Understanding the diverse needs of individuals who are faced with a terminal or life-limiting illness is a challenging endeavor, even for the seasoned hospice and palliative care provider. As such, the task of providing competent and conscientious care requires an intentional choice of approaching each individual patient and their family with openness, sensitivity and compassion, thus limiting the risk of unintentionally excluding their unique experiences and needs. In writing this book, Acquaviva is clear about her goal of promoting an inclusive approach to hospice and palliative care that fosters such sensitivity and conscientiousness for all patients, including LGBTQ-identified individuals and their families. Recognizing and addressing the diverse life experiences of LGBTQ patients is a consistent theme threaded throughout the book. The author refrains from discussing LGBTQ people as another “special population” and avoids reinforcing a stigmatized perception of sexual and gender minorities within the limited context of disease and dysfunction. Instead, Acquaviva strives to present a framework of LGBTQ-inclusive hospice and palliative care that presents a broader paradigm shift of how we view inclusiveness in our expression of care for all individuals facing a terminal or life-limiting illness.
The book presents an affirmative discussion about various aspects of LGBTQ-inclusive hospice and palliative care that is intended for multiple disciplines and is written in an accessible and practical manner, while also retaining scholarly and academic undertones. Each chapter discusses a prominent theme that is relevant for providing inclusive hospice and palliative care, while highlighting diverse considerations for these topics within the context of caring for LGBTQ-identified individuals. Such themes include “Self-Awareness and Communication,” “Sex, Gender, Sexual Orientation, Behavior and Health,” “Understanding Attitudes and Access to Care,” “Psychosocial and Spiritual Issues,” “The History and Physical Examination” and “Ensuring Institutional Inclusiveness.” The chapters include highlighted objectives, a general summary, key points to remember, as well as applicable chapter discussions and suggested activities that could be utilized among groups of hospice and palliative care providers. In addition, Acquaviva includes selected quotations and testimonials from providers, patients and family members who offer additional insight about LGBTQ-inclusive care through the lens of their own lived experiences.
While advocating for a broader approach of conscious inclusivity in providing care, Acquaviva distinguishes inclusive care from generalized care – being inclusive does not mean that every patient is treated the same. The author highlights the lack of adequate attention given to discussing inclusive care for LGBTQ people within many prominent research texts in the field of hospice and palliative care. When aspects of providing care for LGBTQ individuals are discussed in such writings, they tend to reinforce the view of LGBTQ people as “other” or indirectly support biased generalizations about LGBTQ individuals, such as limiting the discussion to end-of-life care for patients with HIV/AIDS.