A Scoping Review of Older LGBTI People's Experiences of Homecare

Abstract

Amidst the global growth of the ageing demographic in the world, an inclusive assessment of the care needs of the older lesbian, gay, bisexual, transgender, and intersex (LGBTI) population is receiving increasing attention, especially in view of reported health inequalities for these minority groups and the position of their sexual orientations and gender identities within a predominantly heteronormative health and social system. This literature review aims to identify and analyse previous research on older LGBTI people’s views, experiences, and perceptions of homecare provision. We searched the CINAHL, Medline, and PsychINFO databases and found a total of 337 records. After an eligibility assessment, 12 studies were selected, comprising 11 qualitative studies, and one mixed methods study. Under an overarching theme of fears of discrimination and of receiving suboptimal care, we further categorised our findings in the following three interlinked subthemes: (a) disclosure of gender identity and sexual orientation; (b) emerging meanings of LGBTI‐competent care; and (c) recommendations for improved quality of LGBTI‐friendly services. The overall surfacing outcome of our analysis of the participants’ experiences described in the studies examined is an aspiration for homecare services ensuring quality of holistic, person‐centred care that recognises this population’s distinct set of requirements, including knowledge and consideration of their histories of inequalities and oppression. Wider awareness about the need to re‐imagine more inclusive care for the LGBTI community has the potential to improve services and practices, reduce access barriers, and prevent inequalities.

Reflections on Community Development, Preventative Care, and Ageing

“…Articles describe some of the measures taken to assess, investigate, and understand the nature and extent of social care problems across these different nations, as well as the success, or otherwise, of efforts to mitigate them. Subjects covered include providing home-based care in isolated mountain regions (Lodi Rizzini et al, 2024), the application of social hubs (Rantala et al, 2024), a senior community care model (Riccò et al, 2024), older LGBTI people's views and experiences of homecare provision in the context of "predominantly heteronormative" health and social systems (Duffy et al, 2024), and community-focussed prevention initiatives (Read et al, 2024).…”

“…Culturally relevant ways to link and share knowledge are covered between older people in Indigenous populations and younger people (Buchanan et al, 2024), through dancing and social connections for older women (Xia et al, 2024), in more inclusive social hubs (Rantala et al, 2024), in community development within a nursing home and cohousing project for older people (Riccò et al, 2024), and within a place-based volunteer service developed by local people (Barker & Roach, 2024). Duffy et al (2024) call for a re-imagining of inclusive home care for older LGBTI people where there is cultural humility and respect for the importance of home, and awareness of histories of oppression and inequality for LGBTI communities. Riccò et al (2024) remind us about the "practical and symbolic aspects" of community and that community-building processes take time and critical awareness.…”