This webpage explores how service providers can engage appropriately with older and old LGBT people and have positive, useful and inclusive conversations.

In everyday life, conversation is the way we learn about people. By having conversations with people who access care and support, you can find out all sorts of things that could be lost if you just followed a form with standard questions. This approach is called conversational assessment.
This puts conversation between equals at the heart of finding out about people, and enables you to learn:
• what’s important to them
• their strengths and talents
• what’s working well and what they want to change
• what they’d like to achieve
• how they’d like to be supported.
This can help you to support people in ways that reflect their wishes and needs and deliver high quality, person-centred care and support.

[Skills for Care]

What’s the issue?

Over the years, in our conversations with service providers, SAND has repeatedly been asked about communication and language. People are concerned about: asking the right questions, at the right time, in the right way – without offending, without feeling awkward or triggering shame, embarrassment or other negative sensations which may prevent someone from sharing aspects of their life related to their sexual orientation or gender identity.

This webpage offers a series of suggestions to help service providers to have better conversations with older and old LGBT+ people. The suggestions below take you through the process step-by-step. They link to other resources on the site. When you’ve explored those, return to this page and continue to the next suggestion.

Suggestion one

As an organisation, agree that this is important and make a commitment to work towards having better conversations. One way you might do this is to sign the EMBRACE Covenant.

Resources which might help:
Questions for service providers and LGBT+ people

Suggestion two

Identify the implications for your organisation – and for older and old LGBT+ people – of not having better conversations. This may include things like your service not meeting needs, failing to meet monitoring requirements, suppressing LGBT+ people in your care.

Resources which might help:
70 Years through LGBT+ eyes
Dignity Day

Suggestion three

Identify the barriers to your staff and volunteers of engaging in better conversations. These may include thoughtlessness, lack of familiarity with terminology, fear of causing offence.

Resources which might help:
Better Conversations – barriers to staff and volunteers

Suggestion four

Understand more about why older and old LGBT+ people may not feel comfortable in engaging in these conversations.

Resources which might help:
Coming Out

Suggestion five

Take some practical steps to enable better conversations. Click or tap the headings below to find out more.

Clarity of purpose - what information do you need?

Examples:

  • Medical history – physical health
  • Mental health – past trauma
  • Life stage
  • Identity
  • Relationships
  • What matters
  • Who matters
  • Support networks

Clarity of purpose - why do you need the information?

Examples – you may be:

  • Providing, intimate care
  • Planning personal health checks
  • Assessing perception and likelihood of risk
  • Treating or prescribing
  • Planning end of life support
  • Undertaking social care assessments
  • Safeguarding considerations
  • Offering retirement living
  • Providing debt counselling
  • Providing financial planning
  • Supporting people to write their Lasting Power of Attorney
  • Gathering demographic information for funders
  • Discharging from hospital
  • Social prescribing
  • Offering bereavement counselling

Clarity of purpose - what will you do with this information?

Examples – you will use it to:

  • Support the individual
  • Treat the individual
  • Monitor your service and/or clients
  • Understand more about the risks of not knowing your clients
  • Contribute to quality assurance
  • Develop understanding of disparities
  • Facilitate open conversations

Planning what you want to say - and how to say it

Remembering the concept of ‘Making Every Contact Count’, person-centred approaches, the value of good communication skills and the role of positive body language

We quite like the Betari Box model – you can get the basics here: Betari

TOP TIP

Learn to listen and read between the lines

Examples:

Tell people why you are asking:

  • We need this information to give you the best service that we can

Ask neutral questions:

  • Who do you go home to?
  • Who have you got at home?
  • Who is important to you?
  • Who might be affected by your circumstances?
  • Who are the people close to you?
  • Who do you get support from?

Give people space to share:

  • Is there anything else that you want us to know?
  • Are there anything particular you would like to tell me to help me treat you appropriately?
  • Do you have any particular concerns about XX?

TOP TIPS

Consider your surroundings – takes into account the sensitivity of what we might be asking

  • Is anyone listening?
  • When might privacy be appropriate – or feel safer and more comfortable for better conversations?

Fess up when it goes wrong

  • Sorry, that was my assumption, I do apologise
  • Sorry, I wasn’t paying proper attention ….
  • Sorry

Planning what you want to say - and when you are going to say it

Timing can be everything. When do you need to know this information?

Examples

  • Immediately, for immediate attention?
  • Can you collect minimal information immediately in order to deliver the service and the rest can wait?
  • Can this information wait until an appropriate client relationship is established?

TOP TIPS

  • Don’t close the door to future disclosure
  • Visual signs of inclusion can help your conversations