It Takes a Community: Older Lesbians Meeting Social and Care Needs

Although specialized formal services are becoming more prevalent in addressing the needs of the older LGBT community, little is known about informal groups that have organized to meet the needs of this population. This article presents two case examples that depict the efforts of older lesbians to meet the social and care needs of members of their communities. The concept of psychological contracting is used to analyze these experiences, and combined with a review of the literature, practice implications for care and support for this special population are discussed.     

Imagined Futures and Communities: Older Lesbian and Gay People's Narratives on Health and Aged Care

This study examined older lesbians' and gays' experiences and expectations of Australian health and aged care service delivery. It was exploratory and comprised in-depth interviews with 14 older lesbian and gay people in the Blue Mountains, west of Sydney. Interview data were analyzed according to the principles and techniques of narrative research. This included an analysis of the socio-linguistic properties of specific narratives, as well as a wider socio-cultural analysis of the meaning expressed in these narratives. Participants conveyed different types of narratives, including narratives on specific past events, habitual narratives, and hypothetical narratives. These involved reflections on past and anticipated care in local communities, lesbian and gay communities, and friendship networks.     

Ageing Lesbians: Marginalising Discourses and Social Exclusion in the Aged Care Industry

The provision of services for ageing lesbians in Victoria, Australia, appears, at an initial reading, to be equitable and inclusive. Government polities suggest recognition and respect for diversity, with a focus on equitable provision of all social services. The reality, however, turns out to be both problematic and exclusionary. The researchers explored how dominant discourses around aged care facilities fail to take into account the identities and needs of ageing lesbians. The advertising brochures of aged care facilities were subjected to a critical and feminist discourse analysis, which was then compared with the perceived needs of a group of ageing lesbians from the same region as the aged care facilities. The data revealed marginalizing of non-heterosexual identities through the absence of representation in the brochures and their exclusion in the construction of aged care space. Further, a review of aged care policies that underpin the provision of services found that lesbian needs and identities were not included or mentioned in the special need groups. This limits the potential of the aged care industry to provide services that are culturally sensitive, safe, and inclusive.     

Older Gays and Lesbians

Summary

This article discusses the impact that coming of age in the Pre-Stonewall era has had on older gays and lesbians. Anti-gay hate and violence, within a historical context of homophobia and heterosex-ism, are examined. Risk factors, as well as coping capacities, for older lesbians and gays are explored. Research on the psychological adjustment and well-being of older gays and lesbians is reviewed, and suggestions for intervention with this population are proposed.     

Using Generational Intelligence to Examine Community Care Work between Younger and Older Adults

Exploring the factors that contribute to sustainable forms of an intergenerational relationship is becoming an important conceptual and practical challenge, not least because of the growing need for an aged care workforce that is both motivated and suitably trained. Generational intelligence is a means of examining interaction between younger and older people which has been applied to community care settings. Dimensions of generational intelligence include recognising and valuing generational differences, finding common ground, plus negotiating social and practical outcomes from the situation. A case study plus a series of qualitative interviews are used to examine the value of this approach both as a means of exploring the processes involved in generational exchange and in providing recommendations for work preparation and training. It is suggested that intergenerational relations have been a missing factor in the understanding of sustainable care and that in future, service delivery should not simply be analysed as comprising professional and lay perspectives but also as containing generationally distinctive perspectives that require negotiation.     

Using an Anti-Oppressive Framework in Social Work Practice with Lesbians

Anti-oppressive (AOP) social work practice addresses the whole person and the practitioner relates to the client in the client's social context. AOP considers personal, institutional, cultural, and economic issues and considers how these influence individuals' behaviors and their opportunities to grow into their full potential as persons living within these oppressive contexts. Lesbians live in a world that is dominated by oppression and heterosexism that can lead to a deep sense of shame regarding their sexuality. Anti-oppressive social work involves taking and supporting action to advance both individual and structural change to improve the lives of lesbian clients.     

Health and Well-Being for Late Middle-Aged and Old Lesbians in a Rural Area

Abstract

Previous research on lesbian health care has drawn primarily from samples of young lesbians living in metropolitan areas. Through face-to-face interviews with twenty-one lesbians aged 54 or older and living in rural communities, this exploratory, naturalistic inquiry begins to fill a gap in the literature by examining the health care experiences of older, rural lesbians. Five themes emerged from the narrative data: issues of access; good health/good care; open to her own diversity; family and community; and visions-ideals and fears. We present these themes through informant quotes and discuss implications for policy and practice.     

