End-of-Life Preparation and the Role of Online Technology: A Comparison of Older Gay Men and Lesbians

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Paterson, Sarah
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Mount Saint Vincent University
End-of-life literature reflects the social determinants, resources, and services that can influence how one experiences EOL and the ways in which to prepare. However, what is currently missing from the available literature is how sexual orientation can influence the ways in which individuals think about or prepare for EOL. If experiences of lesbians and gay men (LG) are mentioned within the literature it is often as a comparison to their heterosexual counterparts, and the experiences of older LG individuals are even less documented. This portrays the LG population as a homogenous group and overlooks the potential for diversity within this minority population. This qualitative study aims to bridge that gap by exploring the similarities and differences between older lesbians and gay men in the way they think about and prepare for EOL, as well as the role that online technology plays in these preparations. A secondary data analysis of a subset of the “Fostering EOL Conversations, Community, and Care among LGBT Older Adults” research project was conducted, guided by minority stress theory and intersectionality. A content analysis of lesbian and gay men’s focus group interviews from British Columbia, Alberta, Ontario, and Nova Scotia was performed, assisted by the use of MAXQDA software for data management. Three main themes emerged from the analysis: (a) ways in which the men and women prepared for EOL, (b) concerns they had about aspects of EOL preparation, and (c) the role that online technology played in keeping LG older adults connected. More similarities than differences were found between the men and women. The areas where variation occurred were the configuration of social networks, openness to new relationships in later life, motivations for putting EOL documentation in place, and confidence in online technology abilities. These differences highlight the importance of looking deeper into the intersections of the older LG population. The diversity recognised within this population also leads to a number of policy and practice implications, including a reconfiguration of policies that uphold the prioritization of blood and marriage ties over LG networks in legal and health care environments, long term care reform to redefine what is considered appropriate residential placement for older LG adults, and working towards a national approach to EOL documentation terminology.
End-of-Life Preparation, sexual orientation, online technology