6 - Good Care

Introduction

"Marcus, an older gay man cared for his long-term partner for many years during which he lived with dementia. They eventually had to ask for help and following his admission to a care home, Marcus continued his caring role, sometimes having to hide or curtail his love and affection but also playing an active role in educating and guiding staff on how to support them both as a couple." (World Café Best Practice Report 2019) This personal experience of Marcus is one amongst others, showing that good care for LGBT older people is still not self-evident or generally applied in the care for older people. In resources LGBT older people report 'people being nasty about homosexuality', and accompanying feelings of isolation, loneliness, vulnerability and embarrassment, particularly in hospital settings. When needing care at an elderly age, older people are keen to start hiding their sexual orientation in fear of judgement or difficult situations. For that reason, LGBT older people often retreat 'into the closet'. Some signals can be given in care homes, one person referred to 'having to start again when you go into a care home' and noted that some older LGBT people may introduce their partners as 'a friend' and then workers look for the family members and decisions are made when we should be talking to their friend (World Café Best Practice Report 2019). But also in literature we can find several examples that show the urge for better inclusive care for LGBT older people. In these resources there is growing documented evidence that LGBT sensitivity and competency training is needed in services that provide care to older LGBT people (Bell et al, 2010; Higgins et al., 2016; Hughes et al 2011; Knochel et al 2011; Stein et al, 2010). Research suggests that specific training on older LGBT issues may result in better knowledge/skills of the health and social care workforce, which in turn may reduce the heterosexual norms and presumed cisgendered (non-transgender) communication between providers and LGBT people, as well as diminish feelings of stigma and discrimination they experienced (Sekoni et al, 2017). The absence of any focus on LGBT health care needs within the content of the care curriculum and in the learning resources that this often relies upon (Sirota, 2013) also lacks diversity in relation to those who are ageing (Fredriksen-Goldsen et al, 2014; Higgins et al, in review). Research has demonstrated that older LGBT people experience social exclusion while interacting with care providers and that their life stories and relationships are overlooked and undervalued (Higgins et al, 2011, Almack et al, 2010, Westwood et al, 2015).

Goal

To learn about inclusive and good care for the LGBT older people

Target group

Teachers and trainers in vocational education and their students

Level

Teachers and trainers in vocational education and their students

Execution

Extra support from the teacher might be necessary depending on the ability of the students to work independently

Sources

Oudkast videoportret Ans: https://player.vimeo.com/video/388041087

An audit tool: LGBT Age Audit Tool – A guide for services and organizations working with older people to becoming more LGBT inclusive. http://www.lgbthealth.org.uk/wp-content/uploads/2015/09/LGBT-Age-Audit-Tool-final.pdf

An E-learning for professionals in social care on diversity in care.

Movisie: https://movisieacademie.nl/mod/page/view.php?id=5022

A photo series with interviews of LGBT older people in The Netherlands "Zorg om de zorg: Roze Ouderen in beeld" (Dutch only). Photography Luuk Wagter, interviews Agnes Sommer.

Almack, K., Seymour, J., Bellamy, G. (2010) Exploring the Impact of Sexual Orientation on experiences and Concerns about End of Life Care and on Bereavement for Lesbian, Gay and Bisexual Older People. Sociology, (5), 908-924.

Anze Jurcek 2019
BEING ME: Project Report on Best Practices in Learning and Education to Support LGBT Ageing Care and Wellbeing

Bell, S., Bern-Klug, M., Kramer, K., & Saunders, J. (2010). Most nursing homes social service directors lack training in working with lesbian, gay and bisexual residents. Social Work in Health Care, 49(9), 814-31.

Board game "Good care for LGBT older people". Marjolein Hottentot 2019 (https://www.olein.nl/educatief-seks-ganzenbord/)

"Doing it for optimal impact. Tips voor effectiever discriminatie verminderen van LHBTI's in voorlichtingen, trainingen en workshops." Hanneke Felten and Afiah Vijlbrief 2018

Fredriksen-Goldsen, K. I., Hoy-Ellis, C. P., Goldsen, J., Emlet, C. A., & Hooyman, N. R. (2014). Creating a Vision for the Future: Key Competencies and Strategies for Culturally Competent Practice With Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults in the Health and Human Services, Journal of Gerontological Social Work, 57(2-4), 80-107.

Hermans, M and Schuyf, J.(2014) Handreiking LHBT emancipatie, informele Zorg en zelfredzaamheid van LHBT ouderen. Movisie Lesbisch-en Homobeleid 2007

Stappen van professioneel handelen m.b.t. LHB, Hanneke Felten (Movisie) 2015, reviewed by Merel Verburgt (NFE) 2016

Higgins et al (in review) Pedagogical principles and methods underpinning education of health and social care practitioners on LGBT ageing: findings from a systematic review, Submitted to Nurse Education Today.

Higgins A, Sharek D, McCann E, Glacken M, Breen M, McCarron M, Sheerin F, (2011) Visible Lives Identifying the experiences and needs of older Lesbian, Gay, Bisexual and Transgender (LGBT) people in Ireland, Dublin, Gay and Lesbian Equality Network (GLEN).

Hughes, A., Harold, R., & Boyer, J. (2011). Awareness of LGBT ageing issues among ageing service network providers. Journal of Gerontological Social Work, 54(7), 659-77.

Knochel, K., Quam, J., & Croghan, C. (2011). Are old lesbian and gay people well served?
Understanding the perceptions, preparation and experiences of ageing service providers. Journal of Applied Gerontology, 30(3), 370-89.

Sekoni, A. O., Gale, N. K., Manga‐Atangana, B., Bhadhuri, A., and Jolly, K. (2017). The effects of educational curricula and training on LGBT‐specific health issues for healthcare students and professionals: a mixed‐method systematic review. Journal of the International AIDS Society, 20(1), 21624. Doi: 10.7448/IAS.20.1.21624.

Stein, G.L., Beckerman, N.L., & Sherman, P.A. (2010). Lesbian and gay elders and long-term care: Identifying the unique psychosocial perspectives and challenges. Journal of Gerontological Social Work, 53(5), 421-35.

Westwood S, King A, Almack K, Suen Y-T, Bailey L (2015) Good Practice in Health and Social Care Provision for Older LGBT people, In: Fish J, Karban K (eds.), Social Work and Lesbian, Gay, Bisexual and Trans Health Inequalities: International Perspectives pp. 145-158 Policy Press.