Integrating art into the research process is becoming an increasingly popular way to explore, understand, represent and challenge human experiences. Fostering Dialogues—a research project conducted at Egale Canada, co-facilitated by social artist Melanie Schambach, supported by VHA Home HealthCare (VHA) and funded by a Catalyst Grant through the Canadian Institute of Health Research—combined art and connection to explore the possibilities for the future of home and community care.

In the fall of 2022, the research team worked with 2SLGBTQIA+ older adults and personal support workers (PSWs) from VHA to reflect on their experiences, both shared and different, as two marginalized groups within the care system.

“Art-based approaches are an engaging way to draw out and reflect on sensitive experiences. This facilitates empathy, transformative learning and validates experiences, which are crucial for shifting deeply held beliefs and values,” said Sonia Nizzer, Senior Research Associate at VHA.

Alternating between virtual conversations and art-focused explorations over twelve weeks, these sessions led to the creation of a collective digital mural representing the complexities of receiving care as a 2SLGBTQIA+ person and working in home care as a PSW.

“The creation of the mural was integral to the process and one of the project’s outcomes, with the intention that this piece would continue to spark conversations as it’s shared more widely,” said Dr. Celeste Pang, who co-led the research. “The mural as a whole tells a story, as does each section within it.”

Imagining Futures of Care

“Let’s create a community that understands and hears each other, regardless of where we’re coming from.” – Gene, 2SLGBTQIA+ Older Adult

Throughout this process, participants explored their current experiences around the themes of ‘home’ and ‘care’ as well as imagining what home care could be. These discussions and art making sessions led to the powerful imagery found on the mural.

PSWs shared some of their struggles including wage equity with other healthcare sectors and staffing shortages. They also discussed the importance of training and professional development around healthcare equity. 2SLGBTQIA+ older adults revealed the concerns they sometimes experience with care workers in their homes, such as facing bias and homophobia, not being recognized as their spouses’ partner and the vulnerability they may experience during intimate care.

“The images on the mural of sharks, clocks and baggage filled with stones represent some of the barriers that PSWs face. Other images and text speak to the hope that PSWs have, their commitment to their work and to supporting 2SLGBTQIA+ clients and families,” Dr. Pang said.

“2SLGBTQIA+ older adult participants shared their hopes for the future of homecare, including continuing to break down barriers and creating community. The images of hearts, glitter and gems and music notes represent these hopes, while the ripple in the water symbolizes taking action to create change,” she added.

Pathways to Change

“In healthcare it’s important for us to be advocates. It doesn’t matter who the clients are—race, ethnicity, sexual orientation—everybody does deserve to receive care”  – Camille, PSW

The participants’ reflections at the end of the project were overwhelmingly positive. Researchers noted a significant change in the participants’ comfort level discussing thoughts, feelings and ideas and improved confidence in expressing themselves through art.

“Many older adult shared how participating in the project made them feel heard, validated and inspired them creatively. Getting to know the PSW participants and learning about the joys and challenges they find in their work changed their ideas about homecare and PSWs and allowed them to find points of connection and common cause,” said Dr. Pang.

“Similarly, PSW participants noted that after this project they held a better understanding of the challenges 2SLGBTQIA+ individuals face in healthcare and were motivated to continue learning and to encourage others to be allies,”  she said.

These reflections also included concrete actions PSWs plan to take in their lives and workplaces. And older adult participants indicated they felt empowered to advocate for themselves and their community.

“Due to a history of discrimination, many 2SLGBTQIA+ older adults avoid using home care services and are afraid of encountering discrimination and disrespect from home care providers like PSWs, despite needing essential care,” said Sonia Nizzer.

“At the same time, many PSWs may lack awareness of the unique needs of 2SLGBTQIA+ persons. Attempting to bridge these divides through dialogue and reflecting on what home and care means to everyone is so powerful. Work like this is how we move the needle and ensure that care remains safe and equitable for all.”

To read the full research report for other key findings from the project, visit: https://egale.ca/egale-in-action/fostering-dialogues-arts-based-research-project.

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Egale is Canada’s leading organization for 2SLGBTQIA+  people and issues. They improve and save lives through research, education, awareness, and by advocating for human rights and equality in Canada and around the world. This work helps create societies and systems that reflect the universal truth that all persons are equal and none is other. Learn more at Egale.ca.