Inclusive aged care for the LGBTI+ community

My area of research is sexuality, intimacy, relational wellbeing and older people. I was fortunate to be awarded a Churchill Fellowship in 2017 and I travelled to Australia and the USA. I had realised that my own research was very hetero-focussed, and was interested in understanding how to encourage older people’s services to be LGBTI+ inclusive.

Older members of the LGBTI+ community are less likely to have children to support them or advocate on their behalf, more likely to live alone, and may be fearful of having to go ‘back in the closet’ or losing ties with the LGBTI+ community.

My drive for understanding the need for greater LGBTI+ inclusive services came from two interviews I had conducted as part of my pre-Fellowship doctoral research. One with ‘Emily’, who described her reluctance to place her husband in residential care because he was a cross-dresser and she was unsure how he would be viewed and supported in care. The other was with ‘David’, who talked of his anxiety at the prospect of recruiting at-home carers for his husband and fears of discrimination, misunderstanding or judgement.

What I found on my travels was both simple and complex. The simplicity of some of the LGBTI+ inclusive ideas I saw was offset by the challenge of leading organisational cultural change. I discovered that the factors required for LGBTI+ inclusive care included national drive, organisational desire and community benefits, all of which should influence good practice. There were simple examples of how to create an inclusive environment - rainbow stickers on entrance doors, staff with rainbow lanyards, Marigold Circle sessions to discuss LGBTI+ relevant issues, LGBTI+ literature in the care home library, statements of commitment to LGBTI+ inclusion in job adverts and organisational literature, members of the LGBTI+ community sitting on decision making boards, and so on.

I was able to visit a range of service providers, many of whom had religious affiliations. These organisations were very open and honest about the cultural changes that needed to occur to create genuinely inclusive services. The impetus seemed to have come from strong leadership, who listened to staff and residents and championed inclusive services. In both the USA and Australia, legislation had come into force that created greater statutory requirements for care providers.

I was also incredibly fortunate to meet with older members of the LGBTI+ community, who expressed their joy at being able to attend inclusive social care services. I was greeted in one care home by residents in the throes of creating their Pride float. All the residents were helping to prepare for the big event. It was an important annual moment and part of the organisation’s commitment to cultural change and inclusive services.

What really struck me, when I was travelling, was the history of the Pride Movement and how this was really important to the older people I met. These were people who had lived through the Stonewall Riots, which took place in the USA in June 1970; they were proud ‘78ers’ - activists who marched in Sydney in 1978 to protest against police violence; they were life-long campaigners for equality and inclusion - but they were still anxious about needing care in their older age. It is so important that we all do what we can to mitigate this anxiety.

Since my return, I have been invited to conduct sexuality and intimacy training during Pride Week in two care homes, have written a book chapter about my Fellowship, and been integral in the development of online training for care home staff which addresses sexuality, intimacy and older residents: this has an excellent sex and gender diversity module. Having spent the last ten years working in academia, I have used these experiences, and those of my Fellowship, to influence, enhance and inform the projects I have worked on. However, the wheels of change move so slowly so I am about to retrain as a social worker, where I hope I can influence inclusive services from the grassroots.

For anyone who has seen the Pride Parade in London, it is a wonderful celebration of the LGBTI+ community. However, it is activist in nature and promotes the values of visibility, unity and equality. There is still so much to champion for, to rail against, to change and to learn.

Encouragingly, the next generation seem ready to meet these challenges. My daughter, who is training to be a paediatric nurse, just submitted her dissertation, which investigated trans youth and their experience of healthcare. Her comment was, “I’m not too bothered about the grade, but I really would like LGBTI+ healthcare issues to appear much more in the student nurse curriculum.” It is with much pride that I say I cannot agree more.

I wish you all a great Pride event if you are involved in one, and if you are not, I urge you to find out how you can become an LGBTI+ ally, to look at your own organisations and see if you can be a bit more inclusive. Together we can create change.