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I'm Michael Boyd. I'm I'm a a nurse practitioner who works for water health. And I also work at University of Auckland, Uh, school of nursing and also, um, affiliated with the Freemasons department of Geriatric Medicine. Uh, we do, uh, research on older people's care. Um, and also, I provide care for older people through Guatemala Health in a clinic. Um, I moved to, uh, New Zealand in 2002 from Colorado in the States. Um, and I can [00:00:30] divide my time between doing clinical and, um, academics, academic work, and I am lesbian. I should probably say when you arrived here in the early two thousands. Can you paint a picture for me? Of what Rainbow Elder Care was like? It was actually invisible. And it and it probably for the most part, is invisible. It's it is not discussed. It's just not There was some research out of, [00:01:00] um, Australia. That's really interesting that talks about the title of the research is we don't have anybody like that here. Um, and I would say that that's the way it is. And even to go one step further. Sexuality in general with older people, it's just It's not a topic of discussion much, so I think that what we're trying to do, as as a new generation of of older, gay and lesbian people that have been [00:01:30] fully out and fully acknowledging their their sexuality, they're now getting to an age where they're going to need long term care. And, um, it is a different environment, um, to the closeted, um, environment that the earlier generation had to deal with. Why don't you think sexuality is discussed when people work with older people? Um, you see your grandmother and [00:02:00] you just don't talk about sex with your grandmother. I think that's part of it. Um, so there's something about personhood and losing your personhood as you age, So there's an ageism in it. Um, there's, you know, that, uh, I think that's part of it. Um, it it's it's a It's a real difficult thing. Um, for younger people to ask older people about sexuality, particularly about homosexuality. It's just, um we have ideas [00:02:30] in our head about how it should be, and and and again, I'll just go back to There's ageism. It's I think it's pure and simple. Ageism and sexuality is not just about sex, is it? I mean, I mean, it's wrapped up with identity and all that kind of stuff, and and it's getting much better now. I have to say, I think I think there's been a real shift in the last 10 years but because, uh, homosexual relationships in older generations they were quiet. They just they just [00:03:00] were not acknowledged. One of the, uh, Gary Bellamy did, uh, some of our work of the original research project. And one of the quotes that, um was talked about is a, uh, two men that had been together for 30 years. But one of the men had remained married. Um, so it was very, very closeted, and so that the care provider didn't even realise that this other men man was his partner because he was married [00:03:30] and it wasn't discussed. And it was, you know, it was very complex. And I think, um, that part of sexuality was so closeted, um, that it was it's been really difficult for people to, um acknowledge it because it's not acknowledged by other people. It's changing. It's hugely changing. But I think it's a generational shift. So it's stonewall. Frankly, I mean it's That's the shift. So you mentioned, [00:04:00] uh, some research in Australia. Can you tell me about that? Yeah. Australia is interesting. Um, even though they don't have gay marriage, and we do, which we're very proud of, of course. Um, they I think just because they have a much larger population, um, and more resources, they're a much more wealthy health care system. Um, they have done a lot of there's pockets of really good work being done, uh, about gay and lesbian older issues, and it's starting [00:04:30] to find its way into policies. And that's what we'd really like to do is get is to kind of move in that same direction. Um, in Western Australia in Perth. Um, there's an organisation called, uh, Grey G capital GRA. I, um And they did some research, uh, where they did qualitative interviews with people in, uh that were working in residential aged care. And again, that's where that quote came from. Their research that we don't have people like that here, but [00:05:00] again, what they found is some pretty severely homophobic attitudes about, uh, gays and lesbians in long term care. There's a group out of Melbourne, um, Curtin University. Uh, does a, uh, a lot of things. There's a a group doing a thing called Vows Cafe, which is just new, and it's a website, And so if people want to look that up, it's got a lot of resources, Uh, about older people's care, Um, out of Australia. [00:05:30] Um, But what? Like I said, what's very interesting is in Victoria, it's the, uh, gay and lesbian, um, policies in older adult care are starting to be visible, which is really quite exciting. Um, as those of us that do research in New Zealand always salivate because they seem to have so much money to do research in Australia, they don't think they do, but we think they do. Um and so they've really been able to to pour [00:06:00] some resources into looking into the into this, uh, issue quite extensively. Of course, as you would imagine there is. They've found a lot of homophobia. And now the next step and the next step for us as well is to say, OK, so we know this now. What do we do now? What's the next step? So there's a lot of education, uh, materials coming out of Australia There's a lot of, uh, really interesting, uh, materials for, um, families and and, uh uh, the gay and lesbian people [00:06:30] and their and their loved ones. Um, so it's really quite an exciting time. That way, it's it's it's just taken off. In the last few years of that, our advocacy is shifting to older gays and lesbians. There's a huge, uh, section of advocacy now looking towards older gays and lesbians. It's quite interesting. There's another thing out of Australia that I quite like, which is a visiting service. Um, so it's a very, [00:07:00] uh, specific gay and lesbian visiting service. Um, and that is I think that's something that we could do here in New Zealand. Uh, you know, there's a lot of gays and lesbians that want to give back and want to contribute. Um, and, uh, so I'm excited about that possibility