LGBTIQA+ Inclusion in Aged Care: Perspectives From Providers and Community Stakeholders.

OBJECTIVES: Experiences across aged care services for older LGBTIQA+ individuals vary, with some receiving affirming care and others having unmet needs. Given the growing demand from this population, it is essential to examine both effective care aspects and ongoing challenges. This study aimed to explore the perspectives of aged care providers, carers and community stakeholders on opportunities and barriers to the consistent implementation of culturally safe care for older LGBTIQA+ Australians. METHODS: Adopting an interpretive descriptive methodology, a thematic analysis using Braun and Clarke's six-step framework was conducted on LGBTIQA+-specific transcripts from the Royal Commission into Aged Care Quality and Safety Diversity Hearing (October 2019) in Melbourne, Australia. RESULTS: Thematic analysis identified two main themes: Inclusive and Culturally Safe Care and Robust Governance for Inclusive Care. Findings revealed that engagement with aged care is severely undermined by historical trauma and a profound mistrust of formal services by some LGBTQIA+ older people. Systemic barriers persisted due to inconsistencies in governance and a lack of accountability for diversity standards. Stakeholders highlighted the critical necessity of mandatory, identity-affirming LGBTIQA+ workforce training and the vital role of advocacy and community connections in bridging access gaps and ensuring cultural safety. CONCLUSIONS: While policy frameworks and 'special needs' recognition exist, genuine inclusion for older LGBTIQA+ Australians hinges on operationalising cultural safety through consistent governance, stronger compliance mechanisms and a mandatory, well-resourced training regimen for the aged care workforce. These findings provide critical implications for policy reform and practice improvement under Australia's evolving aged care standards.