9. Services and care settings
As the person's dementia progresses, they will need more support from different care professionals. In the later stages of dementia, they may need to move into supported living or a care home.
It is important to know that, in any care setting, the person has a right to the same treatment as people who are not LGB or T. The Equality Act 2010 made it illegal for staff and organisations providing services in England and Wales to discriminate against someone because of their sexual orientation or gender identity. This means that it is against the law for health and social care staff or local authorities to treat the person less favourably because they are LGB or T. In Northern Ireland, there are similar laws - the Equality Act (Sexual Orientation) Regulations (Northern Ireland) 2006 and the Sex Discrimination (NI) Order 1976.
Some LGBT people may be worried about meeting different care staff or going into care settings. They may worry that they will experience prejudice or discrimination. In some settings, care professionals may not have enough knowledge or awareness to support the needs of LGBT people with dementia. They may not realise that LGBT people access their services or understand that the person's sexual or gender identity can have a big impact on their needs. For example, reminiscence activities may focus on people's family and children, not realising that LGBT people may not be in touch with families or have children.
It is important to find a setting where the person feels that they are understood and their wishes are respected. Care professionals may not know how to support LGBT people appropriately, or they may feel that it is not an issue because they treat everyone the same. However, many LGBT people want to be treated as unique individuals and have their history and identity respected and their needs met.
Moving into a care home
Many people with dementia remain living at home independently when they have the right level of support in place. However, the time may come when the person needs to move into a care home. They may be worried about staff not supporting them or meeting their needs. They might feel like their home is a ‘safe space’ where they are free to express their identity, and may be worried about leaving it.
The person with dementia, with your support, may find it helpful to talk to care home staff about their sexual orientation or gender identity as early as possible. This can help them find out whether staff have any negative attitudes towards LGBT people.
If the person is trans but does not wish to share this with everyone in the care home, they may wish you to tell one (or a few) of the care home staff. It is against the law for the member of the care home staff to share the person’s identity without the person’s consent.
Remember that care home staff cannot legally discriminate against the person because of their gender identity or sexual orientation.
It is important to find a care home where the person can feel safe and accepted. For advice on housing options for LGBT people, it may be useful to contact Stonewall Housing (see ‘Other useful organisations’).
Complaining about prejudice or discrimination
If you or the person with dementia feel they have been treated unfairly because of their sexual orientation or gender identity, ask for the complaints procedure from the organisation that has provided the care.
If, after following this procedure, you feel that your complaint has not been properly addressed, you can take the complaint further. The next steps should be explained in the organisation’s own complaints procedure. If they are not, depending on where you are and the nature of your complaint, you can contact the relevant Ombudsman in England, Wales or Northern Ireland (see ‘Other useful organisations’).
If you are in England you can contact your local Patient Advice and Liaison Service (PALS) for help with making complaints and other support. The Community Health Council in Wales, and the Patient and Client Council in Northern Ireland, perform similar roles.
You can also get advice and support from the Equality and Human Rights Commission in England and Wales or the Equality Commission for Northern Ireland.
In some cases you might need to talk to a solicitor to get advice regarding discrimination experienced by the person with dementia or yourself.