Enjeux: EMS

This qualitative study describes expectations, concerns, and needs regarding long-term care (LTC) homes and home care services of 12 older lesbian and gay couples living in Canada. Our findings reflect four major themes: discrimination, identity, expenditure of energy, and nuanced care. Discrimination involved concerns about covert discrimination; loss of social buffers as one ages; and diminished ability to advocate for oneself and one{’}s partner. Identity involved anticipated risk over disclosing one{’}s sexual identity; the importance of being identified within a coupled relationship; and the importance of access to reference groups of other gay seniors. We conclude that partners were burdened by the emotional effort expended to hide parts of their identity, assess their environments for discrimination, and to placate others. Nuanced care involved a mutual level of comfort experienced by participants and their health care providers. These themes inform understandings of LTC homes and home care services for lesbian and gay older couples.

An ongoing fear in the gay and lesbian community is that long-term care (LTC) facilities may not be sensitive to their needs. In the present study, 218 LTC staff members responded to one of three v…

Much research on older gay, lesbian, bisexual and transgender (GLBT) adults has focused on refuting the widely held mis- conceptions people have about GLBT lifestyles. To date, however, few studies on older GLBTs have examined their social and health care needs. Further, most studies have collected survey samples of older GLBT adults in large metropolitan areas and have not specifically ad- dressed discrimination or bias in retirement care facilities. In the current exploratory study on perceptions of discrimination and bias in retire- ment care facilities, we surveyed a wide age range GLBT adults in a smaller metropolitan area of fewer than 400,000 people to discover the perceptions of both younger and older GLBTs. We surveyed perceptions of discrimination in retirement care facilities, sources of perceived dis- crimination, and suggestions for how discrimination might be reduced or eliminated in those settings. Respondents indicated that administra- tion, care staff, and residents of retirement care facilities themselves were all potential sources of discrimination, and that education address- ing awareness and acceptance of GLBTs is one potential remedy for dis- crimination against GLBTs in retirement care facilities. Respondents also indicated a strong desire for the development of GLBT-exclusive or GLBT-friendly retirement care facilities. Chi-square analyses of re- sponses to the discrimination questions and respondents{’} demographic characteristics revealed significant differences with regard to age, in- come, gender, community size, and education level of the respondents.

This article examines the literature relating to the attitudes of nurses currently practicing in nursing homes towards caring for gay men and lesbians in Ireland. Nurses{’} knowledge of and attitudes towards the sexuality of those in their care can potentially have an impact on the quality of care they deliver and the patient experience.There is a consensus in the literature regarding the expression of sexuality as a lifelong need and integral element of quality of life. Research to date focusing on the needs of older gay or lesbian individuals has been virtually non-existent, despite increases in life expectancy and increasing numbers of older people, and therefore older gay and lesbian people requiring nursing home care.

The aim of this systematic literature review is to investigate older residents{’} thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care.

European Geriatric Medecine, 8 (2017) 66-70. doi:10.1016/j.eurger.2016.12.003

Older lesbian, gay, bisexual, and transgender (LGBT) adults are a vulnerable yet resilient population who face unique stressors as they foresee health decline. This paper presents the results of a study about community-dwell- ing LGBT older adults{’} anticipated needs and fears related to nursing homes and assisted living. Methods: This qualitative study collected data through seven focus groups. The sample (N = 50) consisted of LGBT-identified adults age 55 and over. We used an inductive, thematic analysis approach to data analysis. Results: Participants seek an inclusive environment where they will be safe and feel connected to a community. They fear dependence on healthcare providers, dementia, mis- treatment, and isolation. Importantly, these fears can lead to identity concealment and psychological distress, including sui- cide ideation. Discussion: This study adds to the existing litera- ture 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 pro- cedural (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 prac- tice, policy, and training.