as well. I think it's a great model in Australian policy. What are the things that are kind of coming up now that that actually deal with rain by people? Well, it's interesting because what it's being seen as is [00:07:30] what you mentioned earlier and I I fully support this. It's not about sex. It's actually about culture that we have a different culture. We we a subculture, if you will. But we we do have a My relationship with my partner is, uh, it has a different cultural connotation than a heterosexual couple. Who I who I who I'm friends with, how I live my life. What do I do? For the most part, it's fairly straightforward and boring. [00:08:00] But for them there are issues that need to be acknowledged in that I have a different cultural context because of my relationships. Um, and so what you're seeing is the policy is focused on. Not only do we have cultural education about ethnic groups, but we also have cultural education about, um, gays and lesbians. And that's, I think, a hugely positive thing. For instance, rather than um not mentioning that homophobia is not OK, it's now part [00:08:30] of cultural policy that racism is isn't OK, but either is homophobia. So I think that's the exciting part. Are there other specific things that you can think of in policy that have kind of come up in terms of, like, protections or not? Not specifically yet. Other than of course, uh, there are specific policies about nondiscrimination for, uh, homosexuals, which is, um, I think appropriate. [00:09:00] But it other than that, um, which I think is a huge step forward. Frankly, um, it there isn't anything specific. Other than that you mentioned earlier that, uh, there is homophobic attitudes in residential care in Australia. Where is that coming from? IE. Is it Is it? Is it? Is it residents? Well, it's interesting in the in the data that you see coming out of Australia, [00:09:30] there is certainly a lack of recognition of gay and lesbians. So that's the first thing. Um, and if they do talk about gays and lesbians in this research, I think like I said, it's moving. But in when this research was done a few years ago, um, it was a a, um they didn't see them as sexual beings, So therefore, yeah, they might be gay, but so what kind of thing? Um, [00:10:00] and also, uh, that that really the the biggest thing the the most striking thing that came out of most of this research is that we just they just don't see it. It's just completely invisible. Um, so the homophobic attitudes from the staff are about invisibility. But the other interesting thing, and we found it in our research, which I'll talk about shortly. But, um is it's not just the staff, it's the other residents. These are communal living situations. [00:10:30] And so if these older people who are all living together now were homophobic when they were young, they're homophobic when they are when they as they get older. And it's complicated by the fact that many people in residential aged care have memory issues, cognitive impairment. And, of course, as you get cognitive impairment. Often there's a disinhibition that comes with that, and so they're just not afraid to say what they wouldn't have said possibly a few years before in polite company. So there is, [00:11:00] uh, there. That is one of the issues that needs to be tackled as well, which is the homophobia homophobia of other residents and their families. And that's quite tricky. Um, it's different than a than a policy of employment is how do you have in a institution say there's no homophobia, including coming from residents, So it's It's quite tricky that way. I'm wondering from [00:11:30] your own perspective if you can, um, compare coming from the States. Uh, and what potentially was happening with kind of rainbow elders there? And when you came to New Zealand in the early two thousands? Look, I think it was I think we were all kind of in the same place. Um, one of the things that was starting to happen I left in 2002, and what was starting to happen was in San Francisco. Of course, there were, uh, organisations that were sprouting up [00:12:00] to do. It's more of a cohousing kind of situation where, uh, it was specifically for gays and lesbians, mostly gay men. I think it started in San Francisco. And so one of the things that's sprouting up a lot all over with all people that are ageing I hear this over and over again is that we're going to buy a property, and this is happening in Auckland as well. We're gonna buy a proper property we're going to. Then you buy, uh, an apartment in that property or a section of that property. And [00:12:30] then, uh, we'll live together, and then we'll hire in somebody, uh, for to take care of us as we age. This is an idea that's happening with gays and lesbians. It's an idea that is also happening with many other subgroups. Um, it's really interesting. In New Ze- in Auckland, there was a, uh, residential aged care facility that was just opened up specifically for Indian people. Um, there are residential aged care facilities, [00:13:00] although they're not specifically designated for Chinese people. It by default. They're mostly Chinese people. There is residential aged care facilities for Dutch people. There's, um so what I think we'll see and what I think is happening is either informal arrangements which are happening or when people get really quite impaired. I think you will see, uh, facilities that are specifically for gays and lesbians, which is quite interesting. [00:13:30] The the interesting thing also from an older person's, you know, health care perspective is that congregate living certainly is is has huge advantages, and we see it in villages. We see the research coming out of retirement villages and so I. I think it's a great idea where it's going to be quite tricky is that as people start to age and they start to get in cognitive impairment, the th the three things that put people in residential age [00:14:00] care that put them into nursing homes are either their cognitive impairment gets to the point where they're disruptive or they get lost or they, you know, it's it's it's too difficult they can't stay where they are without extreme 24 hour care. Uh, incontinence is another issue that, um, it it just is one of the things that if you can't control your incontinence, you can't stay independent. And the third thing is falling in