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Curtin University
Collaboration for Evidence, Research and Impact in Public Health

Retirement Accommodation and Aged Care Issues for Non-Heterosexual Populations - Social Research Project (2009-2010)

Chief Investigator

Collaborating Partners

The project is a collaboration between Curtin University (WACHPR and Centre for Research on Ageing) and GRAI (Gay Retirement Association Inc). An Industry Advisory Group (IAG) was formed and worked closely with the Project Control Group. Members from the following organisations made up the IAG: Aged Care Association Australia (WA), Carers WA, Retirement Villages Association (WA), Aged and Community Services WA, Council on the Ageing WA.

Funding

  • Lotterywest ($110,495)

Project Aim

This study aims to answer the following questions:

  • What are the social and accommodation needs of older and ageing gay, lesbian, bisexual, trans and intersex (GLBTI) people who are considering retirement?
  • How well do existing retirement, residential aged care and lifestyle accommodation providers understand and currently meet the needs of GLBTI people?
  • How can retirement, residential aged care and lifestyle accommodation providers become informed about the needs of GLBTI people?
  • How can retirement, residential aged care and lifestyle accommodation providers ensure appropriate services are provided to meet the needs of GLBTI people in line with best practice guidelines?

Background

The Gay, Lesbian, Bisexual, Trans and Intersex Retirement Association Inc. (GRAI) has been successful in receiving one year’s funding from Lotterywest through their Social Research Grants program to investigate the needs of older GLBTI people who require supported accommodation. Supported accommodation will cover a range of facilities from independent living to residential aged care. From this research, best practice guidelines for service providers will be drawn up to ensure that GLBTI clients are more appropriately catered for in terms of accommodation options as they age. WACHPR and CRA from Curtin University have been contracted to complete the research project.

Project Overview

This study has used a variety of research tools in order to examine and report upon current responses by the aged care residential sector in Western Australia to the needs of GLBTI community members in order to develop best practice guidelines. This has included a literature review; postal survey to supported accommodation facilities in Western Australia, focus groups.

Organisational data were collected through a self administered postal CEO Survey sent to 40 CEOs of retirement and residential aged care organisations in Western Australia with multiple facilities. A response rate of 32.5% (n=13) was received. The CEO Survey was also sent to single entity organisations and a 14.5% (n=23) response rate was achieved. The higher response rate from CEOs of multiple facilities may be attributed to direct phone contact made prior to them receiving the survey.

Operational data were collected through a state-wide Facility Survey sent to 320 retirement and residential aged care providers in Western Australia. A response rate of 26% (n=83) was achieved.

Over half the facility based respondents (53%) were from the Perth metropolitan area, 40% were from rural Western Australia and 7% were from remote Western Australia. The size of respondent facilities varied, with the majority (61%) having less than 25 full-time equivalent (FTE) staff members. The majority were not-for-profit run organisations (55.6%).

Several focus groups with both senior management of retirement and residential aged care facilities and members of the GLBTI community were held.

Key Outcomes

The research was completed and a report launch was held in July 2010. The project resulted in the following documents being produced:

The research findings confirmed that older and ageing GLBTI individuals accessing retirement and residential aged care services in Western Australia experienced unmet needs and fears of discrimination. This was in line with other national and international research indicating that older GLBTI people are likely to be disadvantaged in the aged care sector due to their minority sexuality. A summary of the findings is provided below.

Experiences and attitudes

Eighty six percent of Facility Survey respondents were unaware of any GLBTI residents within their facility with only 30% of respondents agreeing that their facility recognises that GLBTI residents have specific needs. The majority of Facility Survey respondents (79%) agreed and strongly agreed that a resident’s sexuality was not their concern, however over half (88%) indicated that a residents’ beliefs and personal diversity were promoted within their facility’s policies and procedures. The majority of Facility Survey respondents (66%) felt that they provided a GLBTI-friendly and trusting environment which ‘treated everyone the same’. No facilities provided staff training specific to GLBTI issues. Two however had provided staff training around sexual needs for older people in general however this was not GBLTI specific.

