Older LGBTQ adults' psychological needs in long-term care: A qualitative investigation

Abstract

The aim of this thesis was to gain a deeper understanding of older Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) adults' psychological needs and psychological safety within long-term care (LTC) and later life housing. Paper 1 is a systematic review of the literature concerning the psychological needs of older LGBTQ adults receiving LTC. Fifteen studies from six different countries were included and analysed through meta-synthesis applying 'best-fit' framework synthesis. Kitwood's (1997) framework of psychological needs was employed as an a priori framework. Additional psychological needs of acceptance and safety were identified, and the a priori framework was revised to include these needs. Clinical recommendations were recognised. Paper 2 is an empirical study which seeks to explore what psychological safety means to older LGBTQ adults in general, regarding later life housing needs, and considering LGBTQ-majority extra-care housing schemes. Utilising a qualitative focus group and individual interview design, the narratives of 36 older LGBTQ adults were audio-recorded, transcribed, and analysed inductively using reflexive thematic analysis. Sixteen subthemes were identified and organised around six main themes: 1) Historical impact on psychological safety, 2) Discrimination in the current living context, 3) Acceptance from others and self, 4) Belonging and connection, 5) Protection and security, and 6) Moving away from heteronormative care. The findings were considered in relation to the wider literature and recommendations were made for improvements to clinical practice. Paper 3 presents a critical appraisal of the research process, including the rationale underpinning methodological decisions and the strengths and limitations of the work. This paper concludes with the first author's personal reflections on the thesis project.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Louisa Shirley (Supervisor) & Sandra Flynn (Supervisor)