Project Respect: LGBTQ+ Experiences with Healthcare Providers for Serious Illness (SA317A).

Outcomes: 1. Define the extent and type of disrespectful, inappropriate, and abusive practices faced by many lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals and their partners/spouses when receiving care for serious illness, including hospice and palliative care 2. Address the personal impact of serious illness care, including hospice and palliative care, on LGBTQ+ patients and families, and address such disparities of care at their institutions Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals experience discrimination in health care—including palliative, hospice, and long-term care. Providers and institutions may be uncomfortable with, and often don't ask patients about, sexual orientation and gender identity (SOGI). LGBTQ+ patients fear being open about their identities; not receiving equal, competent, or safe treatment; and having their family of choice and surrogates disrespected or ignored. This presentation reports on Project Respect, which describes care to seriously ill LGBTQ+ persons that was inadequate, disrespectful, or abusive due to SOGI. A mixed-methods study using an online survey was conducted. The sample was LGBTQ+ individuals with a serious illness, and partners/spouses and widows of such individuals. Respondents were recruited through organizations serving the LGBTQ+ community, older adults, and palliative and hospice care organizations. Questions included type of serious illness, healthcare services used, and whether and how care was inadequate, disrespectful, or abusive due to SOGI for both the patient and partner, and from healthcare professionals and from support staff. Of 225 respondents, 44% reported their healthcare provider was insensitive; 33% said providers were not aware of LGBTQ+ health needs; and one-quarter said their providers disregarded their treatment decisions, made them feel judged for being LGBTQ, used incorrect pronouns, were rude, refused or denied them care, and/or imposed their religious beliefs. Descriptions of poor care and how it is experienced are included. These findings provide strong evidence that LGBTQ+ patients and their partners often receive discriminatory care at very vulnerable moments of their lives. Disrespectful care can negatively affect patients' trust in providers and institutions, and lead to delaying or avoiding care, and not disclosing medical information. These findings have implications for staff training, practice, and institutional and public policy, including policy barriers to respectful and non-discriminatory care. [ABSTRACT FROM AUTHOR]