A rapid review on the preparedness and practice needs of the home care workforce to support older LGBTQ+ people

Context: Little is known about the preparedness of the home care workforce to support older LGBTQ+ (lesbian, gay, bisexual, trans, queer, and other marginalised sexual orientations or gender identities) people. By preparedness, we mean the skills, knowledge, and confidence to provide affirmative support.

Objective: To identify the current evidence on the preparedness and practice needs of the home care workforce to support older LGBTQ+ people, with a particular focus on workforce perspectives.

Method: We carried out a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane-compliant rapid review of the academic and grey literature. There were no search date or study design restrictions, and we assessed the quality of all evidence as well as the confidence in the findings. Thirty-nine documents were included in the final review.

Findings: Findings suggest preparedness in the home care workforce is underdeveloped, evidenced by incidences of discrimination, a limited understanding of LGBTQ+-specific care needs, heteronormative and cis-normative attitudes, and low workforce confidence. Studies highlighted the distinct training needs of the home care workforce and indicated a need for better workforce support in the form of lived-experience-informed training and inclusive policies.

Limitations: Several limitations were identified. The rapid review method may have increased the risk of errors. The included evidence lacked diversity, and evidence specific to home care was limited.

Implications: Implications for policy and practice concern the careful consideration of system-level barriers to practice improvement. Implications for future research include the examination of effective training using rigorous study designs and larger home care samples.

PROSPERO registration number. CRD420251038242