Evidence Brief: Elder Abuse in the 2SLGBTQ+ Community

Published On 2023/6/16

This knowledge synthesis reports on the literature on the abuse of older adults who identify as 2SLGBT+ (Two-Spirit, lesbian, gay, bisexual, trans, queer plus) published in the past decade (2013-2023). Although there is not a great deal of literature prior to 2013, what we do have indicates that 2SLGBT+ older adults face particular vulnerabilities that can make them experience elder abuse in ways that are specific to their communities and that can present additional barriers to their health and well-being. Objectives (1) synthesize existing knowledge related to 2SLGBTQ+ elder abuse and determine knowledge gaps (2) identify and evaluate the nature of the academic literature, including methodologies and data sources; (3) create an evidence-based agenda for future research and advocacy in the area of 2SLGBTQ+ elder abuse; and (4) where evidence and data are lacking, our work will highlight the gaps in order to help shape future data policies and research agendas.

Published On

2023/6/16

Authors

Gloria Gutman

Gloria Gutman

Simon Fraser University

Position

Professor Emerita Gerontology

H-Index(all)

27

H-Index(since 2020)

16

I-10 Index(all)

0

I-10 Index(since 2020)

0

Citation(all)

0

Citation(since 2020)

0

Cited By

0

Research Interests

Gerontology

disasters

health promotion

housing

elder abuse

University Profile Page

Claire Robson

Claire Robson

Simon Fraser University

Position

H-Index(all)

6

H-Index(since 2020)

5

I-10 Index(all)

0

I-10 Index(since 2020)

0

Citation(all)

0

Citation(since 2020)

0

Cited By

0

Research Interests

University Profile Page

Kathleen Reed

Kathleen Reed

Vancouver Island University

Position

Assessment & Data Librarian ; PhD Student Simon Fraser University

H-Index(all)

5

H-Index(since 2020)

5

I-10 Index(all)

0

I-10 Index(since 2020)

0

Citation(all)

0

Citation(since 2020)

0

Cited By

0

Research Interests

transgender and non-binary youth

surveillance

privacy

digital humanities

research methods

University Profile Page

Other Articles from authors

Gloria Gutman

Gloria Gutman

Simon Fraser University

A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers

ObjectivePaucity of information concerning the efficacy of gerontechnologies to support aging in place among community-dwelling older adults prevents potential users, healthcare professionals, and policymakers from making informed decisions on their use. The goal of this study was to identify gerontechnologies tested for home support in dyads of community-dwelling older adults with unimpaired cognition and their family caregivers, including their benefits and challenges. We also provide the level of evidence of the studies and recommendations to address the specific challenges preventing their use, dissemination, and implementation.MethodsWe conducted a systematic review of the literature published between 2016 and 2021 on gerontechnologies tested for home support in dyads. Two independent reviewers screened the abstracts according to the inclusion/exclusion criteria. A third reviewer resolved eligibility discrepancies. Data extraction was conducted by two independent reviewers.ResultsOf 1,441 articles screened, only 13 studies met the inclusion criteria with studies of moderate quality. Mostly, these gerontechnologies were used to monitor the older adult or the environment, to increase communication with family caregivers, to assist in daily living activities, and to provide health information. Benefits included facilitating communication, increasing safety, and reducing stress. Common challenges included difficulties using the technologies, technical problems, privacy issues, increased stress and dissatisfaction, and a mismatch between values and needs.ConclusionOnly a few gerontechnologies have proven efficacy in supporting …

Gloria Gutman

Gloria Gutman

Simon Fraser University

Anxiety symptoms and coping strategies used by older adults during COVID-19: A national e-study of linkages among and between them.

BackgroundDuring the COVID-19 pandemic older adults experienced a variety of symptoms of anxiety. They employed a number of different strategies to deal with these. The aim of this study was to create a blueprint of older Canadians’ symptoms of pandemic-related anxiety and coping strategies, and linkages among and between them. Particular attention was paid to identifying the most-pernicious symptoms and variables that might facilitate application of the most beneficial coping strategies.MethodsAn e-survey was conducted with 1,327 older Canadians in the Summer of 2022, when public health measures were lifting across Canada. Anxiety was measured using the Geriatric Anxiety Scale− 10. Participants also completed the Coping with Stress and Anxiety personal assessment tool. Network analysis permitted us to examine linkages among respondents’ self-reported symptoms, and between their most pernicious symptoms of anxiety and the strategies to cope with them.ResultsFindings revealed a troubling trio of anxiety symptoms of central importance to our respondents: feelings of restlessness, muscle tension and having no control over their lives. Restless and no control over my life were particularly pernicious because they explained between 64–68% of the variance in 8 other anxiety symptoms. Coping seemed to occur through trial and error. Some strategies appeared to work in tandem and others in opposition to each other. Responders remembering resilience and staying active functioned as bridges shielding older people from worry, restlessness, and tension through spurning other remedial actions.DiscussionThis study …

