Study targets inclusive care for LGBTQ+ people

The large project aims to address the prejudice many older people expect to face.

A five-year multi-stakeholder collaboration is co-designing a best-practice inclusive model of residential aged care for LGBTQ+ older people to roll out nationally.

The Southern Cross University-led study aims to investigate how Australia’s aged care sector can enhance its service delivery to cover a wider demographic of gender and sexual diversity.

Part of the problem is that many older people from the LGBTQ+ community are concerned about discrimination, said lead researcher Mark Hughes – a professor of Social Work at Southern Cross University.

“Many people say they expect to be discriminated against and often their concerns are about faith-based providers. They can be quite fearful about what might happen to them if they end up in residential aged care,” Professor Hughes told Australian Ageing Agenda.

Funded by the Australian Government through the Medical Research Future Fund, the $999,500 study involves Southern Cross University researchers collaborating with four other universities, peak aged care bodies, LGBTQ+ organisations, the LGBTQ+ community, and residential aged care providers to develop a best-practice inclusive model of aged care.

Professor Mark Hughes

Professor Hughes told AAA that faith-based providers will be key to the success of developing such a model. “Faith-based providers are an important stakeholder in the sector … so engaging with faith-based providers in particular – but all residential aged care providers – is going to be important to developing a model that is meaningful for the sector and can be transferrable across the diversity of providers in Australia.”

The first-of-its-kind study is in response to the aged care royal commission, which found inclusive service provision was essential to providing a safe, supported environment for people from diverse backgrounds.

“There were serious concerns raised by the royal commission about the quality of care provided in residential aged care and there are a number of witness statements which spoke to discrimination and abuse experienced by LGBTQ+ when accessing aged care,” said Professor Hughes.

“In order to provide a safe and supportive environment with people with diverse genders and sexualities we really need to look at what enables and constrains inclusive care and also develop a model of inclusive care that residential aged care providers can put into practice.”

Study includes a two-state trial ahead of national roll out

After engaging with the LGBTQ+ community and other stakeholders to design a model of inclusive care, guidelines and resources will be developed to support service providers in putting that model into practice.

It will then be trialled in up to 19 residential aged care facilities across Queensland and Western Australia. Once evaluated, the trial’s findings will inform a refinement of the model before it is rolled out nationally.

Professor Hughes told AAA that the model of care will incorporate the following aspects: “Relationships, communication, leadership, education, training, risk management – so that they all come together to support LGBTQ+ older people living in residential aged care.”

And not just the residents, added Professor Hughes. “But also LGBTQ+ people who visit people in residential aged care and LGBTQ+ staff and family and friends.”

Other factors to be assessed by the researchers include the impacts of the casualisation of the aged care workforce; the high number of aged care staff who are migrants from non-English-speaking backgrounds; and faith-based organisations operating in the aged care sector.

According to government data, as June 2023, 22 per cent of aged care places in Australia were run by faith-based organisations.

Having experienced systemic prejudice over many decades – not least during the HIV/AIDS crisis – the fear of discrimination for the current generation of LGBTQ+ older people is justified, said Professor Hughes.

“It’s the fear that has been generated as a result of that trauma and discrimination that people have experienced. Sometimes that has been the experience of residential aged care itself, although often it may have been an experience of discrimination in other healthcare services or community services that people might have been accessing earlier in life.”

Professor Hughes told AAA the fear of facing discrimination in residential aged care can be extremely triggering for people. “It might lead them to go back into the closet to hide their identity and generate a high-level of concern about how they might be treated in residential aged care. Those are the things that we need to look at and see how we can work with the sector to address.”

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