Sustaining Low Pay in Aged Care Work

This article examines the ways in which employers in the Australian aged care sector justify and sustain low pay for work that is both highly skilled and in high demand. We build on a large body of feminist research that analyses why care work is devalued by showing how such devaluing is produced at the level of the organization. To do so we examine some of the specific discursive mechanisms that sustain low pay. We show that aged care employers actively reproduce a familial logic of care that represents paid aged care work as unskilled and natural for women and therefore not deserving of higher pay. We argue that in order to achieve their goals employers must develop and sustain an opposition between care as love‐centred and work as money‐centred, while upholding the notion that they provide quality care for care recipients.     

Older Professional Women's Views on Work: A Qualitative Analysis

This qualitative study reports on the career experiences of older professional women using consensual qualitative research. Thirteen women over age 50 were interviewed regarding the influences of gender and age on work. In general, all participants reported career adaptability, and many participants also reported specific subthemes of career adaptability (i.e., concern, control, curiosity, and confidence) as resources. These subthemes denote participants' future orientation, self‐discipline as evidenced by their conscientiousness in career decisions, active information seeking, and certitude that they have the ability to solve career‐related problems. Relationships with colleagues were also considered critical, and participants acknowledged the benefits and drawbacks of being a woman and being older. These women were able to achieve flexibility and autonomy in their work and spoke about the importance of work–family balance and boundaries. Practitioners are encouraged to consider how career adaptability is manifested within the interplay between gender and age, because this can influence career counseling with older women.     

Work/Care Regimes: Institutions,Culture and Behaviour and the Australian Case

Increasingly around the industrialized world, labour markets rely upon the paid work of women, many of whom have dependents. Such changing patterns of paid work by women — and by men — are located within work/care regimes that are more or less hostile to the needs of paid workers who care for others. This article sets out a model of work/care regimes and locates the Australian case within international and historical contexts. In Australia, the unchanging normative male worker archetype dominates institutions of work and care, while the cultures of motherhood and fatherhood remain stoically resistant to renovation. In the meantime, the behaviour of working women runs ahead of these unchanging cultures and institutions, creating a policy interest in ‘reconciling’ work and care, but a failure to provide it. The reasons for this failure are outlined.     

Older lesbians' experiences with home care: Varying levels of disclosure and discrimination

ABSTRACT

There is considerable evidence that lesbian, gay, bisexual and transgender (LGBT) older adults have experienced barriers to health care access and have profound fears about how they will be treated in the long-term care system, but the specific experiences of older lesbians have received less attention. Most older adults needing long-term services and supports (LTSS) prefer to remain at home, and this is true for lesbians as well. This article reports on a national, qualitative study of the experiences of 20 older lesbians (age 65 and older) with home care workers. The experiences of six informal partner caregivers with home care services are also included. Emergent themes regarding level of disclosure, experiences with homophobia, evaluation of care received, and thoughts about ideal LTSS are described. Most study participants did not disclose their sexual orientation to their home care workers. A significant minority experienced homophobia, but nearly all ultimately found workers who provided good care with which they were comfortable. Their visions of ideal LTSS included greater affordability and particular qualities that were important for home care workers to possess, such as competence, caring and acceptance. Practice and policy implications are outlined including careful recruitment, training and supervision of home care workers to foster lesbian-sensitive care, but also improved wages and work conditions in order to maintain a quality home care workforce.     

Older Lesbians and Gays Accessing Health and Aged-Care Services

Abstract

The present paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged-care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney (NSW, Australia). Data were analysed by identifying evaluative statements within specific narratives and grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged-care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian- or gay friendly services. The findings highlight the need for health and aged-care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.     

Specifying Long-Term Care Provider Responsiveness to LGBT Older Adults

In-depth interviews and focus groups with lesbian, gay, and transgender older adults addressed the question “What does it mean for long-term care providers to be responsive to lesbian, gay, bisexual, and transgender (LGBT) older adults?” Sixteen domains of long-term care provider responsiveness to LGBT older adults were identified, including awareness of centrality of partners, knowledge of importance of preferred gender expression, openness to welcoming LGBT older adults, and ability to create LGBT-safe environments. Future research should include LGBT elders who belong to ethnic minority groups, bisexual elders, and LGBT older adults who do not identify with LGBT labels.     

