Aged Care Insite Issue 112 | Apr-May 2019 | Page 17

industry & reform For many older LGBTI people, their home has largely been a safe place – possibly the one place where they can go and be safe. By needing to access services and have them coming to your home, it means that safe place may not be so safe and may potentially be violated. There was some recent research done here at La Trobe University called Rainbow Ageing, which found an overwhelming preoccupation and fear of going into residential aged care, and there didn’t seem to be much knowledge about those other support services. We also know that many older LGBTI people often don’t have an advocate, and an advocate is really important as you age, and also if you find yourself in hospital or a range of other situations. By and large, there seems to be, from the research, a real anxiety about needing to ask for assistance, and knowing where to find that assistance. From what you’ve seen, how do carers or nurses in aged care facilities cope with the LGBTI community and residents? I think things are changing. I came to be working in and around LGBTI issues and inclusivity from when I was working in community aged care myself, and our service developed knowledge and capacity to be LGBTI inclusive and then, ultimately, went on to get the first rainbow check. We started doing work potentially around 10 years ago, but got the rainbow check in 2012. At that point in time, there seemed to be an apathy or a misunderstanding – an attitude of “Well, we don’t need to do this because we won’t have any LGBTI clients” or “We don’t have any LGBTI residents living here”. People were coming to that conclusion based on a range of different variables, but it just seemed to me that services were provided in a very heteronormative and cisgendered approach, which I think is changing. In 2012, the federal government released the first national LGBTI ageing and aged care strategy. And while that didn’t require services to actually do anything, it certainly raised awareness about a range of issues and potentially what services could do. That strategy was replaced at the end of 2017 with the Aged Care Diversity Framework. And, just recently, the LGBTI action plans have been released, one for consumers and one for aged care providers. That will provide a bit of a roadmap I think for service providers, and has really worked to elevate that knowledge. We don’t hear as much as we used to that “We don’t have any LGBTI people in our service or accessing our service”. Things are slowly changing, but we still have a long way to go. Because of the royal commission, everything within the aged care framework is under the spotlight and up for debate. What do you think needs to change to make aged care more inclusive going forward? Well, it starts at the top – so organisational commitment and action – and then that flowing down through the different layers of services and, of course, at direct service delivery. I think one of the challenges that keeps coming up is that services say, “Oh, well, that’s great. We can educate our staff,” but by and large, we have other residents that grew up in those times of social stigma and discrimination and were possibly the perpetrators of that discrimination, or at least held the view that LGBTI people didn’t belong or weren’t welcome in a range of social settings. And then that’s translated back into the residential aged care setting, where you potentially have LGBTI and heterosexual people in the same facility. I think that is a challenge. It was only yesterday that a service provider bought that up with me and said, “Our staff are great, but we have some older people in our service who won’t buy this. How do we make our service a safe place for everyone?” It’s a real challenge, but it’s not something that’s insurmountable. It’s about ensuring that we articulate to everyone accessing services that all people are welcome; that there is a resident or client code of conduct that everyone is aware of; that we celebrate diversity broadly but also around LGBTI issues, within a setting so that everyone has an understanding of the lived experience and history of LGBTI people; that they are welcome at services and have a right to access services. Sam, Silver Rainbow was formed in 2013. Did that come about because of a realisation that LGBTI needs were not being met in the aged care sector? SE: That was part of it. We had the Productivity Commission investigation into aged care, and part of the report they produced said LGBTI elders are a group that are not being considered or having their needs addressed within the aged care system. This was the first group to identify the issue. Rising out of that, we had the Living Longer Living Better reforms under the government, and they put some funding towards LGBTI elders and elder people. From that, we were successful in getting the tender. We were just an ageing project then – the name Silver Rainbow came a little later. What then happened was a large consultation nationally, and we developed the first LGBTI ageing and aged care strategies, which ran from 2013 to 2017. We were funded to deliver on some of the actions in that. Silver Rainbow is described as giving national coordination and support for promoting the wellbeing of LGBTI elders. What does that encompass? We do LGBTI awareness training with aged care providers, and the aged care assessment teams regional assessment services. We do that through our partners in every state and territory, and that’s kind of an introduction to what you need to do to be inclusive in the care you deliver. Initially, there was just an online module. We’ve now expanded so everyone does the ‘101’ online module, then face-to-face training, which gives you more depth about how to work with LGBTI elder people. We’re now developing five specific modules looking at the needs of each group in much more depth than the general training can do. The other side of Silver Rainbow, which is predominantly my work, is working with the government, peak bodies and other organisations so that whenever a policy, legislation or something is changing, the needs of LGBTI elders and elder people are included within those changes. We look at the potential impacts and what they are missing in developing this policy that might impact on elder people. How do we ensure their needs and issues are included and considered within those documents? We work closely with the other LGBTI organisations across Australia. And whenever we can, we like to get out and talk to LGBTI elders and older people – they certainly had a big part to play in the new action plans. agedcareinsite.com.au 15