Don't look back? Improving health and social care service delivery for older LGB users

Citation

Ward R, Pugh S & Price E (2010) Don't look back? Improving health and social care service delivery for older LGB users. Equalities and Human Rights Commission. http://www.equalityhumanrights.com/uploaded_files/research/dont_look_back_improving_health_and_social_care.pdf

Abstract
There are wide gaps in knowledge about the lesbian, gay and bisexual (LGB) UK population in relation to their physical and mental health outcomes, use of health and social services and experiences of health and social care more generally. Very little data exists that compares LGB and heterosexual populations. The evidence is even more limited for older LGB people. The existing evidence suggests that LGB people face many of the same issues as other members of society when ageing, including health and care concerns, however, their experiences and needs are mediated through a range of forms of disadvantage and discrimination related to their sexual orientation, and other aspects of their identities. Understanding how this affects the lives of older LGB people, and what it may mean to be older and LGB when accessing health and social care is at the heart of this paper. The paper demonstrates how older LGB people have been overlooked in health and social care legislation, policy, research, guidance and practice which assume service users are heterosexual. The existing evidence points to discrimination and anticipation of negative treatment when older LGB people access services. Particular health and social care issues require greater attention and action: for example older LGB people may be likely to have different mental health needs to their heterosexual peers; some older gay men may become infected with HIV in their 50s or 60s, or are already living with it, and we know that older adults may present later than their younger counterparts for a diagnosis. Older adults appear to be a rising proportion of the overall population diagnosed with HIV, therefore prevention programmes will need to include older people, including gay men. LGB high level service users who are frail and depend upon care services, and LGB carers, have received the least attention, along with people with dementia or people requiring end of life care. The potential exists for the provision of care and support to older LGB people to become a ‘litmus test' - an indicator for how well health and social care agencies engage with minority groups and deliver a non-discriminatory service that works for service users.