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In light of the above, and the significant impact of bereavement on those closest to the deceased (partners), the aim of this review was to identify and appraise the evidence of the bereavement experiences of LGBT people who have lost a partner and to develop a new explanatory model of bereavement to aid clinicians in delivering holistic, individually tailored support among the LGBT communities.
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26, 27 A recent UK survey of 522 lesbian, gay or bisexual adults identified that 34% had concerns about arranging end-of-life care and 24% expected to face barriers relating to their sexual identity when planning a funeral. 25 Moreover, experiences of discrimination against LGBT people are still common in healthcare settings.
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23 Isolation is more common among the LGBT communities, particularly among the older generations, 24 who may face additional barriers when accessing healthcare, resulting in a reluctance to share their identity with healthcare professionals. 19 – 22 A recent systematic review described a potentially increased need for palliative care among these communities. 14, 15 People who identify as LGBT are at increased risk of life-limiting illnesses, including certain cancers, 16 – 18 and exhibit more risk behaviours linked to experiences of discrimination. There is increasing recognition that lesbian, gay, bisexual and/or trans* (LGBT) communities represent minority groups with specific healthcare needs. 12 Compared to non-bereaved individuals, bereaved people have significantly worse health prior to, and in the year following, bereavement and are significantly less likely to be employed up to 2 years post bereavement. 9 Individuals who have lost their primary relationship are less likely to seek medical attention where necessary, 10 are at increased odds of worsened or new illness 11 and have increased mortality. 8 Those who performed a caregiving role are 20%–50% more at risk of mental health problems in bereavement than non-caregivers. 7īereavement heavily impacts those closest to the deceased. 6 Social factors that may lead to disenfranchised grief have been recognised, where the deceased had a stigmatised death or where the relationship with the deceased was not acknowledged or publicly recognised, limiting the individual’s access to support and the grieving role. 5 Recent models have also recognised factors that shape the grief experience, including social mediators and concurrent stressors.
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Recent theories of grief have moved beyond a staged or phased understanding, 1 – 3 to models which recognise the active nature of grief as the survivor navigates pain and loss and begins to restore their identity as an individual, 4 and find a new place for the relationship with the deceased. Grief and bereavement are universal human experiences of adjustment after a death.