Lesbian, Gay, and Bisexual People May Face Higher Dementia Risk Later in Life

LGBT+ communities and dementia

Lesbian, Gay, and Bisexual People May Face Higher Dementia Risk Later in Life

Dementia Equity and Rights June 2016. Race Equality Foundation

This publication looks across all the protected characteristics in respect of dementia. It flags up how access and provision of services must take into account the needs of particular groups.

Dementia care and LGBT+ communities: A good practice paper National Care Forum, April 2016 The 2016 report was developed as a result of roundtable discussions held by the National LGBT+ Partnership with the National Care Forum, Sue Ryder and the Voluntary Organisations Disability Group – the organisations collaborate under the Department of Health Strategic Partner Programme.

The aim was to consider the needs of LGBT+ people with dementia and how the social care workforce could provide more appropriate support. This followed from the original report written after the roundtable:

The dementia challenge for LGBT+ communities
National Care Forum, December 2014

‘Over the rainbow’  Lesbian, gay, bisexual and trans people and dementia project: summary report.   This report on an advocacy project includes the voices of LGBT people with dementia themselves. Elizabeth Peel & Sam McDaid

University of Worcester, February 2015

Providing quality care to LGBT+ clients with dementia in Suffolk: a guide for practitioners, December 2012 Suffolk Lesbian, Gay, Bisexual and Transgender Network (UK)

A practical guide the UK for health care providers working with dementia patients to become aware of clients' sexual orientation or gender identity and how to address the specific needs of these clients.

Lesbian, gay, bisexual and trans* individuals living with dementia: concepts, practice and rights Taylor and Francis, 2016  Edited by Sue Westwood, Elizabeth Price Multi-disciplinary and international in scope, it includes authors from the UK, USA, Canada and Australia and from a range of fields, including sociology, social work, psychology, health care and socio-legal studies. Taking an intersectional approach – i.e. considering the plurality of experiences and the multiple, interacting relational positions of everyday life – LGBT+ Individuals Living with Dementia addresses topics relating to concepts, practice and rights.

Sue Westwood University of Oxford profile

Alzheimer’s Society
Factsheet: Supporting lesbian, gay and bisexual people with dementia (PDF) Download a PDF of Supporting lesbian, gay and bisexual people with dementia

At a glance 42: Personalisation briefing: Working with lesbian, gay, bisexual and transgender people

SCIE, April 2011

Research

The needs of lesbian, gay, bisexual and trans (LGBT+) people who are affected by dementia: a comprehensive scoping review 31st International Conference of Alzheimer’s Disease International, 21–24 April, Budapest, Hungary, 2016 Joanna Semlyen; Joanne Brooke, Elizabeth Peel It is known that this population not only delay in accessing health care but also experience heteronormative services. They conclude that the research evidence-base is very small, and the inclusion of the perspectives of LGBT+ people living with dementia themselves is almost entirely absent. Contact details: Dr Joanna Semlyen https://uk.linkedin.com/in/joanna-semlyen-68084182,

Prof Elizabeth Peel e.peel@worc.ac.uk @profpeel

How do lesbian and gay people experience dementia? James McParland; Paul M. Camic Dementia, 2016

The subjective experience of dementia for lesbian and gay individuals is largely absent from the extant literature.

This study aimed to explore what it means to experience dementia in this context given the documented psychosocial influences facing this population. Results suggest additional and distinct challenges, including experienced and perceived discrimination and heterosexism.

Findings indicated areas of improvement for dementia services, including training in inclusive practice.

the closet, into a difficult place in later life Allison O’Kelly, William Fullick, Giles Richards Journal of Dementia Care, 23(23), 2015, pp.22–24.

Drawing on the story and experiences of Eve, this article demonstrates the particular difficulties and ethical predicaments faced by the lesbian, gay, bisexual and transgender (LGBT+) community and professions caring for transgender people with dementia.

Working with lesbian and gay people with dementia Jenny MacKenzie Journal of Dementia Care, 17(6), 2009, pp.17–19

This article aims to put the contemporary lives of lesbian and gay people into context by examining population profiles and reviewing recent policy and legislation.

It also looks at the history behind gay and lesbian culture.

Among the key messages for practitioners are: recognise the importance of alternative family networks; look out for anticipated discrimination; rethink assumptions of heterosexuality; and, acknowledge that sexual identity means more than sexual expression.

