Five-year research project reveals home care barriers in LGBTQ community

Event AdOntario’s LGBTQ (lesbian, gay, bisexual, trans or questioning) communities are experiencing barriers to adequate home care, according to the results of a five-year research project co-investigated by York University.

School of Social Work Professor Andrea Daley and School of Nursing Professor Judith MacDonnell will share this information, and other results, when they reveal the outcome of their research-based collaboration on Feb. 19 at the LGBTQ Home Care Access Event.

During the event, the researchers will fill gaps in home care research knowledge and will disclose issues faced by members of the LGBTQ community who receive care at home.

Judith MacDonnell
Judith MacDonnell

“Our study is the first comprehensive Canadian data on LGBTQ access to home care and to our knowledge the first data anywhere on LGBTQ access in this sector,” says MacDonnell. “Despite improved awareness of LGBTQ people in Canada and the development of human rights policies over the last decade, LGBTQ communities continue to face health inequities and barriers to finding responsive and relevant care.

“In fact, many avoid care because they anticipate they may face hostility or providers who lack knowledge about their health issues. There are implications for increased mortality and morbidity.”

Home care is defined as any form of care received in the home, whether formally or informally. Formal care could be arranged through a community support or social service agency, and informal care could be provided by family, friends or community members. Care services may include personal care, preparing meals, laundry, house cleaning, meal delivery, shopping, transportation to medical appointments, home safety assessment and physiotherapy.

Daley and MacDonnell found that one in three home care providers reported that, as far as they were aware, they had never worked with an LGBTQ client, and 90 per cent of home care service providers had never received continuing education while employed in home care that focussed on a client’s sexual and/or gender identity as it pertained to high quality care.

Additionally, 40 per cent of LGBTQ service users were not aware of their local Community Care Access Centre (CCAC).

Andrea Daley
Andrea Daley

“The existing research literature on diversity and access in home care has largely taken a cultural competency approach that, despite its limitations, does not consider or include LGBTQ communities and their experiences,” says Daley. “We can think of the ‘home’ as taking on great significance as a place where queer people can ‘do’ their identities and relationships with a greater level of freedom. In stating this, we imagine that the latitude for ‘freedom’ within LGBTQ homes and the potential for self expression and affirmation is likely affected by the discriminatory reactions and unpredictable support, including overt hostility, that LGBTQ people often anticipate and may experience during interactions with service providers.”

Melissa St. Pierre, a post-doctoral visitor, worked extensively with Daley and MacDonnell during the full duration of the project to coordinate various phases and determine key findings.  Co-investigators for this project include researchers from McGill University’s School of Social Work, McMaster University’s School of Social Work, Rainbow Health Ontario and the Toronto Central Community Care Access Centre, with funding from the Canadian Institutes of Health Research.

“The importance of our research also lies in the community-based approach taken to explore home care access for LGBTQ communities,” says Daley.” Our research process brought together members of and allies to LGBTQ communities in Ontario and with varying relationships with home care-related organizations.”

The research team, she adds, worked very closely with two advisory committees throughout the duration of the project that included LGBTQ community members from Northern Ontario and regions east and west of Toronto, as well as LGBTQ and ally service providers and home care administrators.

The Feb. 19 event will bring service users, providers, decision-makers and other stakeholders together to learn about the core research findings of the project. An interactive panel discussion and Q&A will be held on the significance and implementation of these findings. The panel will include a trans senior, a home care administrator, a CCAC administrator and an LGBTQ-focused research and policy coordinator.

Daley and MacDonnell hope their findings will lead to better education and training of care providers, improve policies and programs and promote agencies and services to become more inclusive, and affirm sexual and gender identities and expressions.

“We have developed a user-friendly home care Access and Equity tool to assist service provider organizations in moving towards LGBTQ-inclusive home care,” says MacDonnell. “As we have undertaken the research and shared findings with diverse LGBTQ communities, service providers and decision-makers/policy makers over the last five years, it is clear that there is significant interest across stakeholder groups in taking steps to improve care for LGBTQ home care service users, care givers, their chosen families and communities of care.”

The LGBTQ Home Care Access Event will be held from 2 to 4pm at 519 Church Street Community Centre. RSVP by emailing For more information on the project, visit the LGBTQ Home Care Access Project.