Psychological Safety in Later Life Housing: What it Means to Older LGBTQ+ Adults.

Research on the views and experiences of older LGBTQ+ adults accessing long-term care (LTC) identifies concerns of discrimination and identity loss. However, what the concept of psychological safety means to this population in LTC and later-life housing has been neglected. Understanding psychological safety could help ensure the needs of LGBTQ+ elders are understood and considered more appropriately in LTC planning and operation. Thirty-six older LGBTQ+ adults were interviewed individually or in focus groups. Data were analyzed inductively using reflexive thematic analysis. Eleven subthemes were identified and organized 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. This novel study found that the past and current experiences of LGBTQ+ elders with discrimination and its impact on psychological safety need to be understood and incorporated within staff training. Acceptance, belonging and connection, and protection and security strengthened psychological safety. LTC services and its staff need to move away from heteronormative care, present positive LGBTQ+ attitudes, and show an understanding and awareness of LGBTQ+ intergenerational and intercommunity similarities and differences to engender psychological safety.