Direct Care Workers’ Perceptions of Care Towards Sexual and Gender Minority (SGM) Older Adults

Abstract

PURPOSE: The purpose of this study was to describe direct care workers’ (DCW) perceptions of the care provided to sexual and gender minority (SGM) older adults in the long-term care (LTC), assisted living, and home health settings.BACKGROUND: The intentional and unintentional behavior of those who provide healthcare to patients can impact positively or negatively the decisions made, treatment plan, health outcomes and overall well-being of patients. These intentional and unintentional behaviors by healthcare workers (e.g., any member of the healthcare team who cares for patients) can impact the care of marginalized populations. Marginalized populations, such as sexual and gender minority (SGM) older adults, suffer the greatest repercussions from negative behaviors by healthcare workers because these marginalized populations also often experience other obstacles to optimal care, such as environmental injustices, violence, prejudice, and being stereotyped, in addition to population-specific health concerns. DCW provide the closest interaction with SGM older adults in these settings. The perceptions of care DCWs provide to SGM older adults is important because the quality of care can be influenced by negative attitudes. METHODS: Qualitative description was used to synthesize what is known about DCWs’ perceptions of care toward SGM older adults. RESULTS: The overarching category, “Care is Different, but Not my Care,” was supported by the categories Cues of Stereotyping, Cues of Prejudice, and DCWs’ Care and Social System. DISCUSSION: Scant research on DCW perceptions of care toward SGM older adults living in LTC, assisted living, and home health settings exist. Cues of stereotyping and prejudice show indications of implicit bias in DCW statements toward SGM older adults. DCWs are a marginalized population which will need to be considered when developing future training in caring for SGM older adults in LTC, assisted living, and home health settings. IMPLICATIONS: Specific implications for practice, policy and future research are explicated to guide future interventions to ensure equitable, quality care in the healthcare setting.