mobility. If you're not able to be mobile and and you're falling [00:14:30] and and that's a real issue, you usually need some kind of 24 hour care situation. Now, what's going to be interesting for all of those groups that say, Look, we're just going to get together as mates and we're gonna hire somebody in, and it'll be great is that there will come a time when somebody gets one of these three things or a combination of those three things, and they're not able to stay independent in this unit. That has been, uh, informally put together. And it'll be interesting [00:15:00] to see how that ha. What happens with that arrangement? We see it in, uh, retirement villages now, um, There comes a point in a retirement village independent apartment living where the management has to say, You're not independent anymore, and then you need to go into residential age care 24 hour care. You'll see this with these other arrangements as well, and it gets really, really difficult. It's very difficult for, uh, friends and family of the people that, um are starting to [00:15:30] lose capacity and lose mobility and lose continence. Uh, it's devastating for the person because they thought they were gonna be here for the rest of their lives kind of thing, um, and so that I think will require as these organisations start springing up, uh, which is great. Uh, it will require some real adept management and negotiation and maybe even some [00:16:00] outside help. You know, to really manage that situation, more and more of us don't have Children. Uh, so again, it'll be it will will see different arrangements of living that we never have seen before in older people, groups of people without Children living together. And it's going to get tricky when you can't live independently anymore. So so in the States in the early two thousands were, uh, rainbow people visible in elder [00:16:30] care. It was like in New Zealand, where it was no sexuality. You know, if it isn't heterosexual, it wasn't acknowledged. You know, for the most part, uh, even even unmarried couples would be was a bit of a conundrum, you know, and unmarried heterosexual couples was a conundrum. Like, what do you do with this? Um, there are long discussions about, um, in when I left the states. And even here we're again. We've [00:17:00] moved a long way. But when I was in the States, uh, you have somebody two people in a facility. One person's married but doesn't remember they're married. The other person, uh, is single. They start up a relationship. I mean, it happens. These sorts of kind of dilemmas happen all the time. Some families are like, fine if they're happy, some families are absolutely not. So it is. It is. Uh, homosexuality [00:17:30] was, uh, absolutely invisible. And sexuality is was difficult. We're about to look at your research, but I'm just wondering, um, prior to the research that you've just done, Has there been other research in New Zealand looking at older care for rainbow people? Yeah. Um, just a little bit. Um, Stephen Neville and Mark Hendrickson. Um, did, uh, a survey of older people as part of part of the lavender project. Um, and, uh, they [00:18:00] I think, uh, did surveys of about 2000 people. Um, in 2010, it was published. Um, it's a good piece of research. Um, and it's interesting It wasn't specifically about residential aged care, but was about their kind of experience of older care. Um, and they certainly describe homophobia was quite rife in their experiences. Um, but other than that, to my knowledge and I might be wrong, But to my knowledge, there hasn't [00:18:30] been a lot about older people's care. There's been, uh, uh, some really interesting work through, um, Auckland DH B. Where they, uh in 2011, I believe it was they had a conference specifically about gay and lesbian issue health issues. And part of that conference was about ageing, which was very encouraging. So you're you are starting to see it happen. Um, but really before 2010, there wasn't much happening. [00:19:00] I don't think in New Zealand that I I'm aware of, and hopefully somebody will correct me If I'm wrong, let's then talk about your research and and, you know, what were you looking at and and why? Well, what we We were funded by the rule foundation and the, um uh, rule foundation, uh, funds, um, outline and some other, uh, important, uh, initiatives for gay and lesbian people in New Zealand. G LPT I people in New Zealand. [00:19:30] Um, and they were interested in starting to look at older adult issues. We talked a lot about you know what to focus on. Um, there's certainly older adult issues in the community for people living independently. We wanted to start with something that was fairly contained that we could do something about, Uh, one of the things that they were very interested in is, um, I had done some previous work with residential aged care, looking at guidelines [00:20:00] for care, um, guidelines for very specific things about what older people need. Um, and so they were interested in looking at a a model like that for guidelines for care. Uh, gay and lesbian people in residential aged care. So what we had to start with is, uh So what are the issues in residential aged care for gay and lesbian people. Now, we chose to start with the staff. Um, I think the next part of this would be to, um, interview, uh, older [00:20:30] gays and lesbians. But we we start with the staff of residential aged care. And Gary Bellamy designed this, um uh, study. He's gone back to London, unfortunately for us, but, uh, he he did a great job with this study, and what he used is he went into seven residential aged care facilities. Um, and the staff there, which included caregiving staff, are in staff, Um, and even, uh, cooks and those kinds of things. And he presented two scenarios, uh, about gay and lesbian people in [00:21:00] residential aged care and then, uh, elicited their responses. Uh, it was a qualitative, uh, interview type thing, focus group about their feelings about, uh, and their perceptions of these two scenarios. Um, what we found was very interesting. Um, first of all there is. There was a several, uh, comments about. Well, if my daughter or son were gay or lesbian, I would have a real problem with that. Um, [00:21:30] it would be real difficult for me, but in work, I'm OK with it, you know. So there was no, uh, Steven Neville just