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Cited by 76LGBTQ Health, Identity, and PolicyPalliative Care and End-of-Life IssuesAging, Elder Care, and Social Issues

Staying Out of the Closet: LGBT Older Adults’ Hopes and Fears in Considering End-of-Life

Open access
Wilson, Kimberley, Kortes-Miller, Katherine, Stinchcombe, Arne·2018·Canadian Journal on Aging / La Revue canadienne du vieillissement
DOI 10.1017/s0714980817000514
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Abstract

RÉSUMÉLe vieillissement de la population canadienne et l’hétérogéneité des aînés amène une diversité accrue en fin de vie. L’objectif de cette étude était d’aider à combler les lacunes présentes dans la recherche du vieillissement et la fin de vie des personnes LGBT. À l’aide des groupes de discussion, nous avons tenté de mieux comprendre les expériences vécues des individus LGBT plus âgés, afin de mettre en évidence leurs inquiétudes associés aux dernières phases de la vie. Notre analyse démontre que l’identité LGBT est déterminante lorsqu’on considère le vieillissement et les soins en fin de vie. En particulier, l’identité de genre et l’orientation sexuelle sont des facteurs importants par rapport aux liens sociaux, influençant les attentes des individus envers les soins qu’ils reçoivent, à la crainte unique associée à la révélation de son homosexualité et le maintien de l’identité tout au long du vieillissement et des dernières phases de la vie. Cette étude souligne le besoin de considérer l’identité du genre et l’orientation sexuelle en fin de vie. En particulier, la reconnaissance de l’intersectionnalité et des lieux sociaux est essentielle afin de faciliter des expériences positives par rapport au vieillissement et des soins en fin de vie.

Integrity signals

Registry

Crossref · 10.1017/s0714980817000514

Cites

17 of 17 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 24 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    All participants in the study desired access to LGBT-friendly care, particularly primary care.

    “The experiences of heteronormativity were also reflected in the strong desire shared among all participants to have access to LGBT-friendly care, particularly primary care.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Through inductive analysis, the authors developed a thematic map that centred on the idea that identifying as LGBT matters when it comes to aging and end-of-life care.

    “Through our inductive analysis, we developed a thematic map that centred on the idea that identifying as LGBT matters when it comes to aging and end-of-life care.”
    Quote in the paperSubstantial claim
  • Findingown data

    Fears around social isolation and death were exacerbated for some participants who are without partners and without familial connections to advocate for them.

    “The fears around social isolation and death were exacerbated for some participants who are without partners and without familial connections to advocate for them.”
    Quote in the paperNot a substantial claim
  • Findingown data

    There were strong concerns from participants about increased risk for social isolation as a result of having no children.

    “Although many participants in our focus groups indicated that they had biological children, there were also strong concerns from others expressed about increased risk for social isolation as a result of having no children.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Participants identified their expectations, hopes, and fears around their care towards the end-of-life.

    “Within focus group discussions, participants clearly identified their expectations, hopes, and fears around their care towards the end-of-life.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 22
  • May combine two claims. 20

  • Classified as probably not a substantial claim.

    Findingown data

    The analysis of transcripts from three focus groups with older LGBT adults revealed an overarching theme, three main themes, and six subthemes.

    “The analysis of the transcripts from the three focus groups with older adults identifying as LGBT revealed an overarching theme, three main themes, and six subthemes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants in the focus groups were attuned to system-level barriers, and these were reflected in their discussions concerning social isolation, fears and hopes, and advocacy needs.

    “Participants in the focus groups were attuned to systemlevel barriers, and these were reflected in their discussions concerning social isolation, fears and hopes, and advocacy needs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Anxiety about social isolation was expressed not only about later stages of life but also specifically around dying and death.

    “Anxiety about social isolation was not only expressed about the later stages of life, but also specifically around dying and death.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants discussed concerns that many long-term care facilities were run by Catholic organizations and how this may impact their care.

    “Participants discussed their concerns about the fact that many of the long-term care facilities were run by Catholic organizations and how this may impact their care:”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Participants valued a physician who either identifies as part of the LGBT community or is a strong ally.

    “Participants expressed the value of a physician who either identifies as part of the LGBT community or is a strong ally:”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    Some participants believed that hiding one's sexual identity might be necessary in some institutions if older adults who identified as LGBT wanted to receive the same quality of care as their heterosexual counterparts.

