This paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney. Data were analysed by identifying evaluative statements within specific narratives and 2 grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers' assumption of heterosexuality among clients and their failure to provide lesbian-or gay-friendly services. The findings highlight the need for health and aged care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.
There is growing awareness in Australia of the issues faced by lesbian and gay people as they grow older. This paper examines concerns regarding their health-related ageing, growing older in the lesbian, gay, bisexual and transgender (LGBT) community and accessing carers' and aged care services in later life. It is based on a secondary data analysis of a sub-sample of 371 lesbians and gays, drawn from a survey of LGBT ageing conducted by the Queensland Association for Healthy Communities. The original survey was primarily quantitative and was delivered online between January 2007 and January 2008. The findings of the present study, based on univariate and bivariate analysis of the sub-sample, highlight that a majority of lesbians and gays were concerned that their sexuality or gender identity may affect the quality of services.Many also expected to be discriminated against and were concerned that same-sex relationships wouldn't be recognised and that staff are not aware of LGBT issues.Lesbian and Gay People's Concerns about Ageing and Accessing Services 2 Among other findings, gay men were more likely than lesbians to be concerned about being alone in later life, while lesbians were more likely to be concerned about a lack ofLGBT-specific accommodation and lack of recognition of same-sex partners.
There is little understanding in Australia of the particular issues faced by gay, lesbian, bisexual and transgender (GLBT) people in end-of-life care and advance care planning. This exploratory qualitative study aimed to achieve an initial understanding of these issues to compare with the international literature and inform the development of a larger study involving GLBT consumers. Consultations were carried out with 19 service providers and 6 GLBT community members located in the Northern Rivers and metropolitan Sydney areas of New South Wales (NSW), Australia. Participants reported barriers to health care service access due to discrimination, inappropriate care, and lack of knowledge among both consumers and health care workers of legal rights at the end of life. While advance care planning can assist with improving end-of-life care, respondents reported a number of obstacles. These included a lack of knowledge and absence of perceived need, and the additional obstacle of social isolation, leading to difficulties identifying alternative decisionmakers. The study highlighted the need for community education among GLBT people and health and aged care providers on the existing legal provisions available to prevent discrimination in end-of-life care.
The needs of older lesbian and gay people regarding access and use of aged‐care services remain underresearched. This paper reports the findings of 33 qualitative interviews with older lesbian women and gay men about their perceptions and experiences of residential aged‐care and home‐based aged‐care services in Australia. The focus of this paper is their preparedness for using aged‐care services. The results highlight that participants had a number of concerns related to accessing residential‐care services in particular, including perceptions of a lack of inclusivity and concerns of potential for discrimination and hostility, loss of access to community and partners, decreased autonomy and concerns relating to quality of care and the potential for elder abuse. Participants noted a number of strategies they employed in avoiding residential‐care services, including the use of home‐care services, renovating the home for increased mobility, moving to locations with greater access to outside home‐care services, a preference for lesbian/gay‐specific housing and residential‐care options if available, and the option of voluntary euthanasia to ensure dignity and autonomy. Participants, on the whole, were hopeful that they would never require the use of residential‐care services, with some believing that having current good health or the support of friends could prevent this from happening. The findings suggest that older lesbian and gay people have a variety of concerns with aged‐care and may need additional support and education to improve their perceptions and experiences of services, whether these are needed presently or in the future.
Despite the devastating impact of HIV/AIDS, end-of-life care planning among lesbian, gay, bisexual and transgender (LGBT) communities is relatively under-researched, especially in Australia. This paper reports findings of a survey of 305 LGBT people living in New South Wales, which examined their knowledge of and attitudes towards end-of-life care. The focus of this paper is their preparedness to discuss with healthcare providers any end-of-life care plans. The results highlight that while the majority of respondents were aware of three of the four key end-of-life care planning options available in New South Wales--enduring powers of attorney, enduring guardians and person responsible (only a minority had heard of advance healthcare directives)--a much smaller number of people had actually taken up these options. Only a minority of respondents were able to identify correctly who had the legal right to make treatment decisions for a person who is unconscious following a car accident. A small proportion of people had discussed end-of-life care options with general practitioners or another main healthcare provider, and only in very few cases were these issues raised by the practitioners themselves. Those most likely to not feel comfortable discussing these issues with practitioners included younger people, those not fully open about their sexuality to family members, and transgender people and others who do not define their gender as male or female. The paper highlights the importance of education strategies to raise awareness of the end-of-life care planning options among LGBT people, as well as strategies for increasing health providers' preparedness to discuss these issues with LGBT patients.
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