LGBTQ+ community spaces

This is welcome news, particularly when the current pandemic has exacerbated loneliness and isolation. The current climate of Covid-related restriction has highlighted extra challenges to the LGBTQ+ community, as James Rowland reported in his blog about domestic abuse. For instance, people who identify as LGBTQ+ may have been forced to move in with family who do not accept their sexual orientation or gender identity. Lockdown restrictions may also mean people feel they have to stay in an abusive relationship.

My Churchill Fellowship investigated the challenges faced by people who identify as LGBTQ+ with dementia. My interest started when I met an older trans woman through my clinical practice as a Memory Assessment Nurse. She had developed early dementia that progressed rapidly, resulting in admission to a care home. As her dementia advanced, she started to question her gender and at times become very distressed at her anatomy or why she was wearing female clothing. This ‘regression’ was usually short-lived, but the staff were also upset as they did not know how to care for her. It made me realise how little training caregivers have received in this area.

Statistics show that people who identify as LBGTQ+ suffer poorer mental and physical health. Some 72% have also experienced discrimination or stigmatisation and live in fear of being ‘outed’. Dementia eventually takes away the ability to keep your personal identity private, which is why caregivers need to be informed about their unique challenges and how to support them unconditionally.

My research took me to Australia, where I networked with care providers who facilitated Silver Rainbow training in their care homes and domiciliary services. Silver Rainbow incorporates standards and benchmarks that have been developed across Australia through collaboration with key stakeholders, such as the LGBTI Alliance and Dementia Australia (the equivalent to our Alzheimer’s Society). I was very fortunate to meet some amazing people and organisations, engage in training sessions and workshops, and gather material that I have brought back to the UK to improve our own practice within the NHS. One of the resources used in Australia is a Gender Passport, a handy little booklet containing all the information about a person, which is uploaded to their medical records. This means that individuals do not have to repeatedly keep explaining their chosen gender or sexual orientation. This resource could easily be adapted within the UK.

In preparation for this blog, I asked the Cornwall Partnership NHS Foundation Trust LGBTQ+ network for their thoughts about extra-care housing, in case they had any concerns. All of the people who responded thought that a housing programme for LGBTQ+ in later life was a fantastic idea, as some were apprehensive about their future provisions as they grow older. The Trust’s System Director for Integrated Communities also suggested that this model could be used to develop care homes in Cornwall, something that is already established in Australia. A high percentage of older people who identify as LGBTQ+ reside in residential or nursing homes due to a lack of family, therefore spaces such as these would allow people to be who they really are without judgement or fear.

This increased attention on unique housing for people who identify as LGBTQ+ is certainly timely. One of my colleagues highlighted that there is much to be said for being surrounded by like-minded people with similar life experiences, particularly when you are part of a traditionally marginalised population. This would be a wonderful addition to the growing LGBTQ+ community, especially in rural areas where being seen as different is a challenge.