Richard Ward

University of Manchester

(with Steve Pugh (University of Salford) and Liz Price (Hull University))

Keynote Paper: Don’t look back? Opportunities for improving health and social care services for older LGB users


Getting older within lesbian, gay and bisexual (LGB) groups or communities is not a well-documented experience and for those in receipt of health and social care services little is understood of what happens in care settings or how needs are managed. Indeed, what has been described as the ‘Fourth age’ is largely unknown territory for LGB people as few individuals have had the opportunity to report back upon reaching a great age. Questions of what it is like to live with dementia in a care home as a lesbian woman or to negotiate support from a home care agency as a bisexual older man have largely been overlooked by a research agenda focussing upon clinical issues, while the agencies that inspect and monitor the provision of care rarely seek to specifically take account of the experiences of LGB service users. Yet, ‘Fourth-agers’ arguably have the least capacity for challenging discrimination or ill-treatment of any section of the LGB community. Dependence upon care services can create obstacles to voicing dissent and conditions in care settings are not always supportive of individuals seeking to effect change.

This paper draws upon a review of the literature on health and social care practice and provision in relation to LGB service users in the UK. The emphasis is upon questions concerning opportunities for change to services and how recent developments in policy might provide a context for rethinking how services are delivered and how older LGB users might be taken into account and involved in service development. We argue that long-standing heteronormative conditions, whether localised or national have created a legacy that providers cannot ignore and that younger generations within LGB communities should not forget.


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