Like all spaces, concrete caring places both shape and are shaped by understandings and constructions of normativity and identity. The traditional understanding of care for older people, imagining clearly demarcated dyadic roles, is firmly embedded in heterosexual logics of relationships within families, the own (family) home and institutional support. Social and residential places for older people thus both assume particular gender and sexual identities and contribute to a (re)production of the very normativity. But how can this interlinkage between the construction of caring spaces and the normativity of identities be understood and, possibly, challenged? In this article we discuss the transformative potential of the social (and partly residential) space of La Fundación 26 de Diciembre, in Madrid, Spain, which opened up to specifically support older LGBT people. Drawing on an in-depth case study we explore a space that allows visibility of different forms of living and caring practices of people with different genders, sexual preferences, origins, classes or political backgrounds. Through the daily life narratives of the people who work, volunteer or simply use the centre we discuss the potential of challenging the restricted notions, assumptions and constructions through which particular places gain both social and political meaning. The article highlights the transformative power of the active and collective making of caring spaces through which narratives of care, collective sexual and gender recognition and practices of caring relationships can replace both traditional/informal forms of living together and institutional spaces that provide professional care.

Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care

The needs of older lesbian and gay people regarding access and use of aged-care services remain underresearched. This paper reports the findings of 33 qualitative interviews with older lesbian women and gay men about their perceptions and expe- riences of residential aged-care and home-based aged-care services in Australia. The focus of this paper is their preparedness for using aged-care services. The results highlight that participants had a number of concerns related to accessing residential- care services in particular, including perceptions of a lack of inclusivity and concerns of potential for discrimination and hostility, loss of access to community and partners, decreased autonomy and concerns relating to quality of care and the potential for elder abuse. Participants noted a number of strategies they employed in avoiding residential-care services, including the use of home-care services, renovating the home for increased mobility, moving to locations with greater access to outside home-care services, a preference for lesbian/gay-specific housing and residential- care options if available, and the option of voluntary euthanasia to ensure dignity and autonomy. Participants, on the whole, were hopeful that they would never require the use of residential-care services, with some believing that having current good health or the support of friends could prevent this from happening. The findings sug- gest that older lesbian and gay people have a variety of concerns with aged-care and may need additional support and education to improve their perceptions and experi- ences of services, whether these are needed presently or in the future.

This paper is a conceptual discussion of the ways in which the diverse lives, identities and collective politics of lesbian, gay and bisexual (LGB) people can be made visible, and how they are made visible, in long-term care environments for older people. The purpose of this paper is to problematise strategies of visibility as methods for promoting social inclusion in care environments.,This is a conceptual discussion that draws on several social theorists that have previously discussed the politics of visibility, knowledge and sexuality.,Promoting increased visibility in itself does not fully grapple with the ways in which older LGB can be represented and known as particular kinds of sexual citizens. This potentially curtails a more holistic recognition of their needs, interests and wishes, inclusive of their sexual lives and histories. Making LGB lives visible in care environments may not always be a productive or affirmative strategy for dismantling homophobic views and beliefs.,The theoretical implications of a politics of visibility warrant a deeper consideration of strategies for promoting visibility. The paper concludes with a discussion of some of the practical implications for rethinking strategies of visibility in care environments.,Critical discussions about the application of visibility strategies, and the problematic assumptions contained within such strategies, are lacking in relation to mainstream housing and social care provision for older LGB people. This paper seeks to initiate this important discussion.

This paper centres on a neglected area of social work with older people{—}the social inclusion of older lesbian, gay and bisexual (LGB) adults in long-term care environments. The translation of equality law into the delivery of adult care services is a challenging endeavour for organisations, even more so in the morally-contested terrain of sexual wellbeing. In this paper we report findings from a mixed method study into the provision of long-term care for older adults who identify as LGB. Herein we present findings from a survey of care workers and managers (n=121) and from focus groups with equality and LGB stakeholder representatives (n=20) in Wales. Focussing on the current knowledge and understanding of staff, we suggest that affirmative beliefs and practices with sexual minorities are evident amongst care workers and managers, however the inclusion of LGB residents needs to be advanced systemically at structural, cultural and individual levels of provision. There is a need for enhancing awareness of the legacy of enduring discrimination for older LGB people, for cultural acceptance in care environments of older people{’}s sexual desires and relationships, and for a more explicit implementation of equality legislation. Social workers in adult care can advance this agenda.

Because discrimination against LGBTQ elders is so common in senior living residences, and social isolation is pervasive among elders who choose to remain at hom…