    “Some participants shared that they believed that hiding one's sexual identity might be necessary in some institutions if older adults who identified as LGBT wanted to receive the same quality of care as their heterosexual counterparts:”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The need to advocate for individuals who identify as transgender was thought to be a priority.

    “In particular, the need to advocate for individuals who identify as being transgender was thought to be a priority:”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The overarching theme was 'identifying as LGBT matters,' encompassing social connections and support, expectations for care, and staying out of the closet.

    “The overarching theme,”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants expressed fears about the breakdown of supports as they grow older, and noted that this fracturing might contribute to the risk for social isolation for LGBT older adults.

    “Participants also expressed fears about the breakdown of supports as they grow older, and noted that this fracturing might contribute to the risk for social isolation for LGBT older adults.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants' concerns about access included access to a family physician in terms of proximity and in terms of LGBT-positive spaces.

    “many LGBT older adults cited concerns about access; for our participants this included access to a family physician both in terms of proximity and in terms of”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Focus group participants indicated that they are less likely to have spouses to fulfill caregiving requirements, which might have significant ramifications for the receipt of informal care.

    “While caregiving roles and the risk of social isolation are not unique to LGBT older adults, focus group participants indicated that they are less likely to have spouses to fulfill caregiving requirements, which might have significant ramifications for the receipt of informal care.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Only one Local Health Integration Network (LHIN) in Ontario collected orientation and identity.

    “with one pointing out that only one Local Health Integration Network (LHIN) in Ontario collected orientation and identity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A number of participants conveyed that they would not want to go back into the closet because they had worked hard for the right and freedom to express their identity and would not want it taken away from them.

    “A number of participants conveyed that they would not want to go back into the closet because they had worked so hard for the right and freedom to express their identity and would not want it taken away from them.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Although many participants were well resourced and knowledgeable about the health care system, this highly resourced group still expressed significant concerns and fears about their aging process and end-of-life.

    “Although many of our participants are well resourced and have knowledge about the health care system and this may be viewed a limitation of our current sample, it is important to note that this highly resourced group still expressed significant concerns and fears about their aging process and end-of-life.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A prominent system-level barrier was related to the collection of demographic information, or a lack thereof, which can lead to the invisibility of the LGBT population across the lifespan but particularly in late life.

    “A prominent system-level barrier was related to the collection of demographic information, or a lack thereof, which can lead to the “invisibility” of the LGBT population across the lifespan but particularly in late life.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Some participants perceived that LGBT individuals may be less likely to have children and thus less likely to have adult children to care for them as they approach end of life.

    “Some participants shared that some LGBT individuals may be less likely to have children and thus are less likely to have adult children to take care of them as they approach end of life;”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Discrimination and homophobia have detrimental psychosocial well-being consequences.

    “Negative consequences of such acts of discrimination and homophobia include detrimental psychosocial well-being (Haber, 2009) and barriers to care for older LGBT adults within health systems (Brotman, Ryan, & Cormier, 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haber, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Much of the literature highlights the need for increased education for service providers to increase cultural competency related to LGBT aging and reduce heteronormativity within health systems.

    “To date, much of the literature in this area highlights the need for increased education for service providers to increase the cultural competency related to LGBT aging and to reduce heteronormativity within health systems (Aldredge & Conlon, 2012;Arthur, 2015;Griebling, 2016).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Aldredge & Conlon, 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Arthur, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Griebling, 2016 source

  • May combine two claims.

    Interpretationreasoning

    Much of the research on LGBT aging originates from the United States, Australia, and the United Kingdom, and their findings are not necessarily generalizable to Canadian contexts because their systems and medico-legal contexts are not directly comparable to Canada's.

    “Although much of the research on LGBT aging originates from the United States, Australia, and the United Kingdom, their systems and medico-legal contexts are not directly comparable to Canada's, and thus their findings are not necessarily generalizable to Canadian contexts.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Older LGBT adults may experience disenfranchisement, isolation, and anxieties of being discriminated against due to sexuality as they near end-of-life.

