LGBTI-Inclusive Practice in Aged Care
Published: 21 December 2017
Published: 21 December 2017
Many people may think they already hold an accepting and open view of diversity and treat everyone equally. Often, high-level conversations within healthcare organisations are prefaced with statements such as: 'As far as I am concerned, people can do and live how they want,' and, 'I don’t have a problem with people from the LGBTI community'.
Although these sentiments are encouraging, they are not enough to ensure that our work is truly inclusive. In order to gain a further understanding of the unique issues people from the LGBTI community may have experienced - and in many cases, still do - training and open communication are needed for our healthcare workers.
Presently in Australia, homosexuality has been decriminalised across all states and territories, with Queensland in 1990 and Tasmania as late as 1997.
Due to the lateness of this decriminalisation, the current generation of older LGBTI community members were still navigating their adulthood years when their sex, sexual orientation or gender identity had terrible consequences.
The freedom that many teenagers and young adults experience today was not necessarily afforded to those who identified as LGBTI before them. For some Australians, the impact of past criminal convictions still remains with them today.
As many LGBTI older adults have and may continue to experience discrimination, it is important that we gain an understanding of how this may have affected their health in different ways. It is therefore important that as care providers, we ensure we have a basic understanding of these issues.
Providing a safe and inclusive environment should be the priority of all healthcare organisations and their workers, no matter the client.
Do not automatically assume that everyone is cisgender and heterosexual. Giving people the option to disclose their identity is important, however, it may take some time to build trust between you as a healthcare worker and your client. If a client does disclose their gender identity or orientation to you, make sure that you ask them specifically who the information is for. Some people may be 'out' to you and their close friends, but not to other family members or acquaintances.
It is important to establish who this information may be shared with.
A person's definition of family may be different to your own understanding. Some people may have lost contact with or been rejected by their family members because of their disclosure. As a healthcare worker, it is important to accept and take into consideration the acknowledgement of long-term partners or other members of your client's close group when discussing health options and care treatments.
Listening to and acknowledging partnerships will help you provide a safe and respectful environment to discuss healthcare issues with your clients.
Health issues are unique to the individual. Providing true patient-centred care will enable you to work with different clients and their specific needs.
In the transgender community, for example, some clients will undergo gender reassignment surgery, while others may undergo transitioning without surgical intervention. Listening attentively to clients who are transitioning will allow you to clarify how your client would like to be addressed, possibly reduce embarrassment with personal care needs (especially if there has not been surgery involved) and give support and understanding.
LGBTI clients may be more vulnerable to mental health issues. They may have had to endure a lifetime of bullying, harassment and rejection from others whom they have been close to. Living a life of constant stress of not being able to be themselves; being on constant guard for fear of being exposed; and a fear of losing a health service if their sexual orientation, gender identity or intersex status becomes known can be very detrimental to a person’s mental health.
Sometimes, older adults may return to hiding their true identity even after having lived for many years as an open member of the LGBTI community, for fear of discrimination in residential aged care or from care workers who are providing services for personal and other care needs.
Again, ensuring that your work practices communicate a sense of security and inclusiveness will help to make sure that your client can access proper healthcare.
All members of society have the right to access equal and individualised healthcare. Speaking with your supervisors regarding extra training for yourself or your colleagues will help with ensuring that your practices are diverse and inclusive for everyone. There should be a process for assessing the professional development needs of all staff and volunteers in regards to LGBTI-inclusive practice and the cultural needs of staff members.
There are many ways that you work with your organisation to ensure that it adopts a culture of inclusive practice. Some initiatives are circulating information about LGBTI cultural safety, consumer consultation, appropriate disclosure and documentation as well as safe intake processes.
Often, cultural change starts with one person. Ensuring that your own practice and provision of service is diverse and inclusive should be the goal.
Susan Tredenick is a healthcare consultant with extensive experience in aged and community care. Operating in a range of industries, including Not-for-Profit, NGO and Private companies, she has a special interest in supporting people to be engaged with their healthcare management. Working with innovative companies allows this to be a reality as well as develop her interest in delivering speaking engagements to the community. With a background in nursing and management, her career includes roles in clinical and case management as well as project management with Telehealth and Telecare Research. See Educator Profile