DIVERSITY FUTURES THE REMOVAL OF SAME-SEX DISCRIMINATION: IMPLICATIONS FOR LESBIAN, GAY, BISEXUAL, TRANSGENDER & INTERSEX (LGBTI) AGED CARE DISCUSSION PAPER 2010 DR JO HARRISON MR COREY IRLAM DIVERSITY FUTURES AUSTRALIAN COALITION FOR EQUALITY Copyright notice © Australian Coalition for Equality Inc and Diversity Futures 2010 This publication is copyright. Apart from any use permitted under the Copyright Act 1968 (Cth), no part of this publication may be reproduced in any form without prior permission in writing from the copyright holders. Inquiries for permission to reproduce this publication may be directed to the Australian Coalition for Equality http://www.coalitionforequality.org.au The Australian Coalition for Equality acknowledges Diversity Futures and Dr Jo Harrison with thanks as the author of and holder of moral and intellectual property rights in this document. An appropriate citation for this paper is Harrison, J and Irlam, C B (2010) The removal of same-sex discrimination: Implications for lesbian, gay, bisexual, transgender & intersex (LGBTI) aged care – Discussion Paper Adelaide. Australian Coalition for Equality and Diversity Futures. Table of Contents EXECUTIVE SUMMARY ........................................................................................ 5 Background ............................................................................................................................5 Understanding LGBTI Elders ...............................................................................................5 The invisibility of current LGBTI consumers .........................................................................5 Out & Proud Baby Boomers .................................................................................................6 The 2008 Legal Reforms .......................................................................................................6 The imperative to ‘come out’ to access entitlements ...........................................................6 The impact of the 2008 removal of same-sex discrimination ...............................................6 Concerns related to LGBTI consumers in aged care ........................................................7 A culturally appropriate approach to LGBTI service provision .............................................7 Options for Action .................................................................................................................7 The Way Forward ...................................................................................................................8 Background to this Discussion Paper ......................................................... 9 Introduction ............................................................................................................................9 Understanding LGBTI Elders ...............................................................................................9 More than just ‘gay & lesbian’ ..............................................................................................9 Discrimination - The historical reluctance of older LGBTI people to disclose ............ 10 The invisibility of current LGBTI consumers ................................................................... 11 Out & Proud Baby Boomers .............................................................................................. 12 The 2008 Legal Reforms: The imperative to ‘come out’ to access entitlements ........ 13 Th e impact of the 2008 removal of same-sex discrimination ........................................ 13 Concerns related to LGBTI consumers in aged care ..................................... 15 Immediate Impacts & Concerns in relation to LGBTI Aged Care .................................. 15 Impact Areas ....................................................................................................................... 16 Areas of Concern ............................................................................................................... 16 Mid to Long-Term Impacts & Concerns ............................................................................. 17 Research Evidence to Date ............................................................................................... 18 The impact of ongoing discrimination on health including discrimination in relation to HIV/AIDS status .................................................................. 20 The impact of discrimination and stigma on LGBTI elders ........................................... 20 Taking steps to address concerns in relation to LGBTI aged care ......... 22 A culturally appropriate approach to LGBTI service provision ..................................... 22 Quality, Compliance and Residents’ Rights Mechanisms ............................................. 22 Paperwork and processes ................................................................................................. 24 An Inclusive Residential Aged Care Manual .................................................................... 24 Education and Training Initiatives .................................................................................... 25 An Investigation into LGBTI aged care needs ................................................................. 25 Options for Action .............................................................................................................. 26 Current Support for addressing concerns in relation to LGBTI Older People ............................................................... 28 Viewpoints from the Aged Care Sector ............................................................................ 28 Government / Political Viewpoints ................................................................................... 30 Australian Labor Party (Federal) ....................................................................................... 30 Australian Greens .............................................................................................................. 31 Australian Liberal Party ..................................................................................................... 31 APPENDICES ................................................................................................ 33 APPENDIX A Demographics............................................................................................. 34 APPENDIX B Research Data – Discrimination in Aged Care ........................................ 35 The Perspective of Service Providers ............................................................................... 36 APPENDIX C LGBTI aged care initiatives and activities in Australia .......................... 38 Australia-wide Initiatives .................................................................................................... 38 New South Wales .............................................................................................................. 39 Victoria ............................................................................................................................... 39 Western Australia .............................................................................................................. 40 Queensland ....................................................................................................................... 41 South Australia .................................................................................................................. 41 Tasmania ........................................................................................................................... 42 Northern Territory .............................................................................................................. 42 Australian Capital Territory ................................................................................................ 42 APPENDIX D International Initiatives in LGBTI Ageing and Aged Care ....................... 43 APPENDIX E Training and Education ............................................................................... 44 APPENDIX F Gay and Lesbian Health Victoria Sexual Diversity Service Audit Guide 46 References and Resources in Support of this Discussion Paper ........... 50 Glossary of Terms ....................................................................................... 53 Discussion Paper The Removal of Same-Sex Discrimination: Implications for LGBTI Aged Care 4 EXECUTIVE SUMMARY Background This paper is provided, as a starting point, to encourage further discussion between the Department of Health and Ageing (DoHA) and the lesbian, gay, bisexual, transgender and intersex (LGBTI) community about the specific health needs of LGBTI older people, and to identify key issues for the aged care sector in the provision of services to LGBTI consumers. Peak LGBTI bodies and concerned individuals have recently been involved in providing evidence, regarding LGBTI ageing issues, to current government inquiries into the accreditation process, complaints investigation mechanisms and suicide. This document largely focuses on the implications of the legal reforms for residential aged care and associated processes. We note there are a range of issues raised in this document relevant to in-home care and other components of the aged care industry. Understanding LGBTI Elders The future of aged care in Australia is one in which the LGBTI face of ageing will be visible and prominent.