submitted a paper because he was in on our team as well. Um, and his His premise from his thinking is that if they're saying that they're homophobic within their own lives, but saying that they're not going to be homophobic to older people, how can you actually do that? We do know from other research that if people [00:22:00] are homophobic, they're homophobic, you know, so that the the and gay and lesbian people GL BT I people are, um, hugely sensitive to knowing if somebody's homophobic. And so it is interesting that that was one of the things that came out of the research. The the The other thing that came out of the research was that if people knew somebody that was gay, it's the same old stuff. If [00:22:30] they like, they talked about somebody who had was on a in a leadership position or, uh, nurses that were gay or lesbian that the staff knew in those situations. It's like, Oh, no, he's OK, you know, he's OK. So, um, it's that personal connection. So in the abstract, it was a little less like, Yes, I'm OK with it in kind of a professional way. But when they knew somebody that was gay or lesbian, it's like, Oh, yeah, they're fine, you know? [00:23:00] So again, it it goes back to the same old stuff. Um, So what? What they also discussed, uh, from these scenarios, which is also very interesting was they relayed stories of residents homophobia. So, uh, one, group talked about they had a gay man move in, uh, to the facility, and one of the residents said, Oh, we got a poof dough over here in the dining room trying to get again. It's about [00:23:30] I think it's about, uh, previous homophobia that was just absolutely accepted. And these guys are in their eighties and nineties, and so it hasn't gone away. Um, and also about a disinhibition that with cognitive impairment, you don't have the niceties sometimes that you would normally, um and so that was a concern of the of the staff of So how do we do that? You know, what do we do with residents that are homophobic? Um, we've [00:24:00] tried to put together from that initial research which, like I said, um, Steven's written up a paper. It's been submitted. Um, we should hear back soon. It should be published soon. Um, so the next step for us was the rule foundation came back to us after that original research. They were quite happy with it. We were happy with it. It was interesting. Um, and then they said, OK, so now what we'd like you to do is come up with some guidelines and a way to disseminate these findings. So we have developed, [00:24:30] um, some guidelines we've used. There were some excellent guidelines developed, uh, by Dianne and, um, Anna Birkenhead through the, um, for mental health, um, services for, um, dealing with, uh, you know, appropriate care of people with, uh, uh, GL BT. I people really well received. Uh, very well done. We we've been working with outline, uh, as well with [00:25:00] developing. Um, kind of a way forward from the research where we are now is we have a work group. Oh, sorry. Let me go back. So, we, um we got a second grant from Rural Foundation to develop the guidelines and develop a dissemination plan. So we are now, uh, working with, uh, another project manager named Lisa Williams. who's doing a fantastic job. Um, helping us are the the focus of [00:25:30] this phase of the project is good design and a good strategy for disseminating guidelines in residents aged care, it is, You know, there's, um, 650 residential aged care facilities in in, uh, New Zealand. There's 100 and 52 in Auckland. Um, so it's not without its challenges, but, uh, we're working with industry experts and, uh, health care experts, And, [00:26:00] uh, so we're coming up with, uh, uh, the guidelines. We're also doing, uh, part of that that came became really clear to us. It's not only guidelines for the staff, but there's also a part of it that we need to do kind of a campaign to say These are the issues, or this is an issue in residential aged care. And so part of that is, um, we're developing a short kind of, uh, video, um, of [00:26:30] to that, we can take around to different meetings to it's like a It's like a A two or three minute, um uh, campaign kind of thing. Like this is, uh this is Mr Jones. He's in residential age care, so it kind of says a 10 scenario, and then at the end, we we talk, talk about the things they need to be aware of, um, in, uh, GL BT I issues in residential aged care. We're hoping to take this around to things like, um [00:27:00] age concern and to the Aged Care Association of New Zealand and to, um other large organisations that provide care to government organisations to DH BS so that we can start to get some traction. Uh, as far as policies, you know, because that's the next thing for us is there's on the ground staff education. And then there's another level, which is the policy that provides the funding to provide the staff education. Uh, so we just we [00:27:30] quickly realised that there are those two prongs needed to be approached when we go through this. So what we're hoping to do at the end of this phase is to have the guidelines completed a short, uh, in education session that can be inserted into any, uh, cultural education. Uh, that's happening in residential aged care. So it is the GL BT unit, if you will, Um, and we've had some great, uh, work [00:28:00] from uh, some people that work in residential age care that help us with that to help us put that together. Um, and then we'll have this short kind of video presentation that we can we'll use as part of the education piece. But we'll also use it as a campaign piece so that we can, um, move that forward. Um, we're hoping to have that done by the end of June. I It's getting the end of June very quickly, but we're working really hard on it. Um, and then the next step for us is probably to [00:28:30] seek more funding to do the roll out. You know, how are we gonna roll this out? So we'll have the materials to roll out. The next phase is to say so. Let's roll it out. We need funding to roll it out. So, um, I feel quite positive. We have, uh, uh, a member from, uh, the funding and planning. Uh uh, section of Auckland. DH B on our steering group. He's, uh, Robert Ford. He's been fantastic. Um, he's given us some great ideas [00:29:00] about how to influence, uh, governments and DH BS and that kind of thing. So we're we're going down that road