Understanding care needs of LGBTI people with dementia

NEW RESOURCES AND SUPPORT FOR AGED CARE STAFF, FOR A TRULY INCLUSIVE AGED CARE SYSTEM

Understanding why a person with dementia is experiencing changes in behaviour is critical to developing effective person-centred strategies of support. For an LGBTI person with dementia, particularly in a residential aged care setting, this knowledge can be lacking.

Many LGBTI elders have experienced discrimination, violence, isolation and stigma throughout their lives. These elders often do not—or feel they cannot—disclose their identities or past experiences.

Although the Aged Care Quality Standards state every person in Australia has the right to access quality, inclusive and culturally safe aged care services that meet their individual needs, many do not provide LGBTI inclusive environments— increasing the likelihood of isolation and discrimination.

While an LGBTI person with dementia experiences similar symptoms of behaviour change to people with dementia who are not LGBTI, as underlying causes are specific to each person, it is vital to respond to what is happening at the time and based on life experiences.

LGBTI people living with dementia in aged care may experience behaviours and psychological symptoms of dementia (BPSD) as a result of past trauma or experiences of discrimination. Although changes in behaviour may be related to the progression of dementia, many are a consequence of or impacted by other internal and external modifiable factors.

To better support LGBTI people with dementia in aged care and inform the wider community about this often-overlooked demographic, Dementia Support Australia (DSA) has partnered with LGBTIQ+ Health Australia (LHA). the experience of LGBTI people living with dementia and behaviours, and psychological symptoms of dementia.

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The booklet provides important historical events that may have shaped the lives of LGBTI people and provides additional context for their care. Three case studies help describe some causes of changes in behaviour and considerations specific to LGBTI people. A glossary of terms and links to other services and resources ensure the resource is a tangible reference that care workers can access when supporting an LGBTI person with dementia in their care.

DSA can also be contacted to provide specialised support to aged care providers. DSA provides a three-level nationwide support service based on the needs of the person with dementia who is impacted by behaviours and psychological symptoms of dementia: a Dementia Behaviour Management Advisory Service, Severe Behaviour Response Teams, and a Needs Based Assessment Program for the Specialist Dementia Care Program (SDCP).

When Grant, a 72-year-old gay man, began using explicit sexual language in his care home, asking other residents to remove their clothes, and approaching others in their rooms, his carers contacted DSA. When a consultant visited Grant, he said he had “nothing to live for” and would kill himself if he could.

When the consultant talked to Grant about his past, he learned that his late partner had died from AIDS and that Grant was a member of the ‘78ers’ who protested at the first Mardi Gras in 1978, experiencing police brutality and violence. The consultant advised care staff that although Grant’s needs appeared sexual, he may also just be seeking intimacy and connection.

A link to the local LGBTIQ+ community was recommended to engage a volunteer who could be matched with Grant and visit the care home to socialise and share stories about the gay rights movement. Staff found out that Grant loved gardening and bought gardening equipment. He became close friends with another resident. As Grant’s mood improved, his explicit language ceased completely.

The Understanding changes in behaviour booklet is freely available online and hard copies have been distributed to LHA’s Silver Rainbow LGBTI Aged Care Awareness Training Project partners in each state and territory.

Complementary help sheets are also available to provide practical tips for care staff to support an LGBTI person with dementia who may be experiencing behaviour change: Supporting sexuality and intimacy for LGBTI people with dementia and Understanding the impact of trauma and stress for LGBTI people with dementia.

Marie Alford is Head of Dementia Support Australia. For more information visit www.dementia.com.au

Maximising your organisation’s future through revitalized leadership

Chris Westacott, Managing Director Realise Performance The last couple of years have been very challenging for the Aged Care sector and the need for change is not going away. In fact it is likely to become even greater. At Realise Performance we strongly advocate that organisation’s must take control of their own destiny to make sure they are well positioned to maximise their future. An important first step in realising these ambitions is to establish a highly competent, high performing leadership team encompassing both the Board and the Executive Leadership. Realise Performance works with organisations to help Board and Executive teams through a range of renewal processes designed to strategically reposition individual organisations. To find out more about how we can help call me on 0412 884 865 or send me an email chris@realiseperformance.com.au