Diversity Access Team

The Research:

The Diversity Access Team is assessing, tailoring, implementing, and evaluating ACP tools aimed at minority populations. In multicultural countries such as Australia and the United States, emerging research suggests that there are significant disparities in EOL care planning and decision making for ethnic and sexual minorities compared to mainstream populations.


Work to date:

Work by Principal Investigator Gloria Gutman funded by the BC Ministry of Health with Mandarin-speaking Chinese and Punjabi older adults found that some elderly in these groups are socially isolated, exploited or neglected by their sponsoring children, rendering knowledge about ACP tools and opportunities problematic. Despite the limited uptake of ACP by ethnic minorities, there has been only limited attention given to cross- cultural considerations in ACP and EOL care.

Team members de Vries and Gutman have also studied EOL planning among lesbian, gay, bisexual, and transgender (LGBT) frail older persons. LGBT older adults are less likely to have partners or children than heterosexuals. In their absence, LGBT older adults are more likely to turn to friends and other non-traditional supporters who often are given little social recognition.

In focus groups and Town Hall meetings in Vancouver, Edmonton, Toronto, Montreal and Halifax, LGBT older adults described fears of having to “return to the closet” if they needed to enter LTC or a hospital. They also spoke of ACP tools that do not recognize their unique health and social care needs. The result is that they refrained from completing these ACP tools or engaging in ACP conversations with clinicians. Findings from LGBT groups also have direct relevance for those whose aging experiences lie at the margins of heteronormativity (e.g., non-married, childless, people with diverse family structure). An important aim of this Transformative Grant is to redress the limited attention given to ACP for ethnic or sexual and gender minority (SGM) groups.

Evidence is clear that while many older Canadians view ACP as important, they express discomfort around when and how to engage in pre-emptive end-of-life discussions. As a result, many people are denied opportunities to participate in their own end-of-life planning, resulting in excessive use of invasive medical care at the end of life.


Principal Investigator:

Gloria GutmanGloria Gutman, PhD, FCAHS, C.M., O.B.C., LLD(Hon.)

Simon Fraser University

Gloria Gutman is Professor Emerita in the Gerontology Department and a Research Associate in the Gerontology Research Centre at Simon Fraser University (SFU), having founded and directed both from 1982 to 2005. Dr. Gutman is a past president of the International Association of Gerontology and Geriatrics (IAGG) and the International Network for Prevention of Elder Abuse (INPEA). She is currently the President of the North American chapter of the International Society for Gerontechnology (ISG) and has a distinguished international record of academic and advisory service. Dr. Gutman completed her undergraduate degree and doctorate at the University of British Columbia and her masters at the University of Alberta.  Her research interests are wide-ranging; including seniors’ housing, long term care, health promotion, dementia care, environmental design of age-friendly hospitals and cities, and seniors emergency preparedness.

Diversity Access Team Co-Investigators:

Brian de Vries

Jacqueline Gahagan

Diversity Access Team RC:

Shimae Soheilipour