are one of our goals. One of our lofty aims is to get, uh, a policy change, you know, to have it a very explicit, clear policy. Just like, uh, all the other policies that we have, um, in that you need to be You need to understand, uh, [00:29:30] the ethics of care for older people that you need to understand cultural safety. But that includes GL BT. I issues. Um, so it's just part of what we do as we train you up to work in resident care. It's just what we do. That that's part of it. So we're working on it, and and I'm I'm pretty optimistic. I'm very optimistic because anything that happens in Australia, New Zealand likes to follow, so we'll probably, um I'm I'm thrilled that Australia's took a kind of a step ahead [00:30:00] of us in some ways. One thing we haven't covered off is actually, um, who is actually involved. Could you tell me who who's involved in this research? Sure. Uh, Stephen Park from the Royal Foundation approached me early last year, uh, to see if we were interested in doing this, um, through my work with the University of Auckland and school and nursing. Um, and, um, I was I thought it was a great opportunity. Um, And then I collaborated with, uh, Gary Bellamy, who [00:30:30] led the project the first phase of the project. He wrote up the methods and and, uh, basically led the research. Gary, uh, works for the school of nursing at that point. Unfortunately, he's gone back to London. He's still involved, but, um, kind of peripherally, um, the other members of the research group, uh, included Stephen Neville, Um uh, as well as Jeff Adams from Massey University. Uh, Nigel George and Sonia Caron, Uh, from Auckland. DH [00:31:00] B, Um, and myself, uh, Jan Wilson from the University of Auckland. Uh, and, uh, we've also brought on Lisa Williams, who's who's leading the, uh, second, uh, phase of this project now through the school of nursing. Um uh, so that's the the research group, a collaboration between Massey University and the University of Auckland. How easy is it to pull or bring people together for this type of research? Actually, [00:31:30] um, I was really pleased. Uh, researchers inherently are busy. All of us are busy. We've got about five different hats that we're wearing at any one time. Um, but there was a lot of goodwill because we we see this as a a hugely high priority for gay and lesbian issues. And those of us all work in different ways in with older people's health. So to be able to focus specifically [00:32:00] on, uh, GLBD I issues is it was actually quite a joy. So it wasn't that tough to get people together. I have to say it was It's been quite fun. And what about funding for this kind of research? Oh, that's another discussion. Funding in general in New Zealand is quite slim. Um, it's getting it feels like it's getting slimmer. I have to say, um, it's It's always a challenge for all of us academics to get funding the funding for us. Uh, that's been absolutely crucial. [00:32:30] And we absolutely could not have done it. Is the Rule foundation and their vision? Um and so we we've been extremely grateful for them. They absolutely, uh, see the need. So one of the questions is, Well, where do we get other money to do this kind of research? Um, any money that you get for GL. BT I Research is fairly slim. It's not big money. Um, but, uh, you know, we really it's been the real [00:33:00] foundation, and we'll we'll keep looking for other sources of funding. But that's been the main thing. Just looking at the research and you mentioned earlier about two scenarios. What were those two scenarios? One, that's a good question. Uh, one was about, uh, a gay and lesbian couple. Uh, sorry, a lesbian couple. And the other one was about a a gay male couple. Um, what's interesting? That was The other thing about the research that I found really interesting is that there's also more homophobia towards gay men than there is lesbians. Uh, so [00:33:30] what some of the participants said was that well, it's OK to see women hug and kiss because they're kind of we're kind of used to that women are much more affectionate, but it's when you get two blokes together, is what they said, Um, that they found it more difficult, which I found really interesting. So we did use two scenarios that way just to try to elicit the different views. When you were questioning staff, did you also question them about their own sexual identity and gender. We did, um, but not much. [00:34:00] Uh, it really we tried to focus on these two scenarios. Now, we did have one situation where a staff member who had not been out to other people, uh, came up to Gary afterward and said, Look, I'm lesbian and and actually felt because of some of the comments was pretty convinced why she needed to stay in the closet, you know? So it really it's [00:34:30] not only safety about the residents, it's safety about the people that work with them as well. Uh, you know, being safe in that environment. Um, so we found that interesting. There they were, Um, and this was particularly in caregivers. You know, caregivers unfortunately, are, um, the lowest on the on the totem pole, if you will. They get paid very little, um, and so they they wouldn't have the same, uh, empowerment [00:35:00] to be out. I don't think as some other members of of the staff RN, for instance, or or managers or that kind of thing. Um, the other issue, um, with caregivers and we found this in our research as well is that many caregivers are, uh, Pacific Island and Pacific Island. People are very religious, and they talked about their religious feelings in these interviews that it's actually against my religion. I feel quite strong about that. I can deal with it here [00:35:30] at work because I'm professional. But in my own personal life, I have a real problem with, um with homosexuality. So that was quite interesting. Um, yeah, What are the differences between, say, like registered nurses and and and so registered nurses? Um, have a three year degree? Um, it's a bachelor's degree or the vocational training, Um, in the old days, but recently it's a It's a bachelor's degree in [00:36:00] residential care. It's quite interesting. Um, we just did another survey for another project, Uh, and where we surveyed staff of residential aged care and 90% of the staff that we surveyed were, uh, from a different country had English as a second language. So one of