Evaluating and optimizing rural and urban lesbian, gay, bisexual, transgender, queer, intersex, and Two-Spirit (LGBTQI2S) engagement with hospice and palliative care in the Island Health Region

This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and Victoria Hospice (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.

Existing research focused on the experiences of gay and lesbian older adults with the health care system report that there is a general distrust and reluctance to access healthcare based upon the cumulative effect of discrimination over the life course. At present, while 75% of Canadians have indicated they would like to die at home, 45% of Vancouver Island residents die of in acute care. Clearly there exists a service gap and it appears possible that such a gap may be larger in the LGBTQI2S community. It is therefore vital to explore the level of LGBTQI2S engagement with hospice and palliative care, in order to ensure this population is not further marginalized in end-of-life. Victoria Hospice and Island Health will facilitate access to healthcare service providers, and I will recruit rural and urban LGBTQI2S participants and their families throughout the Island Health region via the relationships I have built with community gatekeepers. A Participatory Action Research strategy will be used and a Community Steering Committee of older LGBTQI2S people representing various geographies as well as sexual orientations and gender identities will be established. The Community Steering Committee will become an integral part of the Project Working Group, comprised of healthcare service providers, Island Health, Victoria Hospice, and the University of Victoria supervisory team and will be integrated into every step of the research process including development of research questions, refining research objectives, participant recruitment, data collection and analysis, evaluation of our findings, and knowledge translation.