Claire Robson

Claire Robson

Simon Fraser University

OBM Geriatrics

The Indigo Project: Participatory Action Research with Gender and Sexual Minority Survivors of Elder Abuse

Though research suggests that older adults belonging to gender and sexual minorities (GSM) are at greater risk of abuse and neglect, more needs to be done to investigate this situation, provide solid data, offer support to survivors and better inform those providing services. This article reports on a participatory action research project in which nine older adults with lived experience of abuse were interviewed, as were the seniors’ programmer from our community partner organization and a trauma counsellor who supported our participants throughout the project. Participants were interviewed at least twice, often more, and the resulting interview transcripts were edited with the help and consent of the participant concerned, to form narratives which were content-analyzed. The goals of the project were to raise awareness of the underreported issue of abuse of elder GSM individuals, to consider how elder abuse might both differ and look the same as it does in the mainstream population, and to offer mental health supports and safe spaces for healing for our participants. This deep dive into lived experience illuminates how homophobia and transphobia (both historic and contemporary) play out in subtle and complex ways. We conclude with recommendations for researchers and care/service providers.

Gloria Gutman

Gloria Gutman

Simon Fraser University

OBM Geriatrics

The Indigo Project: Participatory Action Research with Gender and Sexual Minority Survivors of Elder Abuse

Though research suggests that older adults belonging to gender and sexual minorities (GSM) are at greater risk of abuse and neglect, more needs to be done to investigate this situation, provide solid data, offer support to survivors and better inform those providing services. This article reports on a participatory action research project in which nine older adults with lived experience of abuse were interviewed, as were the seniors’ programmer from our community partner organization and a trauma counsellor who supported our participants throughout the project. Participants were interviewed at least twice, often more, and the resulting interview transcripts were edited with the help and consent of the participant concerned, to form narratives which were content-analyzed. The goals of the project were to raise awareness of the underreported issue of abuse of elder GSM individuals, to consider how elder abuse might both differ and look the same as it does in the mainstream population, and to offer mental health supports and safe spaces for healing for our participants. This deep dive into lived experience illuminates how homophobia and transphobia (both historic and contemporary) play out in subtle and complex ways. We conclude with recommendations for researchers and care/service providers.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Mentally healthy living after social distancing in later life: A national snapshot

MethodsData were collected in a national esurvey (June-August 2022). Our sample of community-dwelling older persons (N= 1,327) was stratified by age, sex, and education to approximate the Canadian population. 3 The short lay-friendly GAS-104 (α=. 747) and a mentally healthy coping strategies checklist5 were adopted to minimize responder burden and maximize participation.Older Canadians’ heightened risk for the physical harms of COVID-191, 2 could make their return to a world without social distancing especially anxiety provoking. When public health restrictions were lifting in the Summer of 2022, we asked Canadians 60+ years of age:(1) How would you rate your anxiety?(2) Which mentally healthy living strategies are you using to manage it? Thus the aim was to identify anxiety-related strategies of significance.

Claire Robson

Claire Robson

Simon Fraser University

Elder abuse in the LGBTQ2SA+ community: The impact of homophobia and transphobia

This book describes and analyzes the lived experience of elder abuse from the queer community. It discusses the experiences by transwomen, gay men and lesbians of financial abuse, physical and sexual abuse, homophobic abuse, and neglect within partner relationships, residential care, in home care, and religious organizations. Queer and trans elders have been described as ‘The Silent Generation’, since they have lived through times when their sexual and gender identities were criminalized and pathologized. The book shows that they are far more at risk to suffer abuse and neglect by those they should be able to trust, since they are more likely to have encountered all key risk factors, such as isolation, previous abuse and trauma, and mistrust of the health care system. Their vulnerability has been overlooked and this book addresses that gap. As such, this book provides a great resource to anyone working with elders, including medical professionals, care providers, police, counsellors, and policy makers.

