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Lesbians and bisexual women and dementia

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Never going awayOlder lesbian and bisexual ('minoritised sexuality') women share many of the same concerns about later older age as older heterosexual identifying women, including concerns about loss of independence, care and housing needs, and fears about physical and/or mental incapacity (ref 1).

Many fear dementia in particular. But in addition to this being a concern for all older women – given that women live longer than men, and so are more likely to be affected by (age-related) dementia (ref 2) – it is magnified for women with a minoritised sexuality. This is for a number of reasons.

Firstly, many older minoritised sexuality women were treated as mentally ill because of their sexualities when they were younger. Some lost their jobs (e.g. being expelled from the armed forces) because of their sexualities for it. Some were offered psychiatric 'cures' including electric shock treatment. Others experienced rejection from religious organisations. So they are very wary of having anything to do with institutions again.

Secondly, many have had difficult prior experiences in medical settings, e.g. G.P. practices where they have felt uncomfortable disclosing their sexuality. This has led to minoritised sexuality women often avoiding women-specific screenings, e.g. cervical smears, breast screenings and so on. And this also informs their fears about engaging with health and social care provision if they are experiencing memory problems.

Thirdly, many older women, irrespective of sexuality, have supported older friends and/or biological family members in care contexts, and have seen first-hand what they can be like. They fear care that is heteronormative (i.e. assuming everyone is heterosexual), heterosexist (i.e. favouring heterosexual individuals), lesbophobic (prejudiced against older lesbians) and/or biphobic (prejudiced against bisexual people).

Some may choose to hide their sexualities, their life histories and/or important relationships in order to stay safe (ref 3). Many also fear having to share care alongside (heterosexual) men, especially those lesbians who have constructed lives apart from men.

Lastly, older minoritised sexuality women are less likely than heterosexual-identifying women to have partners, to have children, and to be in regular contact with extended family members1. This means they have less access to informal social support at a time when they also may be less able, due to memory problems, to speak up for themselves, adding to their fears.

So, when we think about older women and dementia, we need to remember that older lesbians and bisexual women are affected by dementia too (and can be carers of others with dementia), and that recognition and validation of their sexualities is crucial in providing appropriate support (ref 4).

(1) Lesbian, Gay Bisexual People in Later Life, (2011) London: Stonewall: http://www.stonewall.org.uk/documents/lgb_in_later_life_final.pdf

(2) Knapp, M., et al., 2007. Dementia UK: A Report to the Alzheimer's Society on the prevalence and economic cost of dementia in the UK. Alzheimer's Society.

(3) Richard Ward and colleagues (2011) Don't look back? Improving health and social care service delivery for older LGB users, London, EHRC: http://bit.ly/1oDP5V9

(4) Roger Newman and Liz Price (2012) 'Meeting the Needs of LGBT People Affected by Dementia': http://bit.ly/1dGiQCb

Sue Westwood

Tags: carers, lesbian and bisexual women Written 2014-08-12

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