Tips to reducing aged care LGBTI complaints

The tips, which are published by the Aged Care Complaints Scheme, may be useful to help ensure that aged care providers are aware of the potential discrimination that LGBTI people face.

The Aged Care Complaints Scheme handles complaints including discrimination experienced by LGBTI care recipients.

Dr Gávi Ansara, manager of research and policy at the National LGBTI Health Alliance, shared his tips with service providers.

Dr Ansara is the Alliance’s representative on the National Aged Care Alliance (NACA) Home Support Advisory Group, the NACA Home Care Consumer Directed Care (CDC) Group, and the COTA National CDC Project.

Tip one – Learn about the National LGBTI Ageing and Aged Care Strategy

In November 2012, the Commonwealth Government released the National Lesbian, Gay, Bisexual, Transgender and Intersex Ageing and Aged Care Strategy. The Strategy, which is now being implemented by the Ageing and Aged Care Stream of the Department of Social Services (DSS), is the first national Strategy in the world to focus on the needs of LGBTI elders. The Strategy sets out a comprehensive national agenda for LGBTI inclusion and awareness in the aged care sector. We continue to hear from member organisations and partners across Australia that they encounter aged care staff and health administrators who are unaware that the Strategy exists. Successful implementation of the Strategy will require sector wide awareness of its existence and an understanding of how to apply principles of LGBTI inclusion to everyday contexts.

To improve your aged care service, you can make sure that all staff and administrators are familiar with the contents of the Strategy. You can then begin discussing which changes might be needed to existing policies and practices to reduce complaints, based on the priorities identified in the Strategy.

Tip two – Be familiar with new federal anti-discrimination protections and evaluate whether your aged care policies and practices comply with legislation

From 1 August 2013, amendments to the Sex Discrimination Act 1984 made it unlawful under federal legislation to discriminate against people on the basis of their sexual orientation, gender identity, or intersex status. Faith based aged care service providers who receive federal funding are required to comply with these protections in the delivery of aged care services, as the amendments removed the faith based exemption that previously permitted such discrimination.

The definition of sexual orientation includes marital or relationship status. The definition of gender identity is broader than any particular identity label, and also includes appearance, mannerisms, and other gender-related characteristics. The protections specifically include people who have a gender identity other than woman or man. This also includes how people express their gender, which means that people are protected from discrimination against wearing clothing or adopting mannerisms that are associated with a different gender than the one with which they identify. The legislation distinguishes intersex status, which refers to the presence of innate physical characteristics that are not considered strictly male or female, from gender identity.

The legislation prohibits both direct and indirect discrimination, which are defined here:

Direct discrimination:  Treating a person less favourably than a person with a different sexual orientation (including relationship status), gender identity (including mannerisms, behaviour, and characteristics), or intersex status in the same or similar circumstances.

Indirect discrimination: A requirement or practice that is the same for all people, but which has a disproportionate or unfair effect on people of a particular sexual orientation, gender identity, or intersex status.

Here are two brief examples that explain the difference between direct and indirect discrimination:

A federally funded, faith based aged care service provider had staff who refused to assist someone who identified as a man in dressing up for a drag show in which he was planning to perform. This man could file a complaint for direct discrimination.

A federally funded, rural aged care service provider decided to host social events to reduce older people’s social isolation. They decided to start a women’s night and a men’s night. An older person who identified as genderqueer (one term used by some people who do not identify as women or men) was unable to find a social event that they could comfortably attend and where they felt they belonged. This person could file a complaint for indirect discrimination.

It can be daunting for aged care service providers to realise that their existing policies and practices need to be adapted, but these changes will help to improve health and wellbeing for older people. From a management perspective, careful implementation of the new legislation will also reduce liability, manage risk, and reduce complaints against your aged care service.

To ensure that your service complies with legislation and reduces the occurrence of unlawful discrimination, familiarise staff, managers, and administrators with the legislation and review your policies and practices on an ongoing basis to catch possible problems before they occur. For a detailed explanation of the federal anti-discrimination protections for sexual orientation, gender identity, and intersex status, click here.

Tip three – Engage in ongoing learning about the wide range of specific needs among LGBTI people

We often hear well intentioned service providers wonder why they need specific knowledge and skills. As one residential aged care manager said: “I just treat everyone equally. Why do we need to make changes to existing policies and procedures to be inclusive of LGBTI people?”

LGBTI people have similar needs to those of other Australians. In addition to these needs, older people who are LGBTI may have specific needs that affect their health and wellbeing.

For example:

An older intersex woman might need emotional and medical support dealing with the urethral damage caused by unwanted surgical ‘normalisation’ during childhood.

Two older women who are a same gender couple might need help with end of life planning that considers their desire to be buried together without disclosing their relationship to disapproving biological relatives.

A transgender man might need help acquiring a soft packing penile prosthetic to wear in his trousers.

These kinds of reasonable requests will seem daunting or inappropriate to some aged care service providers at first, but finding ways to integrate LGBTI people’s needs into service policies and practices may reduce the number of complaints and allow older LGBTI people to lead longer, healthier, and happier lives contributing to their families and communities.

The National LGBTI Health Alliance is rolling out national LGBTI Ageing and Aged Care Training in collaboration with partners in each state and territory. In addition to training, the Alliance provides guidance on healthy ageing and aged care policy to help service providers implement LGBTI inclusive practices.

Visit the National LGBTI Health Alliance website to download resources which may assist aged care staff in supporting LGBTI care recipients.