LGB&T+ communities and dementia

For lesbian, gay, bisexual and transgender + (LGB&T+) people, living with dementia can be additionally stressful. Not only are LGB&T+ people less likely to have family members and children who can support them as they deal with the disability, they are also more likely to live on their own and be single than heterosexual people. Even with a ‘family of choice’, LGB&T+ people often have an increased need to use social care services for support and help as their disease progresses. Many fear that mainstream care services will not be willing or are not able to understand how to meet their needs.

Commissioners and providers of social and health care often fail to consider the needs of LGB&T+ people (1) when planning and/or running services. Assuming that all people are heterosexual or cisgender, they may unwittingly discriminate against those who are not heterosexual or who do not identify with the gender they were assigned at birth. A recent survey of service users and commissioners about post-diagnostic support (2) confirms this is often the case.

LGB&T+ people may not feel safe to ‘come out’ to new people such as staff and be fearful of rejection. They may worry that they will be isolated from others in a care home and dread that they may experience discrimination or abuse from staff or other residents. In the past, they may have experienced aggression or rejection from others because of their sexuality or gender identity. LGB&T+ people may fear ‘being outed’ and worry that, when their dementia develops to a greater extent, their privacy will be exposed or that staff and residents will not understand their personal history.  LGB&T+ people with dementia have specific health and care needs along with the usual care and support issues as everyone else as they age. The need for a person-centered approach among staff and visitors is paramount.

Examples of good practice are limited (3) but a rights-based approach which regards dementia as a disability is a helpful starting point. Involving LGB&T+ people in shaping policies and practices on dementia care and taking a partnership approach between health, social care and the voluntary sector are all important in meeting the needs and hopes of LGB&T people.