Pride in Death.
Authors: Smith Valerie , Araya Paula Pinto , O'Hagan James 
Published: January 2024

Background: While all ageing populations share common concerns as they plan for old age and end of life, many older LGBTQIA+ people face significant additional challenges.

Prevailing social, religious, and cultural attitudes which existed in Ireland until relatively recently, mean older LGBTQIA+ people grew up in society where asserting their identity often led to exclusion and isolation.

Planning for end of life can make things easier but these factors create barriers for older LGBTQIA+ people who may fear that asserting their identity will lead to discrimination or neglect.

Research has demonstrated while many LGBTQIA+ people feel uncomfortable disclosing their sexual orientation to health care professionals and allied health staff they are also considerably more likely to rely on formal support services as they get older due to diminished support networks in comparison to their heterosexual peers.

During Palliative Care Week we encourage people to have tender conversations about death, dying and bereavement and what it means to them. Therefore we sought to engage and have honest conversations with the LGBTQIA+ community at a death cafe type event, to understand key issues for the community, relating to death and dying, and what really matters to them in planning ahead for their end of life care. 

Who Was Engaged: AIIHPC leads Palliative Care Week and engaged with LGBT Ireland as the gateway organisation to the LGBTQIA+ community. We also engaged with the Irish Hospice Foundation (IHF) who has expertise in advance care planning. Liz Gleeson from Shapes of Grief also joined as a facilitator given her expertise on bereavement. Bettina Korn also joined as a facilitator given her expertise as an end of life coordinator at St James Hospital and an LGBT Champion.

Impact:

- LGBTQIA+ Bereavement Support Groups are needed in the Republic of Ireland. LGBTQIA+ people suffer from ambiguous and complicated grief, making the creation of specific bereavement support groups essential.

- Intergenerational Networks. Younger and older LGBTQIA+ people want connect with one another. Currently spaces outside pubs are lacking.

- Creation of LGBTQIA+  Reference Group to co-design health information resources. LGBTQIA+ people do not see themselves reflected in the health information provided  and are thus, less likely to inform themselves.

- Need for creativity around funeral planning outside of religious rituals that mutes the voice of the individual.

Learning for an International Audience: By having honest conversations with people from different communities, we gain insight into their real needs. Sounds simple enough but open and honest conversations can only take place in a safe space where trust exists. Trust can be gained by working with gateway organisations of underrepresented communities, to ensure services are co-designed with the true individual at heart.

Next Steps:

- LGBTQIA+ death cafe being held on 8th of December in Dublin.

- Training of IHF Bereavement Support Line by LGBT Ireland

- Engaging with other gateway organisations of underrepresented communities such as homeless, refugees, people with disabilities, amongst others to provide a safe space for conversations to take place.