Organisational policy

There was generally poor inclusion of GLBTI issues in policy frameworks. Ninety eight percent of CEO Survey respondents had an established complaints process and the majority (77%) of them were aware that residents could lodge a complaint regarding discrimination based on sexual orientation and/or gender identity. However few CEO Survey respondents’ (37%) organisational policy and procedures made specific reference to GLBTI people, and issues of sexuality were dealt with under general equal opportunity and antidiscrimination policy. Of the 18% of Facility Survey respondents who were aware of state and/or federal legislation relating to GLBTI people being incorporated into their facility’s policy, only 21% made reference to same-sex law reforms.

Current practices

Twenty eight percent of Facility Survey respondents indicated that their facility promotes a welcoming and accepting atmosphere for GLBTI people. Strategies cited included: treating everyone equally, employing gay and lesbian staff and making everyone feel welcome. Having said this, only 5% used any means of indicating an inclusive environment to GLBTI people; 6% had a nominated GLBTI support person and no facilities had partnerships with GLBTI community organisations. The majority of Facility Survey respondents indicated that the data and information collection forms used by their facility did not allow a person to self-identify as GLBTI. Nor did they include the term ‘sexual orientation’ or similar terminology on their resident admission form.

Future directions

Over half of the Facility Survey respondents (59%) did not perceive any challenges by staff when accommodating GLBTI people. Fourteen percent thought there would be some challenges by staff due to lack of knowledge and education of GLBTI issues, and personal attitudes and beliefs. This was similar when asked about perceived challenges by other residents. Of the 19% who thought there would be some challenges, they cited personal attitudes and beliefs of other residents as the most likely cause.

When asked about training needs, most Facility Survey respondents agreed the impact of staff beliefs and values in the delivery of care, and safeguarding GLBTI individuals from discrimination by other residents were important training topics. Having organised sessions, qualified trainers, accessibility, funding and human resources were seen as more likely to lead to training. Barriers included limited funding, time and human resources, staff and residents’ attitudes and beliefs, accessibility and that fact that such training was not applicable to their facility.

Best practice guidelines

To achieve best practice for accommodating older GLBTI people, five principles were identified:

  • inclusive and safe environment;
  • open communication;
  • GLBTI sensitive practices;
  • staff education and training; and
  • GLBTI inclusive organisational policies and procedures.

In the guidelines each principle is expanded with an explanatory statement and a ‘how to’ section, which provides simple low cost strategies for achieving the principle. This is then followed by a brief scenario, providing operational context.

Conference Presentations

  • Comfort, J. & Freijah, R. (2010) Responding to the needs of older gays in supported accommodation, Val’s Café – A forum to promote the health and wellbeing of older gay, lesbian, bisexual, transgender and intersex people (symposium). International Federation on Ageing, Melbourne Convention & Exhibition Centre Climate for Change: Ageing into the future, Melbourne, 3-6 May 2010.
  • Comfort, J., Freijah, R. & Tavener, M. (2010) Accessing and working with residential care providers. A methodological approach. International Federation on Ageing, Melbourne Convention & Exhibition Centre Climate for Change: Ageing into the future, 3-6 May 2010.
  • Barrett, C. (Moderator) Speakers: Hughes, M., Comfort, J., Gahan, L., Wright, T., Rosenstreich, G. & Westacot, R. (2010) Val’s Café – A forum to promote the health and wellbeing of older gay, lesbian, bisexual, transgender and intersex people (symposium). International Federation on Ageing, Melbourne Convention & Exhibition Centre Climate for Change: Ageing into the future, Melbourne, 3-6 May 2010.
  • Barrett, C. (Moderator) Speakers: Hughes, M., Comfort, J., Gahan, L., Wright, T., Rosenstreich, G. & Westacot, R. (2010) Val’s Café – A forum to promote the health and wellbeing of older gay, lesbian, bisexual, transgender and intersex people (symposium). 7th National LGBT Health Conference Health in Difference: Doing Diversity, Sydney, 29 April – 1 May 2010.