ACAP 2010 Cultural Diversity Stream Concurrent Session Presented by Corey Irlam

1. Respect and recognition of Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) consumers during an Aged Care Assessment. ACAP 2010 Cultural Diversity Stream Concurrent Session Presented by Corey Irlam Thursday 20 May 2010

2. Acknowledgements • Thankyou to Dr Jo Harrison (Diversity Futures) for her assistance in co-authoring the discussion paper upon which this presentation is based. • The removal of same-sex discrimination: Implications for lesbian, gay, bisexual, transgender & intersex (LGBTI) aged care – Discussion Paper • It would have been impossible to present today without her generosity. • Also thanks to the Department of Health & Ageing for inviting me to present

3. What is LGBTI? • Lesbian – Women who experience lasting romantic and sexual attractions for other women • Gay - Men who experience lasting romantic and sexual attractions for other men • Bisexual - People who have the potential to experience lasting romantic, emotional and/or sexual attraction to another person of any gender • Transgender - individuals who do not identify with the gender assigned to them at birth. • Intersex - General term used for a variety of conditions in which a person is born with reproductive or sexual anatomy or chromosomes that do not seem to fit the typical definitions of female or male

4. Why include LGBTI in cultural diversity? • Culture is more than just Indigenous or non-english speaking heritage • A persons religious belief, social class, values, sexual orientation and gender identity can have a significant impact on someone’s culture, beliefs and attitudes. • Today’s presentation provides an insight into some of the cultural diversity issues to consider when interacting with LGBTI people

5. Historical Cultural Context • Lived a lifetime of discrimination • Remaining in the closet = survival for many • LGBTI people over 55 are twice as likely to be without a partner • May no longer be connected with their “family of origin”. This may have been replaced with a “family of choice” • “Older people don’t have sex, therefore their sexuality doesn’t matter in aged care” - • Sexuality is more than who you sleep with - romance, friendship, companionship, love, intimacy…

6. No one size fits all rule 228,800 non-heterosexual older people by 2050 • from all walks of life and backgrounds • may remain “closeted” or “invisible” = survival ORmay be “out loud and proud” / visible to providers • may or may not use the label “gay” “lesbian “trans*” • may or may not refer to “partner” as “companion” or “special friend” or other such words Today’s presentation provides insight, but should not be considered a “one size fits all” rule

7. 2008 same-sex law reforms • Federal government removed discrimination faced by same-sex couples in 85 pieces of federal law • Centrelink recognises same-sex relationships for the first time, leading to financial hardship for many older LGBTI couples • Aged Care Act 1997 changes - • Now recognises same-sex relationship • If one member of the couple stay in home, and the other goes into aged care facility • Family home is now exempt from assets test for bonds / fees and charges. • Same-sex couples forced to “out” themselves in order to access new benefits.

8. Key issues during ACAT assessment • Invisibility • Baby Boomers (Loud and proud) vs. Generation Silent (Closeted) • Does identification of relationship led to ACAT assessor altering approach towards consumer • Family, friends & partners • How is partner / companion / other significant nominated person included in decision process • Are biological children/relatives views listened to more favourably than consumers “companion” • Culturally safe & inclusive environment • What steps are taken to make LGBTI consumer and their partner/companion feel included and safe? • Culturally appropriate LGBTI language • Is the language used on forms and in conversation appropriate for LGBTI people? • Do they recognise how their circumstances “fit in” to the form language?

9. ACCR – an LGBTI perspective? • If you’re a pre-operative transgender person, how do you answer this question? • Do you feel the aged care industry is welcoming towards you? • Same-sex couples are unable to marry so may disregard even considering themselves as “defacto married” • More likely to identify as “never married”, “divorced” or “unable to determine”.

10. ACCR continued • Inconsistent with Marital status question (9) • May be less inclined to identify as “partner”, might be more likely to identify as “friend” • What can you do indirectly to make consumer feel safe to disclose the true nature of the relationship? • mention positively you heard / saw something that indicates an accepting attitude • Symbols can indicate acceptance, if it seems appropriate, make those symbols visible

11. What can you do? • Invisibility • Recognise that you may be dealing with someone who is not heterosexual in all dealings • “coming out” should not be a measure of success, but is required in order to access financial entitlements of the Aged Care Act • Family, friends & partners • Include companions or “special friends” in decision making process • Consider that consumer may elect someone other than their biological family to be their primary point of contact. • Listen equally to biological family as to companion/partner • Who is the client nominating as the person to speak on their behalf? Is there a power of attorney or enduring guardianship in place?

12. What can you do? • Culturally safe & inclusive environment • ONUS is on service provider to create a culturally safe and inclusive environment • Symbols / sensitively telling a story to show acceptance – SUBTLE • Make contact with LGBTI health organisations in your local area if you require further support / information • Culturally appropriate LGBTI language • Use term “partner” wherever possible instead of “husband / wife” • Where forms use language not appropriate for the individual, provide assistance in interpreting the situation for the consumer

13. Conclusion • It is not necessary to recognise or be aware of a person’s LGBTI status in order to respect their cultural heritage, • As the first introduction to the aged care sector for many LGBTI people, there is a responsibility on all ACAT members to provide the most positive experience possible. • Further reading – “Dementia: Lesbians and Gay Men” Alzheimer's Australia Discussion Paper No 15, 2009

14. Brian & Norm – a love story ABC Radio National’s 360 Documentaries - 13 March 2010 Produced by Shevonne Hunt

15. Questions & Answers