Older LGBTI+ people feel ‘forced back into closet’
A study conducted by UniSA has found older LGBTI+ people feel unsafe and vulnerable when entering aged care services.
Older LGBTI+ people feel pressured to appear heterosexual in order to blend in at aged care facilities, research from the University of South Australia shows.
The meta-synthesis research project combined findings from 55 studies – which included responses from over 3,000 LGBTI+ people aged 50-94 – from 11 countries who had experienced aged care. It then cross-referenced the results with the perspectives of a consultant group from South Australia on how they felt about accessing aged care services.
“The research from overseas looked at people who had used care or had experienced care, and while there was some great research done in Australia and a lot of research coming out of Australia in this area, a lot of the participants had never actually experienced care,” explained lead researcher Sarah McMullen-Roach told Australian Ageing Agenda.
Researchers found that older LGBTI+ people living in aged care experienced prejudice, exclusion and a lack of respect.
The four commonalities that emerged were:
- heterosexuality is deeply embedded in aged care, shaping the environment, dress codes, activities, and assumptions about relationships
- LGBTI+ adults feel unsafe and vulnerable in aged care settings, due to historical discrimination and care providers being away from the public eye
- many older LGBTI+ people feel forced back “into the closet” to stay safe in aged care
- participants want inclusive, respectful care that affirms their identity, not special treatment that keeps them separate.
Ms McMullen-Roach – who has worked in aged care and is part of the LGBTI+ community herself – said she was surprised to see how much research had been done across the world on LGBTI+ ageing and aged care, especially from countries where homosexuality remains illegal.
Another thing emphasised was “how pervasive the heterosexism is in aged care,” Ms McMullen-Roach added.
“That idea that ‘women dress like this and hold these roles, and would like to do these activities,’ ‘men dress like this and hold these roles and would like to do these activities,’ ‘women and men are attracted to each other,’ you know all these sort of subliminal messaging and just how strong it was – having even worked in aged care, not picking up on that and just that constant messaging, really stood out to me,” she told AAA.
She said the research shows LGBTI+ older adults have clear reservations about aged care, but do not have a desire for LGBTI+ specific care, rather, they want to be seen and accepted for who they are without needing to “retreat from their identities.”
“LGBTI+ people worry that when the time comes to consider aged care they’ll be met with ostracism and discrimination, with gendered roles and standards forced upon them when they can no longer present themselves as they choose,” she said.
“Having to give up their hard-earned rights and identities is unthinkable, particularly when you remember that homosexuality was only fully decriminalised in Australia in 1997, with same-sex marriage made legal less than 10 years ago,” she added.
Multi-level interventions recommended
Ms McMullen-Roach said the faith-based nature of many aged care facilities contributed to concerns about safety, vulnerability and homophobia. Multi-level interventions are needed to ensure inclusive good quality aged care services are available and accepting of the older LGBTI+ community, she added.
Using inclusive language on intake forms, engaging staff in training and advertising, showcasing the diversity of their residents more on advertising materials or simple things such as displaying a rainbow sign at reception can all help in the fostering of a safer environment, Ms McMullen-Roach said.
“Education is also a much-needed intervention that will help change the current state of aged care services, helping them reduce the risk of systemic homophobia while increasing the dignity and respect for older LGBTI+ people,” she added.
Education is particularly important given the diversity of the aged care workforce – with many aged care workers coming from countries where homosexuality is not legal, Ms McMullen-Roach told AAA.
“Care providers need to know that the world’s not exclusively straight, and that LGBTI+ people may have different care needs that should be accommodated,” she said.
“Some of this education is happening in Australia, but we don’t know the impact it has on LGBTI+ individuals’ experiences and willingness to access care services.
“This is what we want to understand in the Australian context: is discrimination truly historical and left in the past? Are people being supported to age free from fear? If not, what needs to change to create a better more inclusive future in aged care?”
UniSA has extended the study. Ms McMullen-Roach told AAA she has just completed interviews with 19 older LGBTI+ people who are currently accessing aged care services. The preliminary results are expected to be published in the new year.
“I’m very much in that early stage of delving into the data at the moment. But when I look at what’s coming through there and what came through in the previous study, what’s consistent is the need for providers to be educated in LGBTI+ histories, LGBTI+ trauma, understanding how that comes into going into an institution, getting services, how people might express themselves – particularly around HIV positive people or people who are transgender and on hormone treatments. Like do providers know how to manage that?” she said to AAA.
Providers have not been involved in the study yet, but Ms McMullen-Roach told AAA that seeking out provider perspectives is likely the next step of the research.
LGBTI+ is the preferred terminology used by older adults included in this study.
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