Gay Boomers and nursing attitudes

Noryn · Oct 11, 2007

Are you sure there are no queer folks living in your facility? I think this is the point of the the NY Times article. When you say "We do not have this phenomenon" I suspect you meant that you do not have out gay residents that are isolated by other residents. But perhaps you have queer residents that are afraid to be out.
You do not make it point of letting your healthcare provider know that you are straight because it is expected that you are. Gays and lesbians, however, sometimes have different health needs from straight people. And in a LTC environment they most definately have different needs.While I very much agree with you that people should not be discriminated against because of their sexuality I disagree when you suggest that sexual orientation does not matter - it very much does.

See my above post, I was referring to Ahmadenijad or however you spell his name. I do not work in a facility anymore btw.

I do have a few questions though. What are the different health needs a gay boomer would need? What are the different needs in a LTC environment that a straight person would not need? I personally feel that sexual orientation doesnt matter--in the end we all need relationships, stable support systems, respect and love--gay or straight.

cmo421 · Oct 11, 2007

http://thelpkids.com/page/9/

I am not sure who was reported or not. I am sure that there is some type of legal action or I would hope. I do know that some states have enacted laws based on this story to prevent it from happening again. This is a link to the families site where more info is available.

kanzi monkey · Oct 11, 2007

See my above post, I was referring to Ahmadenijad or however you spell his name. I do not work in a facility anymore btw.
I do have a few questions though. What are the different health needs a gay boomer would need? What are the different needs in a LTC environment that a straight person would not need? I personally feel that sexual orientation doesnt matter--in the end we all need relationships, stable support systems, respect and love--gay or straight.

I see what you're saying, but we also have to acknowledge individual needs that may be culturally based. See my above post about the transgender pt who didn't want to talk about her prostate.

It's like giving any culturally competent care--doing our best to address specific needs that may be different from our own while recognizing and keeping in check our own biases and potential stereotypes.

One thing I think may be universal in the gay community is the pt's personal history of discovering his/her sexual preference. Depending on how it was accepted in the family, by the peers, revealed or hidden may have an impact on how a interprets relationships, support, respect and love. Many of my gay friends have experienced overwhelming loss in their lives d/t the AIDS epidemic--this has a psychological impact on them. Also is their anything in their own health history that may not have been addressed? Undisclosed risk factors?

This info may not be delineated in a pt. chart, but we can listen, assess mood, look for openings. Sure we might say or do something stupid--like, I could make up a name for the prostate the next time I have a transgender pt--you know, to be culturally sensitive--, and she could be like "what, you mean my prostate you idiot?"

czyja, MSN, RN · Oct 11, 2007

Kanzi writes - "Many of my gay friends have experienced overwhelming loss in their lives d/t the AIDS epidemic--this has a psychological impact on them."

This is exactly the kind of situation I was thinking of.

For example, recent research has show that Holocuast survivors frequently have special needs as they age especially if they have dementia. I am not (please read again not) comparing the AIDS epidemic to the Holocaust. It is, however, reasonable to infer that a client that survived major emotional trauma may have different needs as they age. Does anyone know about LTC of verterans?

Additionally, gay people often have "non-traditional" families that are not recognized or protected by either custom or law. This may present special challenges to the caregiver.

Noryn - I appreciate your desire to give the same care to all people and I reckon you are an awesome nurse, so I am loathe to be critical of your position. But I think and earlier poster hit the nail on the head when she indicated that if she ignored the very real cultural differences among her patients she would be interposing her own cultural norms into their care.

Recognizing cultural difference does not automatically mean discrimination. Recognizing difference is at the core of cultural competence. An earlier posted suggested that she did "not care about what people did in their bedrooms." Being queer is alot more than "sexual preference" - it's a cultural thing.

