“Fear Runs Deep:” The Anticipated Needs of LGBT Older Adults in Long-Term Care

Abstract

This study adds to the existing literature about the worries of older LGBT adults as they anticipate long-term care. The results suggest that older LGBT adults seek LGBT-inclusive residential care settings that encompass two distinct yet related aspects of LGBT-affirmative care: the procedural (e.g. culturally competent skills and knowledge of practitioners) and the implicit (e.g. the values and mission of the organization). This paper identifies implications for practice, policy, and training.

Comfort Among Older Lesbian and Gay People in Disclosing Their Sexual Orientation to Health and Aged Care Services

“…Our study suggests that more frequent experiences of discrimination could potentially contribute to a lack of feeling fully comfortable to disclose. This is in line with studies that found older lesbian and gay people report fears of disclosing their sexual orientation due to expectations of discrimination (Barrett et al, 2015; Furlotte et al, 2016; Hughes, 2007; Löf & Olaison, 2018; Morales et al, 2014; Putney et al, 2018), so it is possible that previous experiences of discrimination contribute to fears of future discrimination.…”

“…Qualitative studies in Australia have found that some participants expressed feelings of stress around disclosure to health and aged care service providers due to fears of unfair treatment, and felt the need for staff to provide an environment where disclosure was facilitated (Barrett et al, 2015; Hughes, 2007). Qualitative studies in the United States (Putney et al, 2018), Canada (Furlotte et al, 2016), and Europe (Löf & Olaison, 2018) have also found that older lesbian women and gay men report concerns around disclosing their sexual orientation in health and aged care settings due to fear of discrimination. A quantitative study of older LGBT people in the United States found that many participants reported fearing that knowledge of their sexual orientation by their health care providers would lead to differential treatment (Morales et al, 2014).…”

Serving LGBTQ+/SGL Elders during the Novel Corona Virus (COVID-19) Pandemic: Striving for Justice, Recognizing Resilience

“…Of the 2.7 million LGBTQ+/SGL adults age 50 and older in the U.S., one-fifth of which are people of color, many are at higher medical risk, as mounting evidence indicates disparities in general health, disability, and chronic conditions associated with past experiences of discrimination and stigma among other factors (Fredriksen-Goldsen et al, 2019;MAP & SAGE, 2020). Prior to the pandemic, this population had also reported unique barriers to accessing care stemming from a lack of financial access, fears of discrimination or judgment, and concerns over one's safety and ability to find community, particularly in long-term care settings (Fredriksen-Goldsen et al, 2019;Putney et al, 2018) and to the greatest degree among older adults of color and transgender individuals (MAP & SAGE, 2020). Limited access to health care due to interpersonal reasons as well as religious freedom policies allowing discriminatory practices, may mean that LGBTQ +/SGL elders are unlikely to access virus testing and medical care required during the pandemic.…”

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review

“…(2014) report that over a fifth of 113 older LGB participants experienced physical, emotional, verbal, sexual and financial abuse and neglect by caregivers. Due to the history of discrimination and ‘othering’, many older LGBT+ adults fear sexuality and/or gender identity‐based discrimination in aged care settings should they disclose their sexual orientation or gender identity to health and social care services (Burton, Lee, Waalen, & Gibbs, 2019; Putney, Keary, Heber, Krinsky, & Halmo, 2018).…”

“…The call to action to address these gaps through education, culturally sensitive and inclusive curriculum and training approaches for health and social care professionals has been highlighted by scholars and activists (Cannon, Shukla, & Vanderbilt, 2017; De Guzman, 2018; Llayton & Caldas, 2020). This is essential to enable inclusive, accessible care for older LGBT+ adults (Putney et al., 2018; Smith, Altman, Meeks, & Hinrichs, 2019). Hence, this paper reports the findings from a systematic review into interventions used to educate the health and social care workforce on the experiences and needs of older LGBT+ adults, in order to guide and improve educational practice going forward.…”