A Sexual Awakening for Caregiving Staff: How Workers in Residential Care Perceive LGBT Residents & What Needs to Change

Although the visibility and acceptance of lesbian, gay, bisexual, and transgender (LGBT) people has greatly increased within society, homophobia and discrimination of these groups continues to occur. For older LGBT adults in a residential care facility, how staff perceives them, and the larger community’s attitudes toward them, becomes an important concern. Recently, a qualitative study was undertaken to investigate the perceptions of care staff toward LGBT individuals in residential care facilities (a term which encompasses communities providing assisted living, skilled nursing, and/or memory care levels of care.) The study was part of a larger project for promoting more LGBT-inclusive services and producing practice guidelines aimed at equal treatment of LGBT residents.

This study employed focus groups of a total of 47 care workers across seven residential care facilities in New Zealand. Three quarters of the staff was over 40 and all but two were female.

The first main theme which emerged was that staff with family members, friends, and/or colleagues who were LGBT were more accepting of caring for LGBT residents. In some cases, staff professed acceptance of LGBT individuals in general, but showed homophobic tendencies when asked how they would react if a son or daughter was gay or lesbian.

Another theme that emerged was that staff preferred to avoid issues related to sexual behavior in older adults rather than accepting and addressing them. This meant that the main way for workers to integrate non-heterosexual individuals into a residential care environment was to keep sexual orientation hidden. If matters of a sexual nature remain hidden, they will not challenge attitudes of care staff or residents.

The staff also reported observing social conservatism and homophobia among residents in their communities, which they described as “a generational thing.” Such behaviors lead some LGBT residents to hide their sexual orientation in order to avoid discrimination. The authors note that the staff’s perceptions of these attitudes as generation-based could “suggest that staff are excusing older residents’ attitudes toward those who are non-heterosexual” and thus supporting the continuation of a discriminatory environment.

In light of their study, the authors conclude that “the residential care sector requires further preparatory work if they are serious about meeting legal and ethical obligations of providing a service that is culturally safe and appropriate for non-heterosexual groups.”

Based on their study’s findings, the researchers provide the following recommendations: First, residential care homes need to ensure that their organizational charters are reflective of the care services offered to non-heterosexual individuals. Second, they recommend the adaptation and implementation of principle-based guidelines that ensure that LGBT residents are treated with dignity and respect within the community. Third, they recommend a commitment to providing staff and other residents with educational opportunities to address homophobia and discrimination of LGBT residents. Lastly, they recommend openly displaying contact information for LGBT organizations, and for residential care facilities to develop partnerships with those organizations.



Neville SJ, Adams J, Bellamy G, et al. Perceptions towards lesbian, gay and bisexual people in residential care facilities: a qualitative study. International Journal of Older People Nursing (2014); 10: 73–81.

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