Study of LGB people in residential care reveals knowledge gap

Research by Swansea University’s College of Human and Health Sciences, examining how the sexual identities and relationships of older lesbian, gay and bi-sexual (LGB) residents are perceived and supported in residential care in Wales suggest that there is a widespread lack of recognition of their care needs, but a willingness in the sector to increase knowledge in this area.

The two year research project, funded by the National Institute for Social Care and Health Research (NISCHR) explored the care practices and policies relating to older LGB residents in care environments in Wales.

The team, from the Centre of Innovative Ageing and the Centre for Social Work and Social Care led by Dr Paul Willis, set out to establish how the sexual identities and relationships of older LGB residents are supported by care and nursing staff in care environments, by agency management and at provider and national levels.

Researchers also looked at attitudes to and perceptions of care and nursing staff towards older LGB resident’s sexual needs, practices and relationships.

The team used mixed research methods: surveying 121 care and nursing staff and managers; interviewing 29 older LGB people; holding 9 focus groups with up to 62 participants and analysing a random sample of 383 Care and Social Services Inspectorate Wales (CSSIW) documents to identify any content about sexual diversity, sexual health and older LGB people.  

The team found that while most respondents hold affirmative and permissive attitudes towards the sexual lives of older people and LGB people more generally, there are large gaps in the knowledge of changes in sexual functioning in older years and on important aspects of LGB history.

Dr Willis said: “It appears that present care environments in Wales are not adequately prepared or sufficiently resourced to provide inclusive services for LGB-identifying residents. Nevertheless, care staff and management are open to increased knowledge and skills development in this area.

“This suggests that training on how to lead affirming discussions with older people about their sexual histories, identities and care needs to be in place for care service providers to meet their duties under the Equality Act 2010.”

The findings also indicate that ambivalent attitudes on the basis of religious views needs to be tackled in training sessions that invite care and nursing staff to reflect on different values and belief systems.

The team have made several recommendations for the CSSIW, policy makers, care managers, care workers and researchers including:

  • improved inspection reporting
  • better future directions by policy makers ensuring concrete actions about how services will be supported and resourced, to help ensure care and nursing staff are actively including older LGB people in their practice
  • enhanced care home environments to increase positive recognition of older LGB people and sexualities
  • training for care and nursing staff in LGB issues which could, for example, feature extracts from interviews for case studies and digital stories about older LGB people’s lives
  • more research to find whether current UK and Welsh law and social care policy is being translated into practice and to examine the specific care needs of older people who identify as transgender

Dr Willis said: “We hope that our research will help promote anti-discriminatory care practices and environments for older LGB people, raise awareness of their hopes, expectations and concerns and make an impact on policy recommendations in care and nursing homes in the future.”