Choosing residential accommodation for lesbian and gay people

It is never easy to make the decision that a partner, relative or friend should move into residential accommodation. There are few, if any, specifically 'gay' residential homes in the UK, which means that moving into residential care can be particularly traumatic for lesbian and gay people, their friends and partners. This factsheet provides advice to help you at this time.

Coming out

If you are a partner

When the decision is taken to go into a care home, it is important to consider what you are going to tell staff and residents about your partner and what you are going to say about your relationship. You may be able to decide whether and what to tell others about your sexual orientation. However, your partner needs to make their own decisions, and this can be more difficult if they have dementia.

Some couples would rather avoid the issue. They do not wish to discuss their sexuality and do not invite questions. The carer becomes known as the resident's 'friend' and care continues on that basis. Others may wish to be regarded as a business partner or close colleague.

However, some people want to be fully recognised as same-sex partners, either from the start or after a period of settling in. Ideally, people in long-term relationships will have considered these issues well before the situation arises and will have agreed on their response.

If you are a friend

When a close friend is in a home, you may face similar challenges to those faced by a partner, although the demands of being 'out' may not be so intense. For example, it may be noticed that most of your friend's visitors are of the same gender, and 'gay' conversations may be overheard by staff and residents.

If you are a relative

It may seem unnecessary and irrelevant for a carer to 'come out' when their relative goes into a home. However, the person living in the home may be asked questions about the carer's married status and the nature of their relationship with friends who accompany them on visits, for example. People will draw their own conclusions.

Lasting powers or attorney

Ideally, the person going into the home will have made a Lasting Power of Attorney (LPA). LPAs replaced Enduring Powers of Attorney (EPAs) in 2007, when the Mental Capacity Act 2005 came into force. An LPA gives the person or people they trust the right to make decisions on their behalf when they become unable to do this for themselves. This becomes particularly important if the person in the home becomes seriously ill and decisions need to be made about their care.

For more information see Factsheet 472, Enduring power of attorney and lasting powers of attorney.

Choosing the right place

Ask your lesbian and gay friends if they are aware of the home you are considering. Has anyone you know been a resident? Do you know of any lesbian or gay members of staff who work at the home? Remember that the existence of lesbian and gay members of staff does not guarantee a lesbian/gay-friendly environment.

First reactions are often a good indication of whether the home will be appropriate. Does it feel like home? Is it busy and cheerful? Do members of staff seem happy? How were your questions dealt with? How long have staff worked there?

Look around you. Are certificates displayed which show the training received by staff? Are there any photos of special events featuring the residents? Ask when the last event took place and how many people took part. Does the culture of the home give you confidence that your sexuality will be respected? Are there private areas for visitors to talk to residents? If you are caring for a lesbian or gay partner, will you be able to express your relationship in privacy and without threat?

If it seems that the sexuality of your loved one may be an issue, you may want to make this evident from the outset. Don't be afraid to ask to see the home's equal opportunities policy - it may include telltale phrases which indicate underlying attitudes in the home and the responses you might expect should you choose to be open about your sexuality. Every home should have an anti-discrimination policy and you can ask for evidence that the policy has been put into practice. You can also ask to see a copy of the home's most recent inspection report. The Care Quality Commission (CQC) regulates health and adult social care services in England, whether they're provided by the NHS, local authorities, private companies or voluntary organisations. It provides information on the quality of care services to help people who use those services and their carers to make informed decisions about their care.

Factsheet 476, Selecting a care home, may also be helpful.

Moving in

The first weeks in a care home are often difficult for both the carer and the person with dementia. Feelings of doubt about the choice of home often surface at this time. You may feel that others have taken over and that they will not necessarily understand the person's needs. There may be unresolved matters related to those needs.

Give yourself time and stay calm. This settling in period is similar to moving home or starting a new job. Visit regularly. Don't be afraid to ask questions or make requests. Keep assuring your partner or friend how much you care for them.

If you take lesbian or gay friends with you when you visit, they may well be noticed. The relatives and friends of other residents will make contact and will want to place you in context. In other words, you will face the challenge of 'coming out'. Consider letting your sexuality be known at least to a few selected people. It will help staff to get to know you and your partner better and this may affect the care that your loved one receives. Try to find out what the person's attitude is towards these matters before they enter the home.

Wherever possible, ensure that you involve other members of the person's family in matters related to their care. They need to take some responsibility. Should difficulties arise later, they will be less likely to complain that they were not consulted. Where a partner is concerned, everyone should regard you as the next of kin.

Recognise where your priorities lie. Your loved one is the first priority. The home is simply an agent employed by you to give the extra care that you can no longer offer. The excellent quality of your care should be fully recognised.

Contact Alzheimer's Society LGBT Support Group for information and help with feelings, difficulties and issues related to the care of family, friends and partners (see 'Useful organisations' for details).

Your local Alzheimer's Society branch will always be willing to talk to you and offer advice and information to support your needs.

For more information, Dementia Catalogue, our specialist dementia information resource is available on the website at alzheimers.org.uk/dementiacatalogue

Useful organisations

Alzheimer's Society LGBT Support Group

Devon House
58 St Katharine's Way
London E1W 1JX
T 0845 3000 336
E lgbtsupport@alzheimers.org.uk
W alzheimers.org.uk/lgbtsupport

Telephone support service for LGBT people with dementia and LGBT people who are current, or former, carers of people with dementia.

Care Quality Commission

National Correspondence
Citygate Gallowgate
Newcastle upon Tyne NE1 4WH
T 03000 616161
E enquiries@cqc.org.uk
W cqc.org.uk

Regulates, inspects and reviews all adult social care services in the public, private and voluntary sectors in England.

Further reading

Sex and relationships: a guide for care homes, Counsel and Care (2002).
Available from Counsel and Care, Twyman House, 6 Bonny Street, London NW1 9PG, or by calling 020 7241 8522.4

Factsheet 482

Last updated: July 2009
Last reviewed: July 2009

Reviewed by: Dr Elizabeth Price, Alzheimer's Society LGBT Support Group Steering Committee