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Neuroprogressive and Dementia Network explores ‘exclusion of LGBTQ+ individuals in dementia care’
NHS Research Scotland Neuroprogressive and Dementia Network (NRS NDN) Network has seen a new paper published, highlighting what has been termed “the persistent invisibility of LGBTQ+ adults” living with dementia.
Clinical Studies Officer at NRS NDN, Bernie McInally believes this is a community that is “often unacknowledged despite likely residing within care home settings” and is keen to see that investigated further after publication in The International Journal of Care and Caring (IJCC).
He believes it is important to question assumptions around instances of “LGBTQ+ absence” in dementia studies and has detailed his findings in a paper entitled ‘Out of sight: addressing the exclusion of LGBTQ+ people in care home research and dementia care’.
With his paper, Bernie – who has been working with ENRICH (ENabling Research In Care Home) Scotland since 2011 – calls for greater visibility and inclusion in policy and planning as first steps towards more equitable, person-centred care for LGBTQ+ people within the care system.
Examining how factors such as “cultural stigma, historical criminalisation and structural barriers” could have contributed to “under-representation and unmet care needs”, Bernie states: “Visibility is not just a moral imperative but essential for improving outcomes in dementia care and research.”
He cites examples of how LGBTQ+ individuals living in care homes have been excluded, including the strict requirement for a ‘study partner’ in most dementia and ageing studies – a stipulation intended to provide supplementary information and support for participants.
“However, given that LGBTQ+ older adults are more likely to be single, childless, estranged from biological families or without close support networks,” Bernie says, “this criterion, while seemingly neutral, structurally excludes them from participating, creating an unintentional but real bias.”
He says: “Possibly through the desire not to discriminate, the sexual orientation of a person referred to mental health services was not considered, which, on exploring current literature, was clearly ill-advised.”
Bernie added that one of his “most alarming discoveries” was evidence of elevated risk of dementia among LGBTQ+ individuals due to “a cluster of overlapping factors” including increased health disparities such as higher rates of chronic conditions, mental health impacts, and social isolation.
The paper further noted that ENRICH Scotland conducts a biennial survey to assess attitudes and support structures in care homes – the most recent being in the winter of 2024.
This went out to around 400 care homes registered with ENRICH Scotland, with 121 homes responding.
For the first time, a question asking if care homes had dedicated champions or support for LGBTQ+ residents was included with 79 per cent responding ‘no’, marking the question ‘not applicable’ or leaving it blank.
Only 6 per cent expressed openness to the idea, despite not currently offering LGBTQ+ support, while just 2.5 per cent reported having an LGBTQ+ champion or support role in place.
Bernie said: “Importantly, this is not about blaming care homes; rather, it reflects a systemic gap in training, awareness and policy – one that urgently needs to be filled.”
He believes “the road to change requires multi-level action” including:
• LGBTQ+ champions in care homes
• Mandatory cultural competency training
• Inclusive research design • Policy reform and advocacy
• Community partnerships
Bernie concluded: “We can debate the numbers, but LGBTQ+ individuals are present in our care homes. They deserve to be seen, understood, supported and included in future planning, which must involve research inclusion.
“I am realistic enough not to expect the recommendations outlined earlier to be implemented across all Scottish homes any time soon, given the pressures on resources.
“Yet, if we can shine a light on these issues and spark debate through ENRICH Scotland, even small steps forward can begin to make a difference.
“If policy makers, managers, clinicians and owners of care homes also start to acknowledge and address this gap, we may finally set ourselves on the right path.”
Publication date: 11th March 2026
