6 - Good Care

"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 LGBT+ older 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 LGBT+ older 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 LGBT+ older 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).