Understanding the needs of LGBTQ+ older people

Supporting LGBTQ+ people in later life requires more than treating everyone the same

While many health and social care professionals aim to provide equal care, research shows that LGBTQ+ individuals face specific barriers in accessing support.  

Discrimination, historical injustices and a lack of tailored services contribute to health inequalities, poor mental health and social isolation. 

Many older LGBTQ+ individuals have lived through periods of criminalisation, social rejection and harmful medical practices. Some were forced to hide their identities to keep jobs or families, while others were subjected to conversion therapies. These experiences shape their expectations of care and their fears about losing autonomy. 

For older LGBTQ+ people, entering care services can feel like stepping back into a world where they were once marginalised. Many fear that their relationships won’t be recognised, their identities won’t be respected or that they will have to educate professionals on their needs. Without appropriate training, care providers may fail to create an inclusive environment, leaving LGBTQ+ individuals feeling overlooked and unsafe. 

Introducing the LGBTQ+ Ageing Learning Framework

To address these challenges, Skills for Care developed a learning framework that outlines the knowledge, skills and values required to provide affirmative, inclusive care for LGBTQ+ people in later life.  

Co-produced with the LGBT Foundation and a small group of older LGBTQ+ people, and steered and supported by researchers and practitioners, the framework is grounded in lived experience and evidence. 

It consists of 19 key subject areas across four domains: 

• LGBTQ+ awareness and affirming practice 
• Health and wellbeing 
• Personalised care and support 
• Leadership, education and service development 

The framework includes guidance on intersectionality in LGBTQ+ ageing, dementia care, end-of-life support and trans-affirming care. It also provides practical resources for training and professional development, allowing care providers to integrate learning into their practice. 

Why occupational therapists play a crucial role 

Occupational therapy has a significant role to play in supporting LGBTQ+ older people. By focusing on meaningful activities, social participation and independence, occupational therapists can make a significant impact.  

The framework highlights key actions, including: 

• Using inclusive language in assessments and care plans. 
• Recognising and recording LGBTQ+ relationships and family structures. 
• Understanding the legal rights and protections for LGBTQ+ individuals. 
• Connecting with local LGBTQ+ organisations and resources. 
• Embedding LGBTQ+ discussions into team meetings and supervision. 

By applying these principles, occupational therapists can help create safer, more inclusive environments where LGBTQ+ older people feel valued and supported. The learning framework provides the tools needed to drive meaningful change and improve care experiences for this community. 

Access the Skills for Care LGBTQ+ Learning Framework