the characteristics of our NS in residential age care, residential age care are that they are from different cultures, which also adds [00:36:30] another dimension. When we start talking about GL BT I issues with caregivers, they may have, uh, they are given training, but it's a There's levels of training. They might have as little training as a day or two, or they might have done, um, a more extensive training. Um, and they do. It sometimes is reflected in their pay, which is nice, but not always, um, so that they we call them an unskilled [00:37:00] work workforce. They don't have any formal qualifications except for what they gain on the job and through, um, correspondence courses, usually or or conferences and that kind of thing. And are caregivers in a day to day situation? Are they the ones that are with the residents the most? Absolutely. They're they're crucial. It's a real I find it really interesting because the caregivers, um, do the day to day work. They [00:37:30] don't have a lot of formal skills and education, but they absolutely are the eyes and ears and the relationship with the older people and their families. Um, there are some amazing, amazing caregivers out there. I can't tell you how I have. I love teaching caregivers. It's one of my most favourite thing to teach. Um, favourite people to teach is caregivers because they just soak it up and they do the job because they love [00:38:00] the job. It's not paid well. It's paid very poorly. It's, um recently, there, Judy McGregor did a, uh, a paper out of the Human Rights Commission talking about how the pay and the conditions of work for caregivers because it's mostly a women's job is a women's issue that you wouldn't pay anybody else that low wage for the work that they do if it wasn't such a women's profession. [00:38:30] So there's lots of issues, Um, but they are fantastically good hearted good people who are trying to do a very good job in a very difficult situation. Um, so I can't say enough about how great the caregivers are, but yes, they are the mainstay. So if we're going to roll this out, if we're going to talk about G, LP D, I issues, we've got to consider that that we start with caregivers, in my opinion, caregivers and nurses. But nurses [00:39:00] are just They're usually supervise the caregivers. We have to take into consideration that they are often from a different culture, um, which adds another level of complexity to what we're doing. Um, and we also have to add into that that they don't have a lot of formal qualifications so that we need to present it in such a way that it's really useful for them. Um, and not very academic, which academics are not not very good at, um so all of those challenges [00:39:30] and and it it may conflict with their own personal religious, cultural beliefs. Um, and that's another issue for us to to discuss with them about. You can still have those cultural beliefs that's in your religious beliefs, and that's fine. But you have to set them aside. When you're working with people here, it's different, you know, this is this is not acceptable. This is just like ageism. Racism is not acceptable. This is not [00:40:00] acceptable. Um, the other thing, that with caregivers, uh, I will say, and also nurses from other cultures. They experience a lot of, uh, racism themselves from from, uh, residents and families. Um and so that's also a challenge for them. Um, so it's It's a very complex, very interesting me of issues. Um, yeah. I'm imagining [00:40:30] that that kind of connection between the caregiver and the resident that the the must or you'd hope there'd be some kind of empathy, And I'm wondering, can you talk about what empathy means in this kind of situation? Uh, that's what I love about caregivers more than anything is that they are, for the most part, women good women who, uh, show they're caring amazingly well. [00:41:00] I mean, they just the intimacy of care that they provide. Um, they do it in a in a very respectful way. In my my experience, for the most part, um, and that they they do this kind of work because they care about older people, you know, that's why they do this kind of work. There's other jobs that they could do, but they stick the ones that stick with it for a long time. Um, are good hearted people who care about older people [00:41:30] and you can see it when they're caring for them. They want to make sure that they're presented well, that they look good, that they're that they're gentle, that they're kind. Um, I I've just seen the most amazing, uh, acts of kindness with caregivers, actually. So when you look back on, say that example, where an older gentleman comes in and somebody says that one of the other residents says, Oh, there's a in the room or whatever. I mean, how do you How do you respond to [00:42:00] that? That's right. Well, that's what we're That's what we're trying to work out with these guidelines and some suggestions is because a lot of times people would let it go because they don't know what to say, you know, So what we are hoping to do is to frame it in such a way to say that just like we don't allow racism. And just like we don't allow other forms of bad behaviour it it is appropriate for you to say to this other resident, we actually don't say that here, you know, we actually don't. This is not what we do here. So setting the boundaries, [00:42:30] so giving them the permission and the and the tools to be able to then say to other people, that's we don't you know, we don't We're not racist and we're not homophobic, and that's not what we do here. Um, I think I think guidelines are really important. I think education is really important to otherwise it's just accepted. Unless they're educated to say no, actually that's not acceptable. So and [00:43:00] also the whole idea of of, of trust, like, I mean, even with the staff member saying, I don't want to come out at work because of you know, some of the the comments that I've heard tonight. Um but as residents, I mean, if you've grown up in a situation where homosexuality was illegal, absolutely well, absolutely. That's that is what that's part of the. The education that we need to include in that is that don't forget that a lot of these guys don't want to talk about it. A lot of women and men who grew up in the closet, [00:43:30] it is ridiculously terrifying for them, um, for other