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Silent Illumination

A Case Study Exploring the Spiritual Needs of a Transgender-Identified Elder Receiving Hospice Care

Campbell, Cathy L. PhD, RN; Catlett, Lauren MSN, CNL, RN

Journal of Hospice & Palliative Nursing: December 2019 - Volume 21 - Issue 6 - p 467–474
doi: 10.1097/NJH.0000000000000596
Ethics Series

With a growing population of transgender-identified elders in the United States, their unique spiritual end-of-life needs are coming to light. This article presents a case study of a hospice volunteer who used skillful means as an artist to help a transgender-identified woman express her spirituality in the last 6 months of her life. After data analysis, 4 themes emerged related to the expression of spirituality by lesbian, gay, bisexual, transgender, and queer (LGBTQ) elders at end of life. The themes that emerged included (1) the human element in advocacy for spiritual care, (2) the importance of safe spaces for reflection and meditation, (3) the importance of skillful means to work with LGBTQ people, and (4) acknowledgement of gender identity as a spiritual need. This case study serves as a springboard to advance research into the end-of-life needs of LGBTQ elders and the ways in which members of the hospice team can support spiritual care and alleviate suffering for this population.

Cathy L. Campbell, PhD, RN, is associate professor, University of Virginia School of Nursing, Charlottesville; and ordained lay Buddhist chaplain, Upaya Zen Center, Santa Fe, New Mexico.

Lauren Catlett, MSN, CNL, RN, is hospice registered nurse and doctoral student, University of Virginia School of Nursing, Charlottesville.

Address correspondence to Cathy L. Campbell, PhD, RN, School of Nursing, University of Virginia, PO Box 800782, Charlottesville, VA 22908 (

The authors have no conflicts of interest to disclose.

Online date: September 11, 2019

© 2019 by The Hospice and Palliative Nurses Association.