do not produce social exclusion with seniors receiving palliative care. Nineteen participants from two local community services centers were interviewed and six multidisciplinary meetings were attended for observation. This study suggests that positive representations concerning the elderly in palliative care and recognition of their autonomy can avoid social exclusion, including its symbolic and identificatory dimensions. However, standardization of practices seems to contribute to institutional exclusion and foster nonrecognition.