people to find out. You know, um, so we have to make a safe environment so that they feel safe to be able to talk about it. Do you think that people go back into the closet when they go into residential care? I've heard that, um, I yeah, I haven't had that experience, but I've certainly heard stories of other people doing that. We're really desperately trying to make a situation where [00:44:00] people don't have to do that. I will say also the other thing that's changing is our society is changing. You know, um, I have a civil union. Uh, you know, uh, we were I was talking to a friend yesterday about getting married. I'm going to a lesbian wedding and, you know, very soon And you know, the the society is changing. And I, I do think with the change in society, it will also [00:44:30] you'll see it in residential aged care. Um, I So I think we're in a different era. I think we're moving along, so we just I feel like we need to give the staff the tools that they need so that they can move along with the way society is changing. So, in your personal experience, have you come across LGBTI people actually in residential care that are openly out? Uh, I have, um And for the most part, uh, people just accepted them for who they were. Um, so, [00:45:00] uh, certainly within our service, there's a huge respect. And, um, I think respect is the way to say it. Uh uh, that I've seen that the nurses I work with, uh, senior nurses with geriatric clinical nurse specialists. Um, and they are hugely, um, respectful. And, um and and inclusive in the care that that person and those people that, uh, how [00:45:30] they were treated and how they were needed, uh, how they needed care. So I haven't again. That's that's the tricky bit. Is that yes, there is homophobic ideas about, uh, because of religion and those kinds of things. The research that we did certainly expressed some of those concerns, but overall, the sense we got was that staff members understood [00:46:00] that it was not OK to be homophobic. Um, the question for us is to then move it to the next level of Yeah. OK, so you know, this is not OK. What about actively? Um uh, being a, uh, advocate for this person who is gay. So not just pretending like it's not there but actually act actively advocating if other residents aren't, you know, great about it and or whatever. So so that we give them the tools now that so [00:46:30] we can talk about it and give them the tools that they need. So but yeah, overall, I think people have been actually really good. So And when somebody is kind of out in a residential situation, I mean, does that mean things like holding hands or kissing a same sex partner. That was one of the things that themes that came out in the research. Is that out of sight? Out of mind. So, yes, it's OK for you to be gay, but not in public. And so if you do it behind closed doors, [00:47:00] But that's true for any sexual activity. Uh, for the most part, um, but certainly as I was saying earlier, the staff thought it was OK for women to cuddle, but it was not OK for men to cuddle, Um, and that I think we need to We have some ways to go on that one, so they can do whatever they want behind closed doors is what was said, but not, you know, kissing or hand holding or anything like that in public. So, I mean, if somebody was doing that, I mean, they they might [00:47:30] not agree with it, but I mean, would they stop it? No, they wouldn't. They wouldn't stop it. But they were, But other residents would would have issues with it. Families might have issues. I mean, the family, the family factor in residential aged care is huge. Um, So the again I, I guess. What? I? I want them to understand that that it's not OK to allow other people to say negative things [00:48:00] about that, that they you know, that there is a it's not tolerated, you know that. But, um, yeah, as long as it's out of sight, they're cool. Cool with it. But if it was in public, it just made them uncomfortable. So that's like, Oh, I wouldn't want to see that, you know, kind of thing. Do you think the, um, results of of of this this kind of research would change depending on which location you were in the country. So, like, I mean, if you're in more rural parts or we don't know, um and that's one [00:48:30] of the questions that we have is that we are in an urban centre. We did it because it was convenient and we could do it. Um, I think it would be very interesting, particularly as we start rolling this out to see how it is, how it plays out in other parts of the country. Um, yeah, be very interesting in rural areas in particular. Do you have a kind of a gut reaction or gut thought. Well, I again one of the things about rural areas, uh, in [00:49:00] residential aged care is a lot of people know everybody. So the people that are working in the facilities know the people that are coming into facilities because they used to be their teacher and you know that kind of thing. So it it's unusual. It's unusual for people not to know each other, So it would be unusual not to know if somebody was out in the community. It would be in a rural area. They would know that they were out in the in the facility. It's for those people that were were not out in the community. [00:49:30] They probably would. It would be difficult for them to be out in the facility as well, because it's the same community. So I do think it's a It's a bit different. It depends on how how open they were able to be in their lives in general again. In rural areas, um, people often take people at face value, and if they get to know you and you're OK, it's just like anything else. Then it's like, Oh, yeah, it's just like she's she's like that, but it's OK. You know, She and Fran that's [00:50:00] fine, you know? So, yeah. So we've talked about, um, kind of gay and lesbian and and how they may be treated differently in in those kind of care situations. What about transgender? That's a whole another discussion. And and I appreciate that because that that is even pushing the norms that much further. Um and I just don't know. One of the things that we are including in the guidelines and in our discussion [00:50:30] is is transgender people. Uh and I do think that they're going to have a harder time, unfortunately, because it's we're just that much behind, you know, getting that acceptable. I think in the future, it's it's also