Caregiving and Care Receiving Among Older Lesbian,Gay, and Bisexual Adults

Abstract

A survey research design was used to examine caregiving, care receiving, and the willingness to provide caregiving among lesbian, gay, and bisexual (LGB) older adults recruited from community groups. More than one-third reported receiving care from people other than healthcare providers in the last five years; more than two thirds provided care to other LGB adults. Those who had given care were more likely than non-caregivers to give care in the future. The gender and sexual orientation of recipients of future help affected participants' willingness to provide care, as did their education level and style of coping. Participants willing to provide care to older LGB adults perceived such experiences to be less burdensome and more personally rewarding than those who were un-willing to provide care.     

African American Gay Men and Lesbians: Examining the Complexity of Gay Identity Development

Abstract

This article addresses the concept of gay and lesbian identity development with respect to African American gay men and lesbians. The authors suggest that the integration of one's gay identity and the coming out process are uniquely constructed for African American gay men and lesbians, who may be multiply challenged by racial prejudice, limited acceptance by the African American community, and a lack of integration into the larger, White gay community. Race, African American culture, a continuum of gay cultures, gender, and individual characteristics are suggested as salient variables that distinguish the gay identity experience of African American gays from that proposed by most gay identity models.     

An International Review of the Long-Term Care Workforce

Abstract

The developed world's population is aging, due to trends of increased life expectancies and decreased fertility rates. These trends are predicted to increase demand on long-term care services. At the same time, the long-term care workforce is in shortage in most of the developed world. Moreover, such shortages are expected to increase due to parallel socio-demographic factors. The increase in demand for long-term care, coupled with shortage in supply of care workers, has promoted some attention from policymakers. The current paper provides an international review of institutional arrangements for long-term care in different developed countries and in particular explores different strategies used or proposed to resolve the shortage in the long-term care workforce.     

Life Course Diversity Among Older Lesbians and Gay Men: A Study in Chicago

How much can we assume about the shared life experiences of older lesbians and gays? This article is broadly concerned with rethinking the significance of this question as it pertains to cultural images and stereotypes of “older gay and lesbian” identities in a large and diverse American city. In 1996, the authors completed a 10-month needs assessment study regarding the lives and needs (social and psychological), which must be addressed for older lesbians and gays in the city of Chicago. The authors take the approach that simply being of the same or similar age is insufficient to understand the meaning of people's sexual identities. They entered into this study aware of some stereotypes about older lesbians and gays, but like previous investigators, they were surprised at the range of diversity that they uncovered. They discovered not only the common denominators in their participants' experiences and their lives, but as some commentators have already suggested, they also discovered a great deal of variation. To address the issues, the authors describe conceptual problems that emerged in a recent needs assessment of older lesbians and gay men in Chicago.     

Life Satisfaction Among Home-Dwelling Older People Who Have Experienced Falls and Have Declined Subjective Health

This study investigated the reported life situations of home-dwelling older people who have experienced falls and have declined subjective health. Mixed method design was used and consisted of a quantitative study comprising questionnaires completed by 434 home-dwelling older people, and a qualitative study consisting of 30 interviews. The findings showed that declined physical function combined with limited health status was associated with falling. Despite limited physical condition, participants experienced well-being and life satisfaction in daily living. Insight obtained from these findings deepens our understanding of fallers and may provide a basis for future research leading to improvements within health care.     

Housing for Older People in Iceland: Apartments and Nursing Homes

The first residential and nursing homes in Iceland were built in the early 1920s, and the first apartments for older people in the early 1970s. Most of the existing housing for older persons was built in the last 30 years. Legislative provisions on housing and particularly on assisted living have not changed significantly since laws relating to the affairs of the elderly were first passed in 1983. While approximately 90% of older people in Iceland own their own home and the primary stated goal of the government is to support independent living, official policy relies on placement in nursing homes. Services and care at home, provided by social and home healthcare services, has not been developed to the same extent as in the other Nordic countries. Clearer guidelines on integrated service housing are needed to reach the government's primary stated goal. Placing more emphasis on delivering services, care, and rehabilitation to people living in the community could shorten individuals’ length of stay in hospitals, delay admission to nursing homes, and better meet the expectations of older people for independent living.