deehaverrn · Oct 11, 2007

While I don't practice in a LTC area, this issue has come up often in our area..Maternity. Some of my coworkers have refused to even care for these famiilies. I chose to care for anyone without discrimination to the best of my ability, regardless of their differences. Our policies have not always coincided with their requests and I have always tried to adjust as much as I could while maintaining patient safety. The only time that I have ever run into any problem is when a woman being induced was permitted to shower with the doctor's order saying that she was to be allowed off monitoring for 20 minutes total. She and her female partner were showering together ( and most obviously engaging in heavy petting), they refused my request to leave the shower..which tried twice. I explained to them that they were jeopardizing the safety of mom and baby, especially since this stimulation could increase her contractions, and then finally left them alone. She was off the monitor for at least an hour ( my shift had ended by the time they left the shower room). I'm not sure if I wasn't "culturally competent" enough to care for them. Yes, I was offended at their behavior, but I would have been just at offended if they were a female/male couple. I just don't believe that intimate behavior is a public thing. This particular couple continued to stretch the limits of acceptable behavior throughout their stay. My biggest problem with them, however, was that they had a problem with me! They actually complained about me interferring with their relationship and told my supervisor that I was prejudicial towards gay relationships! Anyway, I have refused to let "one bad apple spoil the whole bunch". I have been part of some truly special births with both men who have engaged a surrogate mother and lesbian couples. They were more supportive and loving towards the birthing mother and newborn than many traditional couples.

The thing is ..I try to do my best for my patients, and meet her needs, in conjuction with her family and partner, as best as I can. I'm not saying that I always know every cultural nuance, or agree with them. I'm just there to help her have the best birth experience possible.,not to pass judgement. The only thing is...I don't think that I need to learn every cultural situation for example I refuse to learn Spanish even though we have a large population here although I do know some pertaining to childbirth.

My personal beliefs are often in conflict with the situation of many of my patients as far as their lifestyle choices, but I do not allow that to interfere with competent caring nursing. The only assignment that I do refuse is termination of pregnancy. I deserve some cultural understanding too..and in my state this is a protected personal choice for nursing staff.

fronkey bean · Oct 11, 2007

I read an interestiing article, in the NYT, today. Apparently the first wave of gay boomers have begun to hit our LTC, Assisted Living, home health agencies. And more and more of them are being belittled, receiving less then quality care, being transfered to units that are not appropriate to them because of other residents. I am wondering, has anyone encountered this yet? What has happen? What is your attitidue? What is being done to correct the problems?
Woody:balloons:

Woody do you have a link to the article, I couldn't find it. It is so hard for me to understand how nurses can treat people badly based on their opinions of the pts lifestyle, color, or what ever. A hurting pt needs care not condemnation. No matter how they got in the position they are in it is too late now to go back and do things differently, so nurses need to deal w/ all people compassionately and professionally. As far as how to correct the problem, the same way you would any time there is pt abuse. Turn the nurse into mgmt.

I will be interested too see how this thread plays out. I think in todays age we have to be aware of all the different walks of life and learn tolerance and respect. Last year there was a same sex couple boarding a cruise when one suffered a major head bleed. She was transfered to a local hospital and her life partner was denied access to her and denied a play in decisions even though they had a living will. I am not 100% certain of all details,but I know that they had children who were devestated by this event and the treatment of their MOM's. Hospital nurses and doc were rude and disrespectful to the family. The pt died without her lifepartner with her.

I didn't get a chance to read the article to see if there was other family involved so forgive my uninformed opinion. I don't work in long term, but in ICU we often have conflicts b/t various factions w/i families and unfortunately, whoever is next of kin if there is not a power of attorny gets the final say. There needs to be some legislation passed allowing life partners to be next of kin. In the meantime, the gay community should be made aware that they can give their life partner power of attny and that should solve any issues w/ parents or siblings trying to take over.

Nurses must advocate for the clients. I would also suggest that gay and lesbian nurses have a special obligation to look after their elders and advocate for them when they cannot advocate for themselves. It's the right thing to do.
Nurses have an obligation to look after their population of pt's as a whole.I appreciate the basics of ur writing but if gays must look after gays,then catholics must look after catholics,jews to jews, ....we have a responsibility to everyone in our focus of care. I do not think we need to know the sexual orientation of anyone,just treat them fairly as their family,whomever they may be!

I disagree. All nurses have an obligation to care for every pt in a compassionate and professional manner. I do not have to be gay to advocate for my gay pt. It is the right thing for all nurses to advocate for those who can't look after themselves.

Thank you for your thoughtfull reply. I agree that nurses must look after all of their clients and I certainly dont advocate the balkanization of care along religious/sexual/ethnic lines. I do however think that queer nurses might be more likely to see a discrimination/isolation problem that might otherwise elude a straight nurse. And certainly feel that queer youth in all professions must serve as advocates for their elders.

