Intersex Human Rights Australia

Review of aged care standards

Dear Department of Health and Ageing,

I write on behalf of Organisation Intersex International Australia Limited in regard to the recently released draft standards of residential aged care.

We are very disappointed that Lesbian, Gay, Bisexual, Transgender and Intersex issues (LGBTI) have not been addressed in these standards of care.

We know from experiences within the intersex community that we are subjected to prejudice and  discrimination in the provision of services to the aged because of our physical differences. We are often required to disguise or hide our differences so that we might be thought of as “normal” and so that we might avoid being outed to the rest of, what is, generally, a conservative residency.

In some cases our medical needs makes this impossible so many of our seniors are reluctant to go into residential care and consequently suffer isolation in homes where, if their differences are known, even outreach services such as those provided by Home Care or Aged Care packages might be less than adequate or sufficiently hostile as to be unusable.

The hostility and prejudice is not simply directed to those aged who are LGBTI. It is likewise directed to them even when they have LGBTI relatives, children or others in their extended family.

I will give you two concrete examples from my own experience.

Case 1

I was the long-term carer for my aged aunt in Auburn, New South Wales. She had no other immediate family. Her husband passed away in 1984 and the marriage was childless. Her only other relatives lived interstate and offered every support to me but did not themselves wish to care for my aunt. It was my aunt’s wish, and a deeply held one, that she stay in her home until she died.

She was a “gold card” war widow living in her own home. In 1986 she suffered a disabling stroke and I became her full-time carer. I cared for her until she died in 2006. I was at first unaware of any assistance she may have been entitled to by way in home care and respite. When she was discharged from rehabilitation no attempt was made by the hospital, Veterans’ Affairs or the aged care assessment team to inform us of her entitlements.

When we did become aware, by chance, of her entitlements I arranged for respite care and for an aged care package. Things went along well enough until the members of the aged care team became aware firstly that I was engaged in a lesbian relationship and secondly that I was intersex. I made no secret of those things thinking, that in this day and age, it would make no difference. We were also provided with a home visitor from the local Baptist community outreach people. Both the Baptist home visitor scheme and the ACAT, when they became aware of my differences, refused to act with me present claiming I was not my aunt’s next of kin. Consequently my aunt had a power of attorney drawn so that I could act for her and manage her money.

I became ill shortly after the local ACAT became aware of my differences and was admitted to hospital for an hysterectomy. I had some two months’ wait for my surgery and so arranged through the ACAT for in-home respite for my aunt. Two days before my admission I was made aware that the aged care team had made no arrangements for respite and that it was my responsibility. I was unable in the short time left to do anything other than have the district nurse call in twice a day.

While I was in hospital the visiting Baptist worker convinced my aunt that I was establishing a “lesbian bordello” in her home and that when I returned I would bring all my lesbian lovers into the house. They then drove my aunt first to her lawyer and then to the police. Whilst with the lawyer they had her power of attorney revoked and at the police station had an apprehended violence order – AVO – taken out against me. I became aware of this when the day after my surgery I received a call from a distant relative in Queensland informing me my aunt had called her and was very distressed.

I managed to, despite being very ill, call my aunt and was overwhelmed when she told me what had occurred. The AVO was dismissed a fortnight later and I was made my aunt’s guardian with her consent by the guardianship tribunal several weeks later. I am aware that throughout these events that being a lesbian and being intersex were mentioned to my disadvantage and in a prejudicial way suggesting I was not a suitable carer by the ACAT team, by the Baptist outreach worker, by the police, and by my aunt’s lawyer.

The support of the rest of my extended family and the unprejudiced views of the magistrate and the guardianship tribunal saved the day in the end. I saw none of the ACAT team or the Baptist team after this. I was, however, as my aunt’s guardian, able to care for her and have many beautiful days with her until she died. I managed all in-home care and respite for my aunt after this terrible experience. I note that the ACAT is provided by a religious organization and both ACAT workers who visited the home and interviewed my aunt and myself were confirmed and committed to the religious body that provided the services. That religious body then and now consistently promotes homophobic views in the newspapers and other media.

Case 2

My mother has chronic obstructive pulmonary disorder and two years ago became a resident of an aged care nursing home. My mother is 79. The home is run by a religious-based organization. While in the home my mother became aware from conversations around her that the residents and management of the home were quite homophobic. For instance, when marriage equality was mentioned on the television or in the newspapers my mother had to endure, in silence, a tirade of abuse against “those gays.”

My mother has one lesbian intersex daughter, two lesbian grandchildren and a gay grandson. She also has a lesbian niece. My mother feels that she cannot speak out because she would be ostracized, in what is essentially her home, until she dies. When I visit my mum with my partner she is reluctant to take us into the public spaces in the nursing home lest the other residents or nurses put two and two together. My grandnieces, nieces and nephews are treated the same. So long as we visit my mum alone she feels safe enough to take us around the facility.

From my own observations I think my mother’s fears are warranted. I have been in the dining room and overheard homophobic chatter from both the residents and staff when an item on “same sex” marriage was on the midday news.

For my mother her relatives being outed as LGBTI is effectively the same as being outed as LGBTI herself. If the nursing home had a policy of LGBTI inclusion and education I am sure my mum would feel more secure that her long term future would not include being shunned because of her association with “the likes of us.”

I note the religious organization that provides the nursing home care for my mother currently promotes strongly homophobic views in the media and in literature provided to the residents of the nursing home. They provide religious visitors to the residents and those visitors share and promote the same homophobic views as the religious organization they belong to.

In conclusion

Any standards of residential care must include an LGBTI component where organizations are required to promote LGBTI understanding, prohibit homophobic prejudice and care equally for LGBTI elders and elders who have relatives and friends who are LGBTI.

Every worker at aged care facilities must complete training that includes care for LGBTI elders and elders who have LGBTI relatives and friends.

LGBTI education must be included in the qualifications necessary for aged care nursing.

Ongoing LGBTI awareness and education must be a part of the induction process of every worker in aged care facilities and be included in the terms of employment and provided in educational information packages.

LGBTI inclusion must be made known to all residents of aged care facilities and inclusive educational material provided in information packages provided to all residents prior to admission.

All aged care facilities must have an LGBTI inclusive policy and education program.

LGBTI elders, their family and their friends must be able to enjoy the same security and care that any other elder is entitled to in aged care facilities.

Gina Wilson
Chair, Organisation Intersex International Australia Limited