going to be a much more accepted thing. But, um, that is part of I think there needs to be a lot of education about that, that there is a potential for huge, [00:51:00] uh, discrimination that way Now. The tricky part is as you start to lose cognition and frankly, for residential aged care. These days, it's really 70% of people have some kind of cognitive impairment. It's really for people who cognitively cannot stay in the community anymore. Um will there, You know what? How will that manifest as a as a, uh, [00:51:30] transgender or, you know, how is that going to manifest? What is that gonna look like? Will? If I can't tell you what I want, will people assume what I want? You know, that kind of thing? Um, I think there's some I think there's a lot we don't know about that yet. And I do think it's it's a much more problematic area. Mhm outside of the the residential care facilities you've You've also got other organisations, community organisations [00:52:00] who are advocating on behalf of older people. What do those community advocates? Um what what role do they have with with rainbow people? Well, it hasn't been explicit. I don't think at this point what We've talked with age concern just briefly. They're very open to, um, working with us. We see some kind of collaboration with outline and the older, uh, the other older advocates, like grey power age concern [00:52:30] those kinds of things so that they have a a resource that they can go go into, uh, so that they can tap into a like outline that has a whole aged kind of part to it, and I think that's for the Rule foundation. That's also what they're interested in. Um, I. I do think it's fairly invisible in the mainstream, uh, older adult advocacy groups at the moment, but we're trying to, you know, put those together a little bit more [00:53:00] and we like I said, I hope we hope to do it through outline. I think I think outline has a huge role to play. One of the things that I'm really interested in looking at further is I love this idea of a visitor and age Concern already has, uh, friendly visitors and peer support, that kind of thing. I'd love to have, uh, a section where it's just, uh, older adults, gay and lesbian older, the GL BT I older adults that are doing the visiting for for gay and lesbian people. And I think in the future we'll we'll get [00:53:30] there so we'll have a kind of a, uh, specific intervention. That is, uh, volunteers, gay and lesbian volunteers that are visiting gay and lesbian people meals on wheels, for instance. It'd be great if we could do something like that. So looking forward when you look to your own future, I mean, do you Do you plan for your own kind of ageing? That's a great question. Um, I do. And personally, I think about this the [00:54:00] I think about the society I live in now. OK, so I look back on the eighties, the good old eighties when we were young, you know? And it was so fun being a subgroup, it was just such a blast. Um, but we're not a We're not a subculture as much anymore because we've all worked really hard to come out, And we've all worked really hard to have, you know, to get civil union now, marriage and, uh, get equal rights. And, um and so in a way, it's kind of sad, but we're [00:54:30] not as the subculture. How fun that was is kind of disappeared somewhat because we're now in our jobs in our suburbs and our doing our stuff, and I and I'm out to everybody. It's not, you know, it's to me. It it doesn't, you know, I don't have I don't experience a lot of homophobia. Personally, I just don't feel it, You know, um, every occasional once in a while, you know, you think, Oh, they must have a problem. But you don't think about it. [00:55:00] So I guess for me, as I age, I think about the society I'm in will be ageing with me. And frankly, I absolutely can see myself in a village at when I'm 85 you know, can't quite make it at home anymore. But I'll be in a village with the people that I live with now, and some will be gay and some will be straight. And some will be, you know, transgendered. And some be, you know, it'll be the same society. So I personally, uh, I don't I don't look to a just a lesbian, [00:55:30] only situation. I actually look at that. I'll be with a wide variety of groups and part of them will be lesbian, and part of them will be not lesbian and gay. And, um yeah, so I guess that's I guess that's what I'm saying is I don't feel like I need a separate place. I just need to be supported just like anybody else as long as I can in the community. I'd love to have lesbian and gay visitors if I needed peer support in the community. [00:56:00] Um, but once I need villages or residential care, I'll just be with everybody else. Frankly, just treat me good. You know, it it seems to me that, um, I yeah, I, I certainly take the point of that. Basically, it's the society that you're in now is basically going to be reflected in your kind of aged care. How quickly do you think those changes will happen in aged care in terms of, um, you know, acceptance of kind of homosexuality? Actually, I think it'll be very similar to [00:56:30] how it is with racism. You know, if you think back in the 19 sixties in the States, I'm from the States, you know, we you know, we're looking 50 years ago, 50 years ago, racism was OK. Believe me, I you know, I. I lived in the South for a while. It's still fairly OK, um, so racism is still with us, but it's not OK. It's not acceptable. It's not acceptable in institutional situations. Um, and I think homophobia in another 30 years when I get there, [00:57:00] Uh, it'll be the same. I don't I think that homophobia will be just as unacceptable. And it is almost there now as racism is to us now, um and so if we can kind of have some part in getting that education as part of that where it's not OK, and these are your resources that you need to do to to combat that, Um, I think it will. I think I think we'll look back at, uh, homosexual law Reform, for instance, [00:57:30] and think, really, did we have to fight that hard for that? It'll just be an anathema, I think, to the next generation. It already is. I think, to the next generation and then to the next generation of you've got to be kidding me. That was never OK, so I think that that's what you'll see in residential aged care in the future as well.
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