FEBRUARY 10.2007 • Q-NOTES 9
HEALTH
ascertain who has decision-making authority
in the event that the patient can no longer
communicate or make decisions. This process
may be more challenging when assisting elders
in a same-gender relationship because the
patient’s partner does not have the automatic
legal authority afforded to people in heterosex
ual marriages. Hospice and palliative care staff
should honor any advance directive stating
that the same-gender partner is authorized to
make decisions if the patient no longer has the
ability or the capacity to do so.
If members of the family of origin contest
an advance directive of this sort, or if there is
no directive, extremely difficult and painful
conflicts can arise between members of the
patient’s family of origin and family of choice
— especially if the patient has been
estranged for years from the family of origin.
Without an advance directive in place, the
elder’s family of origin has the legal power to
bar the patient’s life partner from the hospi
tal room, even when the patient is dying.
That is why advance directives and related
legal documents are so important: they
ensure that the patient’s wishes are honored
and that the basic rights of the patient’s part
ner are not denied.
Hospice and palliative care programs that
seek to provide quality end-of-life care for
LGBT elders can take the following simple
steps to improve procedures and services.
Admissions and intake process
• Change intake forms to be inclusive of same-
gender relationships or partnered status.
• Determine who has the legal authority to
make decisions in the event that the patient
no longer can do so.
• Ask patients to define their family of choice
and family of origin, and encourage them to
identify any potential conflicts between the
two families.
• Encourage patients to complete advance care
planning, as well as legal and financial
paperwork.
Interdisciplinary care
• Recognize the potential psychosocial issues
related to families of origin and families of
choice.
• Consider any medical issues related to trans
gender patients.
• Pay attention to spiritual issues of EGBT eld
ers whose faith traditions do not affirm their
identity.
Grief and bereavement counseling
• Sup'port the patient’s partner, especially in
the event that the loved one’s death isn’t
acknowledged by others as the deep loss that
it is for the partner.
• Help surviving partners express grief.
Especially for those who are not out, public
acknowledgement of their loss may be mini
mal or absent.
• Advocate for surviving partners whose work
place doesn’t offer bereavement leave to
unmarried partners.
Staff training
• Teach staff about the unique needs of LGBT
people at the end of life.
• Allow staff the opportunity to express their
misgivings or fears about caring for LGBT
elders.
• Reinforce the idea that hospice staff must
respect each and every patient and family
and must provide the highest possible quali
ty of care.
All older adults deserve comfort, care and
compassion at the end of life. Hospice and pal
liative care programs can open doors and
build bridges to ensuye that all older adults in
their community, including LGBT elders,
receive the care and services they need. If your
agency doesn’t care for LGBT elders at the end
of life, who will? I
— Kimberly D. Acqmviva is an assistant
research professor in the School of Medicine and
Health Sciences at George Washington
University, Washington, D.C
info:
Reprinted with permission from “Outword,” (v. 13,2006
Summer issue, pages I & 6) Copyright © 2006.
American Society on Aging, San Francisco, Calif.
www.asaging.org/lgain.
GLMA urges FDA to revise
blood donation policy
Current guidelines cited as
‘dangerous, outdated and
unscientific’
by Lisa Shaner
The Gay and Lesbian Medical Association
(GLMA) has called for the Food and Drug
Administration to revise its blood donation
policy regarding men
‘Two decades ago, when the
agent that causes AIDS was
unknown, these guidelines
might have made sense
— GLMA Executive Director
Joel Ginsberg
who have sex with
men. Within the past
organizations that collect donated blood,
including the American Association of Blood
Banks and America’s Blood Centers, have
encouraged the FDA to review a policy in
effect since the early 1980s that prohibits men
who have sex with men — regardless of sexu
al activity, safer-sex practices or HIV status —
from donating blooci. The groups say that the
likelihood of receiving a unit of HIV-infected
blood is one in two million and that blood
banks use nucleic acid testing,
which detects HIV and hepatitis ear
lier and much more accurately than
older testing methods.
“Two decades ago, when the
agent that causes AIDS was
unknown, these guidelines might have made
sense based on the very limited data avail-
year the American
Red Cross and other
able at that time,” said GLMA Executive
see fda on 28
Alyson Thomas presents a weekend of pageantry notto be missed — Saturday, March 10th
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Ike 8lli A
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Sunday, March 11
The Continental Review Show
hosted by Carmella Marcella Garcia and Brooklyn Dior
Step back into old Hollywood, Carolina Continental Style
Presentation begins at 11:15 pm
Maya Douglas - Miss Continental Elite
Victoria La Paige - Miss Continental
Simba Hall - Mr. Continental
Desiree Demornay - Miss Continental Plus
and performances by Danielle Hunter - Miss NC Continental and Miss Continental 2000
and Deception - Miss NC Continental 2002