Abstract

The aim of the study was to explore plans, considerations and factors influencing long-term care among older sexual minority (SM) women. Qualitative interview study. Semi-structured in-depth interviews were conducted with 37 older Taiwanese SM women between May and September 2019. This study analysed interview data using a socio-ecological model and constant comparative analysis. The most frequently reported long-term care plans were housing and institutions, private medical or long-term care insurance, financial planning and medical decisions. Factors associated with women's long-term care plans were categorized using the socio-ecological model level: (1) intrapersonal factors: current physical and mental health status, ageing signs and women's attitudes towards ageing; (2) interpersonal-level factors: receiving support from partners, child(ren), siblings or significant others, concerns about being a caregiver for parents and worries regarding social isolation; (3) community-level factors: receiving support from lesbian, gay, bisexual and transgender (LGBT) organizations; private lesbian online groups; or religious groups; (4) societal-level factors: concerns about negative social environments, concerns about the healthcare system and healthcare providers, inappropriate policies and insufficient resources. This study identified multi-level factors related to long-term care plans and concerns among older Taiwanese SM women. Recommendations for nurses, managers of long-term care and healthcare settings, policymakers, and governments have been provided to diminish health disparities and reduce anxiety among older SM women. This study assists nurses in understanding older SM women's long-term care concerns and worries when accessing long-term care and healthcare services and helps nurses provide SM-sensitive services and care for women. SM older women were recruited from LGBT organizations, LGBT-friendly bookstores, restaurants, coffee shops and LGBT online chatrooms using purposive and snowball sampling.

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