I could tell that Jill, a lesbian carer and a friend, was anxious as she attended her first carers support group. For a start I knew it was going to be necessary for her to ‘come out’. Everyone would want to know who she was caring for and that meant admitting her sexuality with the ensuing risk that not everyone might react in the best way. I remembered a carer once rounding on me when I spoke about my partner and saying “but I am talking about my HUSBAND”.
So the LGBT person with dementia and any LGBT carer will be faced regularly with deciding whether to ‘out’ themselves and even whether to out the person they are caring for. Since it is likely that there will be contact with relatively large numbers of health professionals and domiciliary carers ‘coming out’ may become too regular a challenge for comfort but I remain convinced that doing so is the best way of ensuring holistic treatment.
However when we admit our sexuality we have said something fundamental about ourselves. It is not enough to say to us ‘ it’s ok, it doesn’t matter, we treat everyone the same’. Instead engage with us. Ask if there is anyone special in our life; our friends; and our culture. Don’t be afraid to ask questions about our sexuality, if you don’t know the answer. Any information which enables you to serve us holistically has got to be good. Your positive proactive response will also help us not to be fearful and defensive, and having to hide things like photos, magazines and all the other ‘incriminating’ evidence from our ‘gay’ lives.
Not for nothing then have some LGBTs looked for LGBT specific service provision as a way out of this challenge and understandably some LGBT groups have set up befriending schemes, support groups and private domiciliary service organisations to counteract a feeling of being left out or ignored. The fact also remains that LGBTs are good at setting up ‘families of choice’ and there are numerous examples of wonderful loving care being provided in such situations. We have got used to making up for what society does not offer.
What else then might our situation be saying something to those working in the field of dementia care? Well for a start, there should be a constant reminder that gay or straight dementia does not discriminate and that there are LGBTs out there with dementia. Yet, and perhaps just as importantly, with the numbers now having dementia there is a new sense of all of us being in this together and the ‘all’ relates to our society as it is and not how we would prefer it to be. Those affected by dementia are therefore not just devoted happily married couples; white and middle class; surrounded by concerned and devoted families; and mostly prosperous. They are also single unmarried persons; they are widowed persons living miles away from family; they are childless persons; they are divorced persons; and those dependant on benefits; and BME people; and persons from fractured families; and also, as you might expect, LGBT persons too. The list then is almost endless and for all of them dementia does not discriminate. Our system of care, therefore, needs to reflect this real society