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Aged care: keeping LGBTI elders safe, included

Cate Swannell
Med J Aust
Published online: 23 July 2018

RECENT legislative and policy measures aim to raise awareness of the needs of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people, often considered “the most invisible and forgotten” Australian elders, according to the authors of a Perspective published online today by the Medical Journal of Australia.

“This invisibility has consequences for access to health and aged care services, and the standard of mental and physical health among LGBTI elders has been notoriously lower than that of their  non-LGBTI peers,” wrote the authors, led by Conjoint Associate Professor Carmelle Peisah, from UNSW Sydney’s School of Psychiatry, and Ms Samantha Edmonds, Silver Rainbow -- National Project Manager, National LGBTI Health Alliance.

“For many LGBTI elders, particularly the very old cohort, making themselves invisible by hiding sexual orientation, gender identity or intersex status was a necessary protection against discrimination and violence, and a way of avoiding imprisonment and loss of employment, social networks, family and friends,” they wrote.

When added to the perception, both generally and within the LGBTI community itself, of the youthfulness of LGBTI culture, LGBTI elders often remain invisible, meaning that many aged care providers may be unaware that LGBTI people are accessing their services.

In 2012 the Australian Government launched the National LGBTI Ageing and Aged Care Strategy as part of its Living Longer, Living Better aged care reform package, setting out the following goals and actions:

  • LGBTI people will experience equitable access to appropriate ageing and aged care services;
  • the ageing and aged care LGBTI sectors will be supported and resourced to proactively address the needs of older LGBTI people;
  • ageing and aged care services will be supported to deliver LGBTI inclusive services;
  • LGBTI-inclusive ageing and aged care services will be delivered by a skilled and competent paid and volunteer workforce;
  • LGBTI communities, including older LGBTI people, will be actively engaged in the planning, delivery and evaluation of ageing and aged care policies, programs and services;
  • LGBTI people, their families and carers will be a priority for ageing and aged care research.

Additionally, the Aged Care (Living Longer Living Better) Act 2013 expanded the meaning of “people with special needs” to include “lesbian, gay, bisexual, transgender and intersex people”, allowing more diversity of choice in residential aged care for LGTBI elders. And the Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013 precluded Commonwealth-funded faith-based aged care providers from discriminating on the basis of sexual orientation, gender identity or intersex status.

“Aged care providers need to be aware of these legal responsibilities with regard to LGBTI elders,” Peisah and colleagues wrote.

“The implementation of these policy and legislative reform measures requires an informed and skilled health care workforce that demonstrates recognition and respect for those who identify as LGBTI and that ensures their safety and choice regarding aged care.

“If we raise awareness in the medical community about these hard-fought, only recently won, triumphs in reform, then we are making progress towards making the invisible visible.”

  • Cate Swannell


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