My Home Life & Care England Series: Thrive Inclusively

This is week 3 of a 6 part series ‘Thriving in Residential Care’ in collaboration with My Home Life England, spotlighting real, powerful stories of how life in a care home has been truly transformative for many older people.

This week My Home Life England’s research explores two dimensions of inclusivity; embracing cultural diversity and enabling people to express their sexuality.

Inclusivity involves making someone feel welcome, safe, valued and respected, regardless of characteristic or background. At My Home Life England, we saw wonderful examples of support across the homes we visited as part of our ‘Thriving in Residential Care’ research. This included validating the experience of those living with dementia by entering the world of the person, personalising spaces and creating innovative environmental layouts. One care home had an unlocked door that led into a walled garden with a circular loop path. This facilitated walking with purpose, both inside and out.

We saw many examples of older people connecting with their identity through embracing faith or culture. 74-year-old Brian particularly enjoyed attending church services, because it was an important part of his faith, but it also reminded him of his church involvement throughout his life. Telling stories about his previous church responsibilities and what they meant to him helped him to retain a sense of self-identity.

Our study also included care homes offering specialist provision for specific cultures and faiths, with culturally appropriate activities and foods, language support for those of whom English was not their first language and multi-faith chapels. For Pali who was living with dementia, sitting in the prayer room each morning and listening to Bhajan music was her favourite activity. Care homes with a specific cultural identity were acknowledged as crucial in challenging community stigma and modelling that it is acceptable, and even beneficial, for a relative to live in a care home. Bruce expressed his relief at finding a placement for his mother in an Asian care home where others from his community lived and worked, as they were able to communicate effectively with his mum in her first language and support her cultural needs.

Having multicultural representation amongst the care team brought great benefit, particularly in terms of recognising and celebrating culture, and it formed part of a more inclusive culture in care. A few care team members did acknowledge that some of the older people they cared for were not familiar with people from other nationalities and ethnicities. It was important to be sensitive to the needs of others when living and working in a communal and multicultural setting and to have open conversations.

We also recognised the importance of fostering an inclusive environment where older people could express their sexual or gender identity. Many care team members described how they recognised and facilitated the need for privacy and time alone in rooms for some of the older people. Care home manager Lucy recognised that there has been a more liberal generation of older people entering into care over the last decade, and that care practices had begun to change in response, including altering the questions asked in care plans to include gender and sexuality, so that “we don’t let anybody go back in the closet”.

We heard powerful stories of the transformative impact that inclusive practice has had. Care manager Jay shared “one of my proudest moments ever working in care”, recounting how his care home’s open and LGBTQI+ inclusive environment supported a gentleman to finally express his sexuality: “We have made an environment where somebody feels so safe that at age 82… he’s been able to come out [as gay]. At age 82! A secret that you’ve kept for all those years. I thought my job is done…if this environment is safe enough that somebody feels that they can do that, this environment is correct.”

There is a sense that, for some, despite the losses that can come with moving into a care home, the move can enable people to rediscover or reframe who they are. Self-identity and inclusion are harder to realise if your life at home is one of isolation, or if you live in a family or community that has not been accepting of your identity. Our findings highlight the importance of respecting the role of faith and culture in the lives of older adults, as well as promoting an inclusive culture in care homes through values-based caring practices and meaningful engagement. This led to very moving stories of people who felt able to be their full selves and were thriving in a supportive, welcoming environment.

Next week we’ll be exploring a sense of safety and security, and the overwhelming reassurance this provides both older people and those that care about them. At the end of the series, we are holding a webinar exploring how all these ‘Thriving’ themes can be embedded into care services. Sign up here.

To read the full report, please click here.