Check out the following best practices in palliative care for LGBT Individuals:

BPP END OF LIFE / PALIATVE CARE
1E: Practice SOGI related issues should be addressed at intake (financial planing, surviving partners/family/dependent children/relationship with family of origin) and be culturally competent to LGBT issues in service delivery.

2E: Practice Surrogate decision making should be discussed and formalized at intake (medical proxy) and hospital visitation issues that are specific to LGBT people, e.g., family of origin, family of choice. This should reflect rapidly changing policies in this regard and accommodate to State-by-State variation. Every effort should be made to ensure that documents follow patients through multiple care settings.

3E: Practice Ensure effective and safe pain and symptom management that is not compromised by psychosocial factors that are more common among LGBT populations. Referral to LGBT culturally competent palliative medicine providers for complex pain and symptom management.

4E: Practice Evaluate all LGBT patients for risk of delayed access to care due to distrust of the medical system and past traumatic experiences.

5E: Practice Hospice and nursing home need to identify and address discrimination to LGBT patients and providers Pastoral care providers need to address fear and distrust of LGBT patients of faith based communities.

6E: Practice Ensure a dignified death is a priority including LGBT specific areas such as continued hormone therapy for transgender patients, identification of their family of choice and gender of choice.

7E: Workforce Training staff to provide cultural competent care to LGBT patients and family of choice/support system including within hospice setting and in home care settings.

8E: Resources Cultural competent and/or LGBT specific bereavement programs for LGBT friends, family and caregivers. Consult with local LGBT CBOs and national resources.

9E: Measurements Research is needed on end of life/chronic illness — experiences of LGBT patients and development of unique psychosocial and existential distress measures for LGBT patients, spirituality.

10E: Practice Address complex spiritual needs of LGBT patients and families.

11E: Communication Have individualized plans in regard to disclosure or non-disclosure of SOGI.