Taking care of equality
Brisbane's Morgan and David are optimistic that "when time catches up with them", equality will have caught up with aged care. Photo: Clare Barry
Going back into the closet after decades living freely is a very real prospect for some of about 25,000 same-sex-attracted over-65s in greater Brisbane looking into aged-care.
Morgan and David want to live happily together until the end. But age and David's fragile medical condition have seen the couple face the intrusion of third-party care and the realities of mortality Australia's many maturing couples can relate to.
David was diagnosed with depression not long after they opened their Gold Coast home to carers. Though able to respond to David's medical needs, these trained strangers were either ill-equipped or ill-prepared to deal with his sexuality or the relationship he shared with Morgan.
“So David began to regress back into a hidden self, if you like,” his partner says.
“I've always been guarded about my sexuality, but David has been out and proud since he was 14. Watching him suffer and doubt himself when he was already vulnerable was very hard. Then he was diagnosed with depression.”
Anguish and anger temper the tenderness in Morgan's voice. His love for David has endured diabetes, a stroke, and regular stints in hospital. But he wasn't prepared for the toll outside care would have on David's character. They took David's prescriptions with doses of bitter laughter.
“When the carers had left we'd quite often joke and laugh about the mannerisms we saw. We heaped ridicule on their ignorance, and then we laughed at that, we shrugged our shoulders. I mean, we're both mature people — David's 60, I'm 57 — so we've seen it all.
“But it shouldn't be like that. The carers' function was fine, but their ability to build relationships or make David feel accepted or at ease was sadly lacking, for many reasons — because of the issues of discrimination or lack of understanding about equality or because of their own personal reasons.
“Here in Australia, we're so bloody backwards — so little is understood of equality and tolerance. The good old Aussie 'have a fair go' idea is all very good, but so many people just pay lip service. To put it in practice is another matter entirely.”
The lack of facilities and care providers in Brisbane equipped to cater to the LGBTI community is a real and significant problem according to Queensland Association for Healthy Communities president Paul Martin.
People in their 70s today came to terms with their sexuality in a vastly different climate, if they came out of the closet at all. And while social norms are changing, the generation currently in care represent very different views and a very different time. The industry itself is also outdated, Mr Martin says, causing great trouble in twilight years that should be about peace, comfort and dignity.
“The number one concern expressed here is where members of the community are going to live in older age,” Mr Martin says.
“Not that they just want to live with other older LGBTI people, but they do want to be safe and in an accepting environment, otherwise they're faced with little choice but to, essentially, go back into the closet. And the reality is that a minority of people will face care in nursing homes — and clearly there are issues associated with that — but the majority will be cared for in place, in their homes.
"Not being able to find care that is sensitive to lifestyle choices in the context of your own home poses a real problem, especially when you consider that this is really very personal care — bathing, undressing. Will the person administering that be sensitive to all of [the patient's] needs?”
In addition to the lack of public services, Mr Martin said Brisbane's current cohort of ageing LGBTI people were also negatively impacted by the increased likelihood they would receive little or no support from children, unlike many other older Australians.
“And there's also the idea that a significant proportion of age-care providers here are backed by religious organisations,” he said.
“Some people in the LGBTI community may have a personal faith, but have struggled with organised religion, and there are church groups who are actively opposed to homosexuality and issues relevant to the community such as marriage equality for example.”
However, there are signs of positive change.
Members of the community are invited to attend a community consultation in Brisbane this week hosted by the LGBTI Health Alliance. Over lunch, attendees will share their views about the issues faced with age. Their views will go towards the development of a new government initiative that represents the first step in a long road of acknowledgement and change.
Announced in July this year, the National Lesbian Gay Bisexual Transgender and Intersex Aged Care Strategy aims to address equality in the aged-care system and will result in a $3.7 billion reform package including new training for staff and improvements to services.
In communicating the initiative, Minister for Ageing Mark Butler said it was brought about by the advice of the Productivity Commission as well as groups like ACON Health Ltd, the National LGBTI Health Alliance and the GLBTI Retirement Association.
Mr Butler said demand for aged care in the LGBTI community was predicted to increase significantly in the coming years.
“And there is a broad community consensus that it is important to recognise people who are LGBTI in the same way as we recognise the needs of other diverse groups such as people from culturally and linguistically diverse communities and Aboriginal and Torres Strait Islanders,” he said.
“Ultimately it's about recognising difference and ensuring equality.”
Community consultations are a pivotal first step in determining how that outcome is to be achieved, says National LGBTI Health Alliance general manager Warren Talbot.
Mr Talbot said depending on the recommendations and view of the minister and other stakeholders, change could begin to be seen by next year.
“Of course it will take a lot longer than that for the full impact to be felt,” he says.
“We're talking about a large-scale program of education and training that also seeks to address some long-held community views ... the principles we're seeking to introduce are similar to those catering to people of culturally and linguistically diverse backgrounds.
“There's a lot of work that needs to be done, but at least we're taking steps in the right direction.
"It will also be very important for the Queensland authorities in health and ageing to develop policies and programs in response to Queensland's needs.”
A spokesman for Queensland Communities Minister Tracy Davis said the Commonwealth had assumed sole responsibility for aged care for those over 65, and over 50 for indigenous Australians, but that the minister was committed to the cause.
“The Department of Communities, Child Safety and Disability Services continues to deliver programs that support active ageing, social inclusion and the safety of all Queensland seniors,” he said.
Such programs will need to cater to the broad differences in the experiences of LGBTI people living in metropolitan areas and their counterparts in the bush where attitudes towards homosexuality were markedly different, Mr Martin says.
He said Ms Davis had been supportive of QAHC initiatives conducted as part of Seniors Week held at the end of August, but more support was needed.
However, Mr Talbot said there were faith-based organisations, such as Uniting Care, that were taking a lead role in addressing the community's needs, while groups such as CareConnect lead the way in LGBTI-sensitive services.
CareConnect has a special place in David and Morgan's heart. Since the agency took over David's care, the couple have found cause to hope again.
“Before, the carers we had coming into the house caused so much worry and apprehension — we felt that we had to 'behave ourselves' somehow,” Morgan says.
“But that's lessened over the last year-odd, since we found CareConnect. And David most certainly — I can see it — he's relaxed, he's happier. We feel like we can be who we are and there's no judgment. That's all we want, to be who we are, and have the care that we need, and just to have the same respect as everyone else.”
Morgan says they are optimistic about the future. Though change will come about too late for many older Australians, it's likely that when time catches up with both of them, equality will have caught up with aged care.
“David and I have been together now five years, and as such we're likely to stay together for life,” he says. “I don't think we'll find it difficult to find a place together because it is 20 years down the track and hopefully there'll be a big shift in society's attitudes.
“And in any event, it would be water off a duck's back for both of us — as it was we ceased caring that other people don't see us in a favourable way. It's not right but that's how we've coped. But hopefully we won't have to forever.”
Brisbane's National LGBTI Aged Care Strategy community consultation session will take place at Riverside Receptions on October 11. Information is available via the website.