Claire Robson

Claire Robson

Simon Fraser University

Interview with Courtney Dieckbrader: Seniors’ Program Specialist at QMUNITY

Courtney Dieckbrader is the specialist in Seniors’ Programming for QMUNITY, the British Columbia (BC) queer, trans and Two Spirit Resource Center. As such, she receives many direct inquiries from 55+ elders across the province and is the person who fields these inquiries and attempts to find and offer support and resources to GSM elders across the province. In this interview, Dieckbrader talks about QMUNITY’s goals in partnering with SFU’s research team on the Indigo Project, QMUNITY’s ongoing role in providing therapeutic support to participants, and also, some of the project’s chief challenges and achievements.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Canadian Journal on Aging/La Revue canadienne du vieillissement

Primary care physicians’ and hospitalists’ experience with advance care planning with South Asian Canadian older adults before and during COVID-19

Few older adults discuss their end-of-life care wishes with their physician, and even fewer minorities do this. We explored physicians’ experience with advance care planning (ACP) including the barriers/facilitating factors encountered when initiating/conducting ACP discussions with South Asians (SA), one of Canada’s largest minorities. Eleven primary care physicians (PC) and 11 hospitalists with ≥ 15 per cent SA patients ≥ 55 years of age were interviewed: 10 in 2020, 12 in 2021. Thematic analysis of transcripts indicated that cultural and communication barriers, physician’s specialization, SA older adults’ lack of ACP awareness, and decision-making deference to family and physicians were barriers to ACP discussions. Although the COVID-19 pandemic impacted physicians’ practices, contrary to our hypothesis most reported no change in frequency of ACP discussions. Although ACP discussions were viewed …

2023/12/13

Article Details
Claire Robson

Claire Robson

Simon Fraser University

Jackie’s Story: In Home Care

Jackie’s story is told by a care giver, Zoe. Jackie is now deceased. Zoe faced great pressure from both a university and a well-respected charity to remain silent about the neglect she saw in Jackie’s situation and others. Jackie’s case is one of neglect by caregivers who were too blinkered and too rushed to see that Jackie was a recent lesbian widow. They thus offered care that did not recognize her grief, and their heteronormative assumptions resulted in neglect. Jackie’s neglect was exacerbated by her own internalized homophobia and fear of being revealed, which led her to be hostile to carers and initially to Zoe.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Interview with Devan Cecelia Christian: Individual Counselor and Peer Group Facilitator for Indigo Survivors

Devan Cecilia Christian is a registered clinical counsellor who has worked extensively with elders who have experienced grief, loss, and trauma. As part of The Indigo Project, she was hired to offer participants free one-on-one counselling and/or the opportunity to take part in a peer support group that she facilitated. Two participants received individual counselling and four took part in the peer support group, which met virtually for 8 or 9 weeks. She discusses group process at some length, and in particular, the ‘toolkit’ they requested, which included techniques designed to help them with mindfulness and relaxation that might help them overcome stress. She emphasizes the importance of emotional and spiritual wellbeing as the basis for self-care and speaks to the importance of the provision of counselling support in The Indigo Project.

Claire Robson

Claire Robson

Simon Fraser University

Evidence Brief: Elder Abuse in the 2SLGBTQ+ Community

This knowledge synthesis reports on the literature on the abuse of older adults who identify as 2SLGBT+ (Two-Spirit, lesbian, gay, bisexual, trans, queer plus) published in the past decade (2013-2023). Although there is not a great deal of literature prior to 2013, what we do have indicates that 2SLGBT+ older adults face particular vulnerabilities that can make them experience elder abuse in ways that are specific to their communities and that can present additional barriers to their health and well-being. Objectives (1) synthesize existing knowledge related to 2SLGBTQ+ elder abuse and determine knowledge gaps (2) identify and evaluate the nature of the academic literature, including methodologies and data sources; (3) create an evidence-based agenda for future research and advocacy in the area of 2SLGBTQ+ elder abuse; and (4) where evidence and data are lacking, our work will highlight the gaps in order to help shape future data policies and research agendas.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Matthew’s Story: Residential Care

Matthew’s story is one of two told ‘second-hand’ as Matthew is now deceased. Matthew was an elderly war veteran who was admitted to residential care after collapsing. Doug, Matthew’s husband, visited every day and so was very aware of neglect, which he of course spoke about. Despite Doug’s presence, Matthew suffered neglect, ill-treatment, and character assassination. Doug strongly suspects that covert homophobia was the root cause of Matthew’s experiences, yet as is typical for GSM people, this cannot be proven.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Twelve Grace’s Story: Spiritual Abuse

Grace was in her mid-seventies at the time of writing, and identified as a lesbian, though she also considers herself to be possibly nonbinary. Though she engaged in the interview process, Grace ultimately chose to write the narrative that follows in entirely her own words. It details her lifelong and often disappointing and traumatic search for a Christian organization that would satisfy her desire to find a faith community accepting of her GSM identity. In most instances, she encountered what she describes as a “quelling and quenching of life’ that met her “personal definition of spiritual trauma.” From outright rejection to unwanted sexual advances by women who were presumably themselves deeply closeted, Grace’s story provides a telling account of spiritual abuse, complicated by illness and depression.

