A York University graduate student is conducting groundbreaking research in a largely uncharted area, the lives of LGBTQ2S older persons in long-term care (LTC) homes.
Stephanie Jonsson, a PhD student in the Gender, Feminist & Women’s Studies program, is a queer woman whose research specializes on the healthcare needs of LGBTQ2S older persons. Her research has led her to LTC homes in Ontario, where exclusionary legislation means many LGBTQ2S older adults are struggling to have their housing needs fully met.
Jonsson’s interest in this area grew while she was working at a for-profit assisted living centre in Toronto, where she learned that discussions about the sexuality of older adults often went unexplored, resulting in some of them feeling invisible.
Stephanie Jonsson
“Hearing all these little stories, I started reading more about the isolation that LGBTQ2S seniors experience, because a lot of the times they have to go back in the closet when they go into retirement homes,” Jonsson said. “There’s a lot of old-world views in retirement homes so homophobia and heterosexism are quite rampant on the resident side and the staff side.”
In general, Jonsson explained, LGBTQ2S people are confronted with existing systemic issues in their everyday life, and in LTC homes, these conditions are magnified.
“There’s just this long history of LGBTQ2S adults not trusting," she explained. "There is a distrust and discomfort between them and health care providers because of how they’ve been pathologized, criminalized and then now they’re experiencing all that homophobia, heterosexism and transphobia again in long-term care or end-of-life care."
As a research assistant at the University of Windsor, Jonsson worked on a study that focused on evaluating the Responsive Behaviour Program, a quality improvement project that involved reviewing all 657 LTC homes in Ontario. While reviewing the reports, Jonsson noted how the Ontario Resident Bill of Rights (Long-Term Care Homes Act, 2007), a bill that outlines how people in LTC homes should be protected, did not explicitly include protections for gender and sexual diversity.
“This was a concern to me because the legislation did not incorporate language that protected individuals from racism, sexism, homophobia and/or transphobia,” Jonsson said.
Jonsson says that in Canada, LTC homes are largely privatized and expensive. Public LTC homes, on the other hand, make up a small percentage of sites and aren’t always LGBTQ2S-friendly. Often, because bed choice is not optional, LGBTQ2S older persons find themselves with a less comprehensive list of homes that meet their needs.
For example, Jonsson’s research indicates in Toronto there are 10 public LTC homes, three of which say they are LGBTQ2S-friendly. One home that has a track record of being LGBTQ2S-friendly is Fudger House. Part of this LTC home’s success is because it references the The Ontario Centres for Learning, Research and Innovation in Long-Term Care LGBTQ2S tool kit, an optional resource that suggests ways to improve care and create services that consider the needs of LGBTQ2S people.
To become more LGBTQ2S-friendly, LTC homes, their residents and staff would benefit from using this resource and creating a more welcoming atmosphere that considers individual needs, Jonsson suggested.
However, Johnsson maintained policies have to echo these improvements. As such, her research has shifted towards policy changes within the Resident Bill of Rights. She has recently completed her comprehensive exams and is now a PhD candidate. Jonsson plans to work with organizations like the Senior Pride Networks to include community perspectives on the Resident Bill of Rights into her research.
For example, one article states individuals have the right to participate in decision-making, yet, Jonsson explains, many times services are fragmented, not patient-centred and standardized to serve as many people as possible without individual consideration.
“My hope is that through that research, I could develop a policy that could be put forward that could change that legislation,” she said.
Effective change, she added, also needs community participation. Jonsson believes her work is not insular and younger LGBTQ2S people advocating for older persons will lead to quicker implementation of inclusive policies.
“If we want those homes to get better and to address our needs and for them not treat us like profit pawns, we need to advocate for those changes and that means volunteering and being involved in these communities at any level,” Jonsson said.