Working with LGBT older people: key practice points

Ensure you are properly trained and feel comfortable with LGBT terminology

By Ruth Hardy on October 16, 2017 in Adults, Older people

This week, the British Association of Social Workers set out a statement covering the knowledge and skills required for social work with older people. One of the capabilities for qualified social workers covers diversity: “I understand how age discrimination can intersect with other dimensions of social inequality … I challenge limitations on older people’s choices, for example about sexuality, sexual identity and gender identity.”

A recently-updated article for Community Care Inform Adults provides guidance for social workers working with lesbian, gay, bisexual and transgender (LGBT) older people. The in-depth guide is written by Trish Hafford-Letchfield, professor in social care at Middlesex University. Inform Adults subscribers can read the full piece. Here, we present an excerpt.

Key practice points in asking people about their sexual identity

Frame your request for information about sexual orientation confidently and with a positive attitude and be clear about your reasons for asking.
Ensure you are properly trained and feel comfortable with LGBT terminology. Don’t be defensive if you are challenged by a service user and ask the person about their concerns and provide reassurance. The language used should be as straightforward as possible. Depending on the audience, it may be appropriate to provide an explanation of the terms heterosexual/straight, gay, lesbian and bisexual. Given that clear communication sits at the heart of effective monitoring, it is important to check that people understand exactly what is being asked. There should be no qualifying or judgemental statements that preface the questions about sexual identity. This is easier to achieve when the questions are self-completed. Interviewers conducting face-to-face monitoring need to be trained to ask the question neutrally, without embarrassment or qualification (Creegan and Keating, 2010).
The Alzheimer’s Society advises that just because someone has never married, you should not assume that they have never had an intimate partnership. Give opportunities for people to discuss important romantic and sexual relationships that go unnoticed when they get older simply because they have not been legitimised by marriage. Likewise, if the older person is living with someone of the same sex and you think it may be a gay relationship, try to offer positive messages in subtle ways. For example: “You obviously mean a lot to each other”; “Have you lived together a long time?”. These kinds of questions do not compel someone to ‘come out’ if they don’t want to, but give an opening and indication that you are happy to talk about the relationship.
Locating sexual orientation within the full range of diversity monitoring will help prevent anxiety about stigmatising or prioritising one particular group over another. It also serves as a reminder of how equality monitoring is a way of gathering a whole picture of individuals and organisations. Getting a better understanding of the intersection of identities may also help to address multiple discriminations. Sexual orientation and gender identity are just aspects of who people are, and LGBT people have many other facets to their identity such as disability, race, faith and age. They may have a ‘dual identity’ like being gay and black, or transgender and disabled. If the person chooses, all of these can come into play when designing self-directed support and undertaking person-centred care and support in residential settings such as care homes. The Office for National Statistics has shown that accuracy of responses is achieved when the question about sexual orientation precedes religion (Civil Service, 2009).
Ensure that your use of personal information complies with the Data Protection Act. For more information on this, read Community Care Inform Adults’ guide to understanding the Data Protection Act and how social workers should use it.