Gloria Gutman

Gloria Gutman

Simon Fraser University

After social distancing advice from older Canadians for older Canadians

MethodsThis study was part of a larger e-survey study about mentally healthy living among 1,327 community-dwelling persons 60+ years of age. A sample stratified by age, sex, and education to approximate the Canadian population was asked: With COVID-19 public health measures lifting, based on your own experience, what would you suggest other older Canadians do to reduce social isolation?

Gloria Gutman

Gloria Gutman

Simon Fraser University

OBM Geriatrics

Sexual orientation and risk for elder abuse: Findings from the Canadian longitudinal study on aging

This study addresses knowledge gaps concerning prevalence and risk factors for elder abuse among sexual minority (SM) compared to heterosexual Canadians aged 65+. Data derive from the Canadian Longitudinal Study on Aging, a national cohort study. Outcome variables include self-reports of psychological, physical, or financial abuse in the 12 months before interview and overall. Main explanatory variables are sexual orientation and gender identity; covariates include other socio-demographic characteristics, general and mental health. Overall prevalence of elder abuse was 10.0% among heterosexual and 12.0% among SM participants, with highest prevalence (18.1%) among SM females. The most common subtype was psychological abuse (8.8%), with highest prevalence among SM females (15.5%) followed by financial (1.4%), also with highest prevalence among SM females (7.0%). Physical abuse was least common (1.3%), with highest prevalence (2.4%) among SM males. Bivariate associations showed higher odds of experiencing psychological, financial and overall abuse among SM compared to heterosexual individuals (Odds Ratio (OR)= 1.41, 3.33 and 1.53, respectively), however within multivariable logistic regression models, sexual orientation was a significant predictor only for financial abuse (OR= 2.62). Our study is among the first to determine prevalence of elder abuse among SM older adults, and examine the interplay of gender identity and sexual orientation with other risk factors. Findings suggest divergent risk across gender and sexual orientation groups and abuse subtypes. Implications include addressing gaps in …

Claire Robson

Claire Robson

Simon Fraser University

Michele’s Story: Residential Care

Michele is in her mid-sixties, identifies as a lesbian, and lives with considerable disability as a consequence of her advanced ALS. She uses an electric wheelchair for mobility and an iPad to communicate. She was admitted to an extended care facility where she suffered neglect, harassment, and physical abuse. Although Michele was open about her sexuality, staff would make homophobic remarks quite freely, and residents had little power to prevent this. However, this is a story of agency and resilience.

Claire Robson

Claire Robson

Simon Fraser University

Scrutinising Science: The Changing UK Government of Science

Historical Context

In Chapter 1, we explored the differences between organic scientific change and policy-driven change. We also explained that this book was about just such a shift from organic to policy-driven change, and the consequences of that. We suggested that a shift from organic to policy-driven change could be complicated, or even frustrated, by a failure to achieve congruence between organic change processes and new desired policy outcomes. That is, if the change is too violent and pays no heed to past practices and cultures then policy-driven change will be difficult to achieve. A particular and recurrent theme of this book is that policy-driven change was indeed complicated and frustrated by echoes and resonances from the period of organic scientific change and development.

Gloria Gutman

Gloria Gutman

Simon Fraser University

Elder abuse in the LGBTQ2SA+ community: The impact of homophobia and transphobia

This book describes and analyzes the lived experience of elder abuse from the queer community. It discusses the experiences by transwomen, gay men and lesbians of financial abuse, physical and sexual abuse, homophobic abuse, and neglect within partner relationships, residential care, in home care, and religious organizations. Queer and trans elders have been described as ‘The Silent Generation’, since they have lived through times when their sexual and gender identities were criminalized and pathologized. The book shows that they are far more at risk to suffer abuse and neglect by those they should be able to trust, since they are more likely to have encountered all key risk factors, such as isolation, previous abuse and trauma, and mistrust of the health care system. Their vulnerability has been overlooked and this book addresses that gap. As such, this book provides a great resource to anyone working with elders, including medical professionals, care providers, police, counsellors, and policy makers.

Claire Robson

Claire Robson

Simon Fraser University

Pam’s Story: Partner Abuse

Though Pam’s story is based upon the two interviews conducted, she is a talented writer, and took the lead in revisions. Pam was 72 at the time of her interviews and reported that she had defined as a lesbian from the age of 26. She grew up in a family with domestic violence, in which she acted as her mother’s caretaker and protector from Pam’s highly abusive father. Pam fell deeply in love with Meera, a highly regarded professional, as was Pam herself. Meera told Pam that her parents, traditional and conservative Sikhs, would be suspicious of Pam’s intentions, and to reassure them, Pam signed her cash and investments over to Meera. This trend continued throughout their relationship as Meera took increasing control, both financially and socially. Ultimately, Pam allowed herself to be separated from her family and friends and lost her autonomy and financial resources. Realizing that she was left with no home, no …