Older LGBTI people ‘avoiding aged care’

Having experienced profound discrimination and harassment in their youth, many older lesbian, gay, bisexual, transgender and intersex (LGBTI) people are fearful of disclosing their sexuality or gender identity to aged care providers and delay or avoid accessing services, the inaugural LGBTI Ageing and Aged Care Conference has heard.

While social isolation and poorer health outcomes were experienced widely by older LGBTI people, those with dementia and those living in rural and remote areas faced even more pronounced challenges, experts told the event.

Older LGBTI people, service providers, peak bodies, researchers and policy makers packed into Melbourne Town Hall on Tuesday and Wednesday to attend the event organised by Val’s Café, a project supporting providers in delivering LGBTI inclusive services.

The conference heard from the researchers behind Australia’s first-ever study into older LGBTI people who are living with dementia.

Teresa Chorazyczewski from Alzheimer’s Australia Queensland and Sally Lambourne from Alzheimer’s Australia NSW have been interviewing older LGBTI people living with dementia for their study, which aims to improve services.

Discussing the themes emerging from the research, they said social isolation was frequently raised by participants, as well as the need to be connected to other LGBTI people. Ms Lambourne said:

“LGBTI seniors grew up in a time when disclosing resulted in being sacked, being rejected, being disowned by family; the implications of this are that LGBTI people will avoid routine health checks due to these past negative experiences.”

As a result, while an early diagnosis of dementia was important, older LGBTI people were likely to be diagnosed much later than their straight counterparts.

Many older LGBTI people led closeted lives by necessity, she said. “We are finding in the research that people believe it’s wrong to flaunt your gayness, people who do are ‘asking for trouble’. There seems to be a real fear of offending others for being who you are.”

Older LGBTI people may be unlikely to reveal their sexuality, and services and staff had to bear in mind that LGBTI seniors “probably spent years perfecting highly effective camouflage.”

The researchers also spoke of older LGBTI people who were closeted and private, and had experienced the “real distress of being outed by a partner when they get dementia.”

Difficulties in rural and remote

The conference heard that many rural communities were still “incredibly challenging environments” for LGBTI people and this impacted on their willingness to access services and social support.

Kylie Stephens from the Centre for Excellence in Rural Sexual Health at the University of Melbourne and Dr Rachel Richardson from Charles Sturt University said there were few visible signs of diversity in many rural communities and this meant services were not compelled to respond to specific needs of minority groups, such as LGBTI people.

There was an irony in the fact that LGBTI seniors were unlikely to disclose their sexual orientation or gender identity until services demonstrated inclusivity, which in turn could reinforce an organisation’s belief there were no LGBTI people in the community.

Ms Stephens said there was a fear of loneliness and isolation among LGBTI seniors, who were more likely to have fewer social connections and supports.

It was likely that older rural LGBTI people would want to ensure they had access to the internet as this was a vital source of support and information, yet in some areas internet access remained an issue.

“The virtual world is very much part of the trans world because, for many of us, we have remained hidden for many, many years and the only place we can discuss openly how we feel has been the internet,” said Dr Richardson.

Ms Stephens said that lack of choice was “definitely a rural issue” and there was a real fear around it. She said:

“Travelling from the country to the city for service and support is especially common if not essential for trans women and men, but what happens as we age and travel becomes more problematic, especially without those social supports.”

Dr Richardson said that aged care organisations and staff had to advocate on behalf of their LGBTI clients, but to successfully do that they must educate themselves so they would understand their health needs.

‘Rainbow tick’

Elsewhere, Sunil Patel from Gay and Lesbian Health Victoria (GLHV) spoke about the development of The Rainbow Tick program, a set of six standards against which services can be accredited to demonstrate LGBTI inclusive practice and service delivery.

GLHV delivers the HOW2 program which delivers workshops to agencies preparing to apply for rainbow tick certification.

The organisation had conducted 20 sessions with nearly 400 participants, and with 2015 sessions almost booked out Mr Sumil praised the response from aged care organisations.

Australian Ageing Agenda was a media partner of the LGBTI Ageing and Aged Care Conference. 

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