    “Furthermore, feelings of disenfranchisement, isolation, and anxieties of being discriminated against due to sexuality have been identified in previous research as negative emotions that older LGBT adults may experience as they near end-of-life (Arthur, 2015;Brotman et al., 2007;Kimmel, 2014).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Arthur, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Brotman et al., 2007 source
    • cites Kimmel, 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    All participants received an information letter and provided informed consent.

    “All participants received an information letter and provided informed consent.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Many LGBT communities and older adults who identify as LGBT have experienced discrimination.

    “Many gay, bisexual, and transgender (LGBT) communities, and older adults who identify as LGBT, have experienced discrimination (Averett, Yoon, & Jenkins, 2011;Haber, 2009;Kimmel, 2014).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Averett, Yoon, & Jenkins, 2011 source
    • cites Haber, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Kimmel, 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    None of the participants withdrew from the study.

    “None of the participants withdrew from the study, and participants were reimbursed for costs incurred while participating, such as for travel and parking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study received approval from the Research and Ethics Board (REB) at the University of Guelph, Ontario.

    “The study received approval from the Research and Ethics Board (REB) at the University of Guelph, Ontario.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Education in LGBT cultural competency is mutually beneficial between service provider and patient.

    “Education in LGBT cultural competency has been shown to be mutually beneficial between service provider and patient, with work from Porter and Krinsky (2014) indicating that such training can increase the levels of comfort a service provider feels when treating or providing care to an individual who is not heterosexual.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Porter and Krinsky, 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    LGBT cultural competency training can increase service providers' comfort when treating or providing care to an individual who is not heterosexual.

    “Education in LGBT cultural competency has been shown to be mutually beneficial between service provider and patient, with work from Porter and Krinsky (2014) indicating that such training can increase the levels of comfort a service provider feels when treating or providing care to an individual who is not heterosexual.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Porter and Krinsky, 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A key lesson from this work involved the need to build rapport and trust as relative outsiders.

    “Another key lesson from this work involved the need to build rapport and trust as relative “outsiders”.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    The less visibility of LGBT older adults is reflected in epidemiological gaps, research and policy, and clinical care.

    “This is reflected in epidemiological gaps, research and policy, and clinical care.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Despite policy advancements around equal rights related to sexual orientation, gaps remain in the rights related to gender identity.

    “Furthermore, despite policy advancements around equal rights related to sexual orientation, gaps remain in the rights related to gender identity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Gender identity and sexual orientation matter when it comes to social connections later in life, in the expectations that individuals have for their own care, and in the unique fear related to staying out of the closet and maintaining identity throughout aging and end-of-life.

    “In particular, gender identity and sexual orientation matter when it comes to social connections later in life, in the expectations that individuals have for their own care, and in the unique fear related to staying out of the closet and maintaining identity throughout aging and end-of-life.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The experiences and needs expressed by this sample of 23 mostly highly educated, advocate participants in Ontario can be generalized to older LGBT adults more broadly.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The analysis used an inductive thematic analysis approach with collaborative coding and review to ensure agreement and accuracy.

    “We then analysed transcripts using an inductive thematic analysis approach (Braun & Clarke, 2006).”
    • Also stated in: § Procedure · plain
      “Members of the research team reviewed all coding to ensure that there was agreement and accuracy within the coding process and thematic analysis.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Braun & Clarke, 2006 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In one focus group, the researchers were explicitly questioned about their positionality and commitment to valuing the voices of their LGBT participants.

    “In one focus group, we were explicitly questioned about our positionality and commitment to valuing the voices of our LGBT participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Gaining trust within that particular focus group required reflexivity and debriefing in order to proceed with the research.

    “This was an important component of gaining trust within that particular focus group, and as a research team this required reflexivity and debriefing in order to proceed with our research.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study conducted focus groups in three different regions in Ontario but did not include rural or remote regions.

    “Although we conducted focus groups in three different regions in Ontario, the study did not include rural or remote regions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Although social policy advancements have been made to promote greater equality, individuals growing older who identify as LGBT are one particular group that has remained less visible.

    “Although social policy advancements have been made to promote greater equality, individuals growing older who identify as LGBT are one particular group that has remained less visible.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Fears around staying out of the closet and around institutionalization, coupled with the need for different social support networks, are salient for older LGBT adults.

