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The acronym LGBT refers to groups of people who are lesbian, gay, bisexual and transgender, groups historically marginalized, mistreated, ignored by society and the health care delivery systems, including hospice and palliative care services. The purpose of this litera- ture review was to explore the characteristics, history, health and health care disparities, social support systems and legal issues of LGBT persons with a particular focus on older adults, end- of-life care, and ways in which hospice and palliative care organizations can better meet their needs. Despite the fact that sound enquiry is needed to improve health-related outcomes, what little research has been done with LGBT adults in general and, specifically, with older LGBT adults, has focused mainly on HIV/AIDS and other sexually transmitted diseases. As a social minority, LGBT persons are more likely to experience economic insecurity, lack health insur- ance, experience invisibility, and be victimized and mistreated. This is especially true of older LGBT adults who grew up in a less tolerant era when sexual minorities were criminalized and stigmatized as pathological, sinful, and immoral. Their minority status has led to health issues and health care disparities, and requires health professionals to consider systems in a way that redefines family, addresses legal concerns, and responds with options of care unlike those of their heterosexual counterparts. With recent changes in societal attitudes and some progress in addressing legal concerns, hospice and palliative care organizations now have a unique op- portunity to lead the health care community by pioneering culturally sensitive and appropriate methods to better serve this population.

palliative medicine and hospice care

Hospice and Palliative Care for Older Lesbian, Gay, Bisexual and Transgender Adults: The Effect of History, Discrimination, Health Disparities and Legal Issues on Addressing Service Needs