The forgotten: dementia and the aging LGBT+ community J. McGovern Journal of Gerontological Social Work, 57(8), 2014, pp.

845–57

This article reviews the current state of knowledge on the experience of dementia for LGBT+ older adults, and suggests areas for further research.

In addition, it aims to promote social work's engagement with related disciplines and global dementia care.

Overall view of need for research evidence
Larger scale research projects are needed in order to fully understand the perspectives of, and nuances in, these especially vulnerable communities. Without the research evidence-base to inform improvements to dementia care for LGBT+ people there is the risk that increased visibility will not result in better care.

‘The same, yet different’ : a review of the evidence of the needs of older lesbian, gay, bisexual and transgender (LGBT+) people and access to health and social care services Edinburgh Voluntary Organisation’s Council, Evaluation Support Scotland, 2015

This review looks at selected evidence sources and highlights key issues for older lesbian, gay and bisexual and transgender people in accessing health and social care support. The review finds that some older LGBT people face considerable challenges which affect their ability to make full and appropriate use of mainstream services. Difficulties highlighted include bullying or becoming ostracised by existing service users; discriminatory behaviour by staff; and staff not receiving sufficient support to tackle discriminatory behaviour. Whilst older LGBT+ people share many of the same concerns as non-LGBT+ people, the review also highlights additional challenges they face. These include hate crimes, the pressure on older LGBT+ people to deny their sexual orientation and/or gender identity and additional issues for those with dementia or those needing personal care. An evidence matrix is included which references the sources of evidence with a brief summary. The paper ends with a number of recommendations from a 2010 Stonewall report which focused specifically on the needs of lesbian, gay and bisexual people.

Assessing current and future housing and support options for older LGBT+ people Sarah Carr, Paul Ross Joseph Rowntree Foundation, 2013

In this viewpoint discusses how the choice of housing and support for older lesbian, gay and bisexual (LGB) people is perceived, and how it could support LGBT+ individuals to have a better life. It looks at the potential of personalisation in improving choice and control, and the importance of LGBT+ people feeling safe to share their identity and life history, particularly for dementia. The authors present the findings of an online survey of younger LGBT+ adults (30–69) who were asked to consider how and where they would to live in older age, particularly if they have high support needs. Thoughts from a discussion day held by the Stonewall Housing ‘Insights’ Older LGBT+ People’s Housing Group Manchester Forum are also presented. Some examples of emerging international innovations in housing and support for older LGBT+ people are also summarised. The conclusion draws together some of the key themes and messages about alternatives to traditional support and housing that enhance the lives and promote the independence of LGBT+ people as they grow older.

Books

Living better with dementia: good practice and innovation for the future Jessica Kingsley, 2015

Shibley Rahman

Lesbian, gay, bisexual and transgender ageing: biographical approaches for inclusive care and support Jessica Kingsley, 2012 Edited Richard Ward, Ian Rivers, Mike Sutherland

This book explores the lives and perspectives of older lesbian, gay, bisexual and transgender (LGBT+) people. As their distinct needs are often overlooked due to lack of understanding, this book demonstrates how life course approaches can offer insights into their support needs as they grow older, from housing and health care to community support.

Источник: https://www.scie.org.uk/dementia/living-with-dementia/lgbt/

Loneliness and Social Isolation Linked to Serious Health Conditions

Lesbian, Gay, and Bisexual People May Face Higher Dementia Risk Later in Life

Social isolation was associated with abouta 50% increased risk of dementia and other

serious medical conditions.

Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.

A reportexternal icon from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more ly to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.

Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.

Health Risks of Loneliness

Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:

  • Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
  • Social isolation was associated with about a 50% percent increased risk of dementia.1
  • Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
  • Loneliness was associated with higher rates of depression, anxiety, and suicide.
  • Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.1

Immigrant, LGBT People Are at Higher Risk

The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.

Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.

” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states.

Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.

What Can You Do If You Are Experiencing Loneliness?

Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:

AARPexternal icon—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.

Area Agencies on Agingexternal icon (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.

Eldercare Locatorexternal icon—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.

National Council on Agingexternal icon—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.

National Institute on Aging (NIA)external icon– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.

Health Care System Interventions Are Key

People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.

Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.

NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).

But patients must make their own decisions. Some people may being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.

1 National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663external icon.

Источник: https://www.cdc.gov/aging/publications/features/lonely-older-adults.html

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