Am I missing something? I was not aware that "queer" was an acceptable way to refer to homosexuals. Am I behind the times of what?

cmo421 · Oct 11, 2007

I disagree. All nurses have an obligation to care for every pt in a compassionate and professional manner. I do not have to be gay to advocate for my gay pt. It is the right thing for all nurses to advocate for those who can't look after themselves.

The first part of that was not mine, I messed up in quoting. I agree with what u say 100 %. Also that family did have all the paper work,it was not acknowledged or accepted.

Am I missing something? I was not aware that "queer" was an acceptable way to refer to homosexuals. Am I behind the times of what?

THANK YOU, I have been thinking it as my hair stands on edge but was

unsure how to approach it.

James Huffman · Oct 11, 2007

Yeah that was such a joke. See this is off topic (sorry) but that is why I dont care to allow these leaders like that here to talk. It is so easy to call them out on things. Actually there probably are a much lower proportion of gays in Iran because they kill them. Which gets us right back onto topic. As civilized and advanced as we think we have become, we still often tolerate horrible actions against our fellow man (and woman).

As an American, I have difficulty complaining about the leaders of other countries. With 655,000 Iraqis dead because of the US invasion, it's hard for me to get worked up over President Aminijad's idiot comments.

Noryn · Oct 11, 2007

My basic premise is this, we are all human beings and share the same basic needs--be it food, water, love, etc. When we are deficient in one then that is when problems can develop. Gay, Straight, Black, White, Christian, Muslim, etc--doesnt matter.

My point is that your sexual orientation generally doesnt matter as far as medical treatment goes. If you have a prostate, it doesnt matter if you are gay, transgender, straight, etc. It should be checked, but ultimately that is up to the patient. There is a high incidence of older straight males who do not want to talk about their prostate as well and will refuse any testing. That is why I am unaware of any specific health need that is unique only to the Gay Boomers. The males statistically may have a higher incidence of hiv but that doesnt mean that a straight female doesnt have it as well.

As Czyja posted about the Holocaust survivors. Their issues are not directly related to being Jewish. Their issue however is directly related to being abused, tortured, and having atrocities committed against them by a mad man. Likewise, any individual who has been through abuse, rape or tragedy will likely have some issues.

So my main point is this, we are all unique individuals. Sexual orientation should not change how we treat people one way or the other. A gay person faces alienation from family after coming out. That to me is not an issue of sexual preference. That is an issue of the actual family member having issues, being prejudiced, etc. So yes the issue does affect the gay person but the true cause is not that they are gay, it is the family members reaction, behaviors and thoughts. A gay person may have lost a good number of friends to AIDS, so could a straight person. I think it goes much deeper than sexual preference to events in a person's life.

Noryn · Oct 11, 2007

As an American, I have difficulty complaining about the leaders of other countries. With 655,000 Iraqis dead because of the US invasion, it's hard for me to get worked up over President Aminijad's idiot comments.

Well I do agree with you but the post is not about Iraq, it is about gay boomers. I was making light of his idiotic comment and I was also explaining how gays are still killed just for being gay. This current administration is a horrible failure I wont argue that. I wont disagree with the fact that Iraqis have suffered and died but I dont think that this issue should overshadow the tragedies other groups face as well.

In Iran and all around the world (including here in the US), it goes far beyond the "idiotic comments" to abusing and killing gays. Is it a tragedy in Iraq? Absolutely, is it also a tragedy in Iran, again absolutely.

woody62, RN · Oct 11, 2007

Woody do you have a link to the article, I couldn't find it. It is so hard for me to understand how nurses can treat people badly based on their opinions of the pts lifestyle, color, or what ever. A hurting pt needs care not condemnation. No matter how they got in the position they are in it is too late now to go back and do things differently, so nurses need to deal w/ all people compassionately and professionally. As far as how to correct the problem, the same way you would any time there is pt abuse. Turn the nurse into mgmt.

Sorry, I don't. You can go to the NYT website and look in their archives but you will have to pay for the article.

Woody

lpn2rnstudent, LPN, RN · Oct 11, 2007

What does a homosexual patient of an ALF or LTC facility require that a heterosexual patient does not?

I am thinking through all of my years as a LPN and honestly I cannot think of one patient telling me their sexual orientation.

If everyone treated everyone with respect and dignity this would not be an issue.