Choosing residential accommodation

A guide for lesbian women and gay men

If you are lesbian or gay and caring for a partner, a relative or a friend, it will not be easy to make the decision that they should move in to residential accommodation. Choosing the right place for them can also be difficult.

Here are some ideas to help you through this time.

The 'coming out' issue

Being in residential accommodation can be forbidding to some people, and may be more so for a lesbian or gay person with a partner or friend who has been part of their life for a long time, who they may also have lived with for some time. There are few, if any, specifically 'gay' residential homes in the UK, and going into residential care can, therefore, mean moving from a 'gay friendly' environment to a non gay environment.

The important question when this decision is taken is - what are you going to let people in the home (staff and residents) know about you and your partner/friend?

It is one thing for you to decide whether other people know your sexual orientation; it is a separate decision for your partner or friend to make, and an even more difficult decision to make if they have dementia and cannot make it for themselves.

Some couples do not wish to deal with this challenge at all. They are not willing to talk about their sexuality and they do not invite questions about it. The carer becomes know as the person in the residential home's 'friend' and care continues on that basis.

Other people may not want to go even that far and may want to be known as a business partner, or a close colleague.

Some people want to be recognised as full same-sex partners, either from the start or after the settling down period has taken place.

Ideally, lesbian and gay people in long term relationships should consider these matters well beforehand and hopefully come to some agreement about how they will respond when the time arrives. The issue will become far more crucial should the partner in the residential home become more seriously ill, when the home will need decisions to be made about their care needs.

When a close friend is in a home, you may face the same challenges although the demands of being 'out' may not be so intense. Nevertheless they will be present, 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.

When it is one of your relatives in a home, the need to 'come out' is reduced considerably and could be regarded as being of little consequence. However your relative will still be asked questions about your married status and the nature of the relationship with any friend who may accompany you on your visits. People will obviously draw their own conclusions.

Choosing the right place

Ask your lesbian and gay friends if they have any knowledge of the home you are considering. You may feel better if lesbian or gay people have used the place for their own loved ones or know of lesbian or gay people who have worked there or work there still. However, remember that the fact that gay or lesbian people work there is not a guarantee that the place is gay/lesbian friendly.

Your gut reactions on your preparatory visits will tell you a lot. Does the place feel like home? Is the home busy and cheerful, with no eery silences? Is there a smell of urine anywhere? Do the staff seem happy? How were your questions dealt with? How long have the staff worked in the home? Look around you for certificates that indicate what training the staff have received. Are there any photos of special events for the residents? Ask when the last event was and how many attended it. How far does the background, ethnicity, language and culture of the people working in the home give you confidence that your sexuality will be respected?

If it appears that the sexuality of your loved one is going to be an issue, you may want to 'lay your cards on the table' from the outset. Don't be afraid to ask to see the equal opportunities policy of the home - it may contain tell tale phrases which indicate the real attitudes and responses that you can expect should you choose to be more 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 may also want to see a copy of the home's most recent inspection report. If you do not feel confident about doing this, you could at least ask if there are any other single people in the home who have friends and relatives visiting (that might indicate that other gay/lesbian people are also in residence).

Are there private areas for visitors to talk to the residents? Will your loved one, if they are lesbian or gay, be able to be themselves within that environment? If you are caring for a lesbian/gay partner, will you be able to give expression to your relationship with privacy and without threat? These are all questions you may not be able to answer immediately, but can use them as goals to be achieved as time goes on.

You could recommend the recent Counsel and Care booklet: Sex and relationships - a guide for care homes to the home as a way of informing and educating them about your needs (Counsel and Care, Twyman House, 16 Bonny Street, London NW1 9PG. Tel: 020 7241 8555).

You will find other more general and helpful comments about choosing residential homes in the Alzheimer's Society advice sheet Selecting a care home.

Being there

The first weeks can be traumatic both for the carer and the person being cared for. Feelings of doubt related to your choice of home often surface at this time. You may also feel out of control regarding the needs of your loved one, and there may be unresolved matters concerning their requirements.

Give yourself time and stay calm. This is a settling-in period, similar to moving home or starting a new job. Visit regularly, don't be afraid to ask questions or make requests, and keep assuring your partner of your love for them. When you visit, you may want to take your lesbian/gay friends or partner with you. You can be certain that these people will be noticed. Other relatives and friends of residents will make contact with you and will want to place you in the context of the person you are visiting. In other words, you will face the challenge of 'coming out'. For the sake of your loved one consider letting your sexuality be known, at least to a selected few. It may well enhance the care your loved one receives.

If your loved one is also your partner, make sure that your rights as partner are recognised and acted upon. You should be the first person to be invited to any events in the home. The medical needs of your loved one should always be discussed with you and no appointments with other services should be made without reference to you. All discussions related to care programmes should involve you and policy and financial issues related to the needs of your loved one should be sent to you.

If it is your friend in the home, find out what their attitude to these matters is well before they enter the home. Having an Enduring Power of Attorney for a relative, friend or partner is very important.

If your loved one's new residence involves a change of doctor, make sure that you make an appointment to see her/him so that your role in the caring process is immediately recognised and established.

Don't be afraid to involve other members of your own lesbian/gay community in the care process. Encourage them to visit, and if a celebration is arranged consider holding it in the residential home.

Ensure that, wherever possible, you involve other members of your loved one's family in all matters related to their care. They need to have some responsibility for care, and should difficulties arise later on, they are less likely to complain that they were not consulted. Where a partner is concerned, everyone should recognise you are regarded as next of kin.

When you feel under pressure regarding the residential home and your sexuality, recognise where your priorities lie. Your loved one is the first priority, and the home is just an agent employed by you to give the added care that you now cannot offer. The excellent quality of your own care and love should always be recognised.

Please remember that the Lesbian and Gay Carers Network is here to help you deal with your feelings, your difficulties and any other issues related to the care of family, friends or partners.