A groundbreaking study by the University of South Australia has exposed significant shortcomings in aged care facilities for LGBTI+ seniors, with many residents feeling pressured to conceal their identities just to feel safe.

Researchers analysed 55 studies representing over 3,000 LGBTI+ people aged 50-94 from 11 countries, supplemented with insights from LGBTI+ older adults in South Australia. Their findings reveal systemic issues of heteronormativity, safety concerns, and identity concealment within aged care environments.

“From dress codes to daily activities, aged care settings are often assumed to reinforce heterosexual norms, making LGBTI+ residents feel invisible or unwelcome,” said lead researcher Sarah McMullen-Roach from UniSA.

The research identified four major commonalities in the experiences of LGBTI+ seniors: aged care facilities predominantly assume heterosexuality, residents feel unprotected, many hide their identity for safety, and they desire inclusive rather than separate care.

“LGBTI+ people worry that when the time comes to consider aged care they’ll be met with ostracism and discrimination, with gendered roles and standards forced upon them when they can no longer present themselves as they choose,” McMullen-Roach explained.

The findings are particularly concerning given Australia’s rapidly ageing population – now the third highest globally – suggesting a growing need for inclusive aged care services. The timing of the research is significant, coming just ahead of the International Day Against LGBTQIA+ Discrimination (IDAHOBIT) on 17 May.

Many LGBTI+ seniors report feeling forced to regress in terms of their openness about their sexuality and gender identity – effectively returning “to the closet” in their later years. This represents a painful retreat from hard-won rights and visibility.

“Having to give up their hard-earned rights and identities is unthinkable, particularly when you remember that homosexuality was only fully decriminalised in Australia in 1997, with same-sex marriage made legal less than 10 years ago,” McMullen-Roach said.

The problem is compounded by the fact that many aged care facilities are operated by faith-based organisations with historical records of excluding LGBTI+ individuals, adding to concerns about safety and homophobia.

McMullen-Roach suggests several straightforward solutions that could make significant differences: “This could be so simple as displaying a rainbow sign at reception, using inclusive language on intake forms, engaging staff in training and development, and adopting advertising materials that showcase the diversity of their residents.”

Education for care providers is highlighted as a critical intervention. “Care providers need to know that the world’s not exclusively straight, and that LGBTI+ people may have different care needs that should be accommodated,” she emphasised.

The University of South Australia is now expanding this study to specifically examine aged care experiences for LGBTI+ older Australians, with preliminary results expected early next year.

“This is what we want to understand in the Australian context: is discrimination truly historical and left in the past? Are people being supported to age free from fear? If not, what needs to change to create a better more inclusive future in aged care?” McMullen-Roach concluded.

The research comes amid ongoing reforms following the Royal Commission into Aged Care Quality and Safety, which identified systemic issues of neglect, abuse and substandard care across the aged care sector, with LGBTI+ people noted as a particularly vulnerable group.