The Center for Healthy Aging staff and providers enrolled in training in order to learn cultural competency and inclusive care in order for aging LGBTQ+ patients to know they’re welcome, seen and safe in their care.
There are millions of LGBTQ+ people living in the United States. Despite the great strides made for LGBTQ+ rights in the past few decades, many of those people are not out. In fact, nine out of 10 LGBTQ+ people fear they will be discriminated against in a healthcare setting if their provider knows their sexual orientation or gender identity.
Located in the heart of Philadelphia’s Gayborhood, the Center for Healthy Aging at Thomas Jefferson University Hospital is the most accessible healthcare resource for many of the aging LGBTQ+ residents within the city. Recently, the team at the Center for Healthy Aging has embarked on a new initiative to improve upon cultural competency and inclusive care for the older LGBTQ+ population.
We spoke with Jefferson Health’s Dr. John Liantonio, geriatric medicine physician and hospice and palliative medicine fellowship director, and Dr. Michael Danielewicz, family and community medicine resident, about the steps their team is taking towards a more inclusive healthcare environment.
An Opportunity to Grow
Dr. Liantonio has been involved in the community’s LGBTQ+ initiatives for many years. “As a gay man in the medical community, I’m aware of my position of privilege and I have a social responsibility to give back,” he shares. He has worked with the LGBT Elder Initiative in Philadelphia, serving on their board and helping organize “The Doctor Is In,” a program that gives community members access to healthcare resources like educational talks and screenings.
With Jefferson’s location in the Gayborhood, Dr. Liantonio saw the opportunity for their team to provide better care and services for the aging LGBTQ+ population.
Many adults are forced back into the closet as they age because there are not a lot of safe spaces or resources to help them age well. We need to make sure that LGBTQ+ patients know they’re welcome and seen. – Dr. Liantonio
It’s important for geriatric healthcare professionals to be trained in cultural competency because the needs of the older LGBTQ+ population may be very different from those of the general public. “The LGBTQ+ population, which is made up of many different communities, faces a number of unique health challenges and equity issues. For instance, gender-affirming care is a specific need for members of the trans community; this includes hormone care. There’s also a higher rate, in general, of HIV, smoking and mental health issues among LGBTQ+ individuals,” says Dr. Danielewicz.
“There are a lot of places that specialize in geriatric care or LGBTQ+ care, but not both,” shares Dr. Danielewicz. The Center for Healthy Aging is looking to fill this need in the local community so aging LGBTQ+ people have access to high-quality primary care, feel comfortable coming into the office and can express themselves to staff and providers as they truly are.
Cultural Competency Training and Beyond
To become a resource for older LGBTQ+ adults in Philadelphia, the Center for Healthy Aging has enrolled staff and providers in SAGECare training. This program creates more LGBTQ+-welcoming communities by teaching healthcare professionals cultural competency for older LGBTQ+ adults, including proper terminology usage and baseline communication skills. “We’re pairing the SAGECare training with surveys of all providers and staff to determine what more we can offer to help them best improve the practice for LGBTQ+ patients,” says Dr. Danielewicz.
Once the cultural competency training is completed, the team has plans to educate staff and physicians even further. “As physicians, we want to be able to provide our patients with the best clinical care that’s appropriate for their situation. If we have a patient who is a trans male, we should be aware of screenings necessary to their care that may be traditionally categorized as women’s services. For our patients with HIV, we should be aware of drug management and other medical issues that may pop up as they age,” says Dr. Danielewicz.
Making a Difference
While the medical community still has work to do, Dr. Liantonio and Dr. Danielewicz have already seen the difference that SAGECare training has made in their relationships with patients.
Dr. Liantonio shares, “I’ve been in tune with the issues that come up with misgendering patients at the hospital. Our system lists the gender that is on a patient’s license, which many people can’t change. So now it’s even more important that I champion and advocate for those patients among their care team to make sure that they’re being addressed properly and they’re comfortable during their treatment and hospital stay.”
The training has also helped Dr. Danielewicz understand how to make a patient feel welcome in his care. “In med school, we’re taught to ask questions using specific terminology surrounding gender and family history. But not everyone identifies as male or female. And many people in the LGBTQ+ community rely more on their ‘chosen families’ than biological families, so it’s important to understand that when getting to know a patient and their needs,” he says.
Looking to the Future
As we’re all having more conversations about health equity among marginalized communities, it’s important to keep in mind that all people deserve access to quality healthcare. Dr. Liantonio says, “For people of color in the LGBTQ+ community, especially older adults, there’s so much they’re up against. This work is intersectional. We should be working towards health equity, cultural competency and sensitivity for all people, from cradle to grave. I’m excited that Jefferson has given us this platform and I’m looking forward to what we can accomplish together.”