Group in aged care setting with a younger nurse

Co-creating rainbow inclusive care for gender and sexually diverse people in residential aged care

Funder: Medical Research Future Fund (MRFF) - 2023 MRFF Models of Care for Sexuality and Gender Diverse People & People with Innate Variations of Sex Characteristics - Stream 2. 

Funding awarded: $999,533 over 5 years (2024 to 2028).

The project will follow an Appreciative Inquiry approach and identify what enables and constrains inclusive care. Co-creation, co-design, and co-research methods with LGBTQ+ people as active participants will shape the project and its outcomes. It will include a national survey of residential aged care workers and field research in two project sites (Queensland and Western Australia), involving two aged care providers and up to 19 residential aged care homes.

Communities of practice in both states will bring together stakeholders, people with lived experience expertise, and researchers. They will interpret the findings from all project stages and develop a shared vision for a rainbow-inclusive model of care. Co-design workshops will develop resources and guidelines to support implementation. The model will then be implemented and evaluated in partner residential aged care homes, with the learning and resources refined and disseminated to the aged care sector.

The study will provide evidence-based recommendations and resources to promote the inclusion of gender and sexually diverse people in residential aged care and provide a foundation for improving their health outcomes. By involving LGBTQ+ people as co-researchers and utilising a collaborative approach, the project will ensure the rainbow-inclusive model will be effective in achieving the goal of inclusive care.

Governance

The aim of the Lived Experience Advisory Group is to contribute lived and living experience expertise into each stage of the project, supporting the co-design of a rainbow-inclusive model of care. The group's objectives are to: 

  • Provide advice on lived and living experience as it relates to the project and its outcomes.
  • Discuss and assist interpretation of the findings from each stage of the project.
  • Discuss the safety protocols, research instruments, the rainbow-inclusive model of care and the guidelines and resources.
  • Provide feedback and engage in dialogue with the National Reference Group. 

The Group comprises six LGBTQ+ people with lived or living experience of any of the following: ageing, residential aged care, caregiving, dementia, HIV or other blood-borne viruses, frailty. Drawing on diverse lived experience expertise is critical to the project’s success. The perspectives of transgender, nonbinary and bisexual people will be sought and welcomed, as well as people who are culturally diverse, disabled, those living in both urban and regional or rural areas, and across Australia. Recruitment to the group is based on an expression of interest process. 

The aim of the National Reference Group is to draw on members’ expertise to provide feedback on and approve project material and promote the project and its outcomes nationally.  Its objectives are to: 

  • Provide advice on the wider contextual issues impacting on the project – e.g., in relation to the LGBTQ+ community needs, the lived experience of LGBTQ+ older people, the aged care industry, aged care policy and practice reform, workforce issues.
  • Engage in dialogue and feedback with the Lived Experience Advisory Group.
  • Facilitate distribution of the survey through organisation and networks.
  • Discuss and assist interpretation of the findings from each stage of the project.
  • Provide feedback on safety protocols, research instruments, the rainbow-inclusive model of care and the guidelines and resources.
  • Approve safety protocols, the rainbow-inclusive model of care and the guidelines and resources.
  • Promote the project and its outcomes through partner organisations and wider networks and for national impact.  

Membership comprises a representative from each of the partner organisations, all associate investigators, a member of the Lived Experience Advisory Group, the lead chief investigator, research staff and others as invited. The Group meets three times per year for the life of the project. 

The aim of the Project Management Committee is to provide strategic and operational oversight of the whole project, including risk management/mitigation strategies. Its objectives are to: 

  • Guide the implementation of the project in line with the initial proposal, partnership agreements and implementation plans.
  • Support the research staff and investigators to carry out their work.
  • Identify and manage risks. 
  • Monitor the budget to ensure appropriate expenditure to deliver the project.
  • Ensure all parties fulfil their responsibilities as agreed to in the initial proposal, partnership agreements and implementation plans.
  • Ensure compliance with MRFF requirements.  

The committee comprises all nine Chief Investigators, research staff and others as invited. The committee meets monthly. 

Project stages and timeline

Stages Activities Timing
Stage 1: Dawn
  • Set up governance groups
  • Develop implementation plans
  • Form communities of practice
  • Design national survey
  • Train and support co-researchers
Mid 2024 to early 2025
Stage 2: Discovery
  • Conduct national survey
  • Investigate what constrains and enables inclusive care: observations, focus groups and interviews in residential aged care homes
  • Communities of practice interpret findings 
Early 2025 to early 2026
 Stage 3: Dream
  • Creating a shared vision for a rainbow-inclusive model: focus groups and organisational summits in residential aged care
  • Communities of practice interpret findings and draft model of inclusive care
  • Inclusive model of care finalised with Lived Experience Advisory Group and National Reference Group
Mid 2026 to late 2026
Stage 4: Design
  • Co-design guidelines and resources to support inclusive model of care: workshops in communities of practice
  • Evaluation survey developed
  • Model, guidelines and resources implemented and evaluated in residential aged care homes in fieldwork sites
  • Finalisation of model, guidelines and resources through communities of practice, Lived Experience Advisory Group and National Reference Group
Early 2027 to mid 2028
Stage 5: Destiny
  • National forum to bring together knowledge, share model and resources and workshop sustainability strategies
  • Resources disseminated nationally 
Mid to late 2028