Newswise — (NEW YORK, NY, Sept 25, 2014) – Lesbian, gay, bisexual, and transgender older adults often have unmet health needs because they don’t receive care that is tailored to their unique circumstances. As they age, LGBT people are generally at greater risk of depression, certain cancers, and complications related to HIV than their heterosexual peers. A new project led by Jeffrey Kwong, DNP, ANP-BC, director of the adult gerontology primary care nurse practitioner program at Columbia University School of Nursing, is working to eliminate health disparities in the LGBT population in New York City. As the project director of the newly established Elder LGBT Interprofessional Care Program (E-LINC), Kwong secured a $1.5 million cooperative agreement from Health Resources and Service Administration to help address common medical and mental health needs of the aging LGBT adult population. Walter Bockting, PhD, professor of medical psychology in psychiatry and nursing at Columbia, is associate director of the project. In partnership with SAGE (Services & Advocacy for Gay, Lesbian, Bisexual & Transgender Elders), interprofessional collaborative practice (IPCP) teams that include nurse practitioners, social workers, psychiatrists, psychologists, physical therapists, and occupational therapists will provide culturally competent care to LGBT older adults in New York City. “Many times older LGBT people remain a silent population because they don’t bring up their sexuality or talk about sex with their health providers,” says Kwong. “Our IPCP teams of health professionals are developing a comprehensive health assessment program that will help us identify treatment needs that might otherwise go unnoticed.” Based on the results of the initial assessments, patients will receive a personalized health and wellness plan that may include preventive health screenings and referrals to workshops that focus on chronic disease management. Individuals with more extensive medical needs will receive assistance from E-LINC’s nurse practitioner and social worker team, which will provide home visits and care coordination as needed. In addition, patients who require LGBT culturally competent primary care or mental health care will be referred to Columbia University’s soon to be opened Nurse Practitioner Primary Care Practice in Washington Heights or access psychotherapy and psychiatric care at the newly established LGBT mental health program at the Lucy Wicks Clinic.
According to Bockting, there is a tremendous need for mental health care accessible and sensitive to the specific needs of LGBT elders: “Depression is more common among the LGBT population, often related to stigma and isolation, yet not enough knowledgeable mental health professionals who accept Medicare are available.” Another goal of E-LINC is training the next generation of health professionals to provide LGBT culturally competent care, says Kwong. This isn’t just asking about HIV risk or discussing sex with gay men. It’s also considering the health needs of lesbian women who are at higher risk of obesity, cardiovascular disease, and certain cancers, or transgender individuals who may be at risk for certain comorbidities due to long-term hormone therapy. Training and evaluation will be facilitated by the Center for Practice Innovations of the New York State Psychiatric Institute.
Clinicians also need to pay close attention to the ways that people tend to cope with stress and anxiety, such as smoking and alcohol, Kwong says. “Smoking rates are twice as high in the LGBT population,” he says. “Our goal with providing interprofessional, comprehensive screenings is that we won’t just find the smokers, but we will find and address the underlying stressors that may be causing them to reach for cigarettes in the first place.”
The overall goal of the E-LINC program is to promote wellness, keep people engaged in care, and to provide a resource for older LGBT adults to receive unconditional, well-coordinated, comprehensive care.
The E-LINC program is being funded by the Health Resources and Services Administration Bureau of Health Workforce Division of Nursing and Public Health Nursing Education and Practice Branch. (UD7HP26907).
Columbia University School of Nursing is part of the Columbia University Medical Center, which also includes the College of Physicians & Surgeons, the Mailman School of Public Health, and the College of Dental Medicine. With close to 100 full-time faculty and 600 students, the School of Nursing is dedicated to educating the next generation of nurse leaders in education, research, and clinical care. The School has pioneered advanced practice nursing curricula and continues to define the role of nursing and nursing research through its PhD program which prepares nurse scientists, and its Doctor of Nursing Practice (DNP), the first clinical practice doctorate in the nation. Among the clinical practice areas shaped by the School’s research are the reduction of infectious disease and the use of health care informatics to improve health and health care. For more information, please visit: www.nursing.columbia.edu.