A project to improve conditions for older lesbian, gay, bisexual, transgender, queer, intersex, and two-spirit individuals when they enter long-term care has new tools for people in the field thanks to innovative work by a Salt Spring-based researcher.
Robert Beringer is a Health Systems Impact Postdoctoral Fellow at the Institute on Aging and Lifelong Health, University of Victoria. During his two-year fellowship he is working to evaluate and optimize LGBTQI2S engagement with hospice and palliative care in the Island Health region. Three film vignettes that he produced on-island over the past fall to highlight different needs and experiences of people outside the hetero-norm have now launched and are available for viewing and sharing from his website, www.lgbtqi2sdignityproject.ca.
Beringer’s previous research into gerontology and LGBTQ issues showed there is a lot of anxiety around losing independence, as people with non-conforming genders or sexuality suddenly face the bizarre and tragic situation of having to go back into the closet, or perhaps face discrimination from staff and fellow residents.
“There are fears about going into such homes at all because people wonder if they’ll have to hide their identities,” Beringer observed.
The LGBTQI2S Dignity Project website and film vignettes were first conceptualized in February 2018 at a “design jam”-style event that was organized in partnership between the Canadian Institutes of Health Research’s Institute of Gender and Health, EGALE Canada, Hacking Health, Rainbow Health Ontario, Cossette Health and the Michael Smith Foundation. The vignettes were filmed last November and were completed with 100 per cent use of Salt Spring talent.
Screenplays were written locally, along with a local director, videographer and actors, and Beringer himself acting as executive producer, caterer and financial manager. The vignettes were filmed in his home, which was made over to resemble different rooms of an assisted living facility.
“Filmmaking, I learned, can be a long, drawn-out process, with many starts and stops along the way,” Beringer reported. “After failed attempts with two [off-island] production companies, I decided to take a community-based approach and this began by asking members of LGBTQI2S organizations around B.C. for script suggestions. We chose to develop Never Married, It Still Hurts and Special Occasion, and I am pleased at what my team, entirely based on Salt Spring, has produced.”
“These are situations that are very moving,” said series director Suzanne Laine. “Everybody that got cast felt this was something really important to do. They felt it was really unique and important work.”
The vignettes average just six minutes in length, but they successfully bring home an emotional connection in a way that educational materials can’t really do. Scenarios include an older gay man seen in a care home’s common area, where he is subject to loud comments and exclusion by two female residents. The scene comes with both a “status quo” ending depicting how problems like this often get treated by staff, and then a more positive alternative showing how the care aide on site could have better responded to the situation.
In another film, a transgender resident is bullied by the home’s administrator, who doesn’t tell the staff the man is trans and refuses to refer to the patient in the gender he has lived with for many years.
“It puts both the worker and the client in a really awkward situation because the worker is looking for someone with the former gender identity,” Beringer said. “It’s really sad because it’s coming from the higher-up, who just doesn’t want to accept their identity.”
Although finding accurate statistics can be challenging, it is estimated that anywhere between three and 10 per cent of the population are lesbian, gay, bisexual, queer, two-spirited or transgender. Using these parameters, there are between 4,500 and 15,000 LGBTQ2+ seniors served by Island Health.
Beringer credits Nicole Tremblay, clinical social work educator for Island Health, for leading the way to educating health authority staff and creating a manual called Developing Inclusive and Affirming Care for LGBTQ2+ Seniors. The manual was developed following a review of international and national research and through input from local focus groups, and is a model for the LGBTQI2S Dignity Project website. But more awareness is needed, Beringer said.
“I think there are lots of toolkits and strategies that people are trying to use, but they’re under-utilized. Either people think that they have no LGBTQ2+ residents in care, or they treat them like everyone else — which we know from research doesn’t work,” he said. “We’re hoping people will use these film vignettes as part of their toolkits if they’re doing sensitivity training. I’m not attached to who’s using them. I just want people to use them.”