    “In particular, fears around staying out of the closet and around institutionalization, coupled with the need for different social support networks, are salient.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The experiences and needs expressed by this sample of 23 mostly highly educated, advocate participants in Ontario can be generalized to older LGBT adults more broadly.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Within each community, a key to the recruitment strategy was working with community agencies and having a champion who supported the research.

    “Within each community, a key to our recruitment strategy was working with community agencies and having a champion who supported our research.”
    Quote in the paperNot a substantial claim
37 of 37

  • The paper relies on this without support.

    Health research, health education, and health care landscapes in Canada have not fully accounted for the unique health needs of LGBT older adults.

    “Despite recent legislative action to grant equal rights to LGBT individuals (e.g., the Civil Marriage Act), health research, health education, and health care landscapes in Canada have not fully accounted for the unique health needs of LGBT older adults.”

  • The paper relies on this without support.

    Participants in this study grew up during a time when same-sex relationships were often hidden and even considered to be illegal.

    “Participants in this study grew up during a time when same-sex relationships were often hidden and even considered to be illegal.”

  • The paper relies on this without support.

    The intersection of age and gender identity/sexual orientation is an important consideration given the potential for the layering of ageism with discrimination.

    “The intersection of age and gender identity/sexual orientation is an important consideration given the potential for the layering of ageism with discrimination.”

  • The paper relies on this without support.

    The experiences and needs expressed by this sample of 23 mostly highly educated, advocate participants in Ontario can be generalized to older LGBT adults more broadly.

    “Older LGBT adults have unique needs and expectations when it comes to aging and end-of-life.”
    “Although our participants were diverse in terms of self-identified sexual orientation, they were otherwise a fairly homogenous sample.”

  • The paper relies on this without support.

    The baby boom generation (and those older) experienced significant shifts in how the legal system addresses the rights of LGBT individuals, and this may have been a unique feature of aging for this cohort.

    “however, the baby boom generation (and those older) experienced significant shifts in how the legal system addresses the rights of LGBT individuals, and this may have been a unique feature of aging for this cohort.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Many LGBTQ+ older adults are terrified of the notion of moving into a nursing home due to awareness that they may be in greater physical or emotional danger or forced back into the closet.

    “It is also documented that many LGBTQ+ older adults are terrified of the notion of moving into a nursing home due to awareness that they may be in greater physical or emotional danger or forced back into the closet (Singleton, 2018; Wilson et al., 2018; Knochel and Flunker, 2021).”

    From Algorithmic harms and digital ageism in the use of surveillance technologies in nursing homes (2022) · cites this paper as Wilson et al., 2018

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Wade, 2015, The social dimensions of health and health care in Canada

Cited by

Sorted by citations

Related

Authors
Wilson, K., Kortes-Miller, K., & Stinchcombe, A.
Affiliations
  • University of Guelph (CA)
  • Centre for Education and Research on Aging & Health (CA)
  • University of Ottawa (CA)
Corresponding author
Wilson, Kimberley
ORCID
Venue
Canadian Journal on Aging / La Revue canadienne du vieillissement
Publisher
Cambridge University Press (CUP)
Published
2018-01-16
Volume
37
Issue
1
Pages
22-31
ISSN
  • 0714-9808 (ISSN-L)
  • 1710-1107
DOI
10.1017/s0714980817000514
OpenAlex
W2783159496
Semantic Scholar
e5c33d100886051e9af8d8194058c08a7ec1004f
Cited by
76
References
17
Citations by year
2026: 6 · 2025: 6 · 2024: 11 · 2023: 12 · 2022: 16 · 2021: 8 · 2020: 6 · 2019: 8 · 2018: 3
FWCI
8.48
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Canadian Journal on Aging / La Revue canadienne du vieillissement (publishedVersion)
  • PubMed (publishedVersion)
  • Project Muse (Johns Hopkins University) (submittedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
Keywords
LGBT older adults, end-of-life care, LGBTQ identity, gender identity, sexual orientation, social networks, intersectionality, aging, end-of-life experiences, care expectations
MeSH terms
Sexual and Gender Minorities, Aged, Aging, Fear, Female, Gender Identity, Health Services Needs and Demand, Humans, Male, Middle Aged, Ontario, Quality of Life, Social Isolation, Terminal Care, Focus Groups, Qualitative Research, Hope

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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