Biographical Approaches for Inclusive Care and Support (book review and discount)

LGBT aging bookWhat does knowing someone’s life story have to do with providing good care to them?  Everything, says a new book, Lesbian, Gay, Bisexual and Transgender Ageing: Biographical Approaches for Inclusive Care and Support.

“[T]he telling of life stories has a status and significance within the LGBT communities that is closely intertwined with a history of emancipation and the struggle for recognition and rights.  Such narratives have been central to the process of developing a collective awareness, as Riessman (2008) notes in her discussion of the power of biographical narrative for minoritised groups.  ‘Major resistance movements of the twentieth century were born as individuals sat together and told stories about small moments of discrimination.  Commonalities in the stories created group belonging and set the stage for collective action’ (Riessman 2008, p. 9).”

“Crucial to this process, as Plummer (2001) has pointed out, is that a community emerged to listen to these stories and spaces were created that allowed their telling.  Very much at the heart of this book lies a call for health and social care practice similarly to create the spaces for LGBT lives to be told, with practitioners serving in the role of what Plummer has described as ‘coaxers, coachers and coercers’, skilfully and sensitively eliciting these stories to the benefit of their tellers.  Knowing something of the backdrop to these narrative traditions in the LGBT communities is, then, a useful consideration for practitioners.  It illustrates the connection between personal biographies, a collective community history and broader structural change.  Indeed, in the context of health and social care, where limited evidence currently exists of good practice in working with LGBT service users, work with a biographical focus is one of the few areas where some form of an evidence base exists (see Chapter 6 in this book for some examples of this work), with many commentators recommending such approaches precisely because they support an understanding of the connection of personal experience to broader collective histories of discrimination and oppression.”  (pp. 198-199)

“For anyone who believes in the idea that biographical narratives provide a means by which to connect the self to the social world that we inhabit, it would seem perfectly reasonable to fear the prospect of living in an environment where no space exists to share such narratives.  So, one question this book raises is, to what extent does space exist for LGBT people to tell their life stories in residential and other forms of care and how might space be created in order for future LGBT residents to do so?”  (p. 202)

With both positive and negative results, not all of the book’s chapters are fully on-target to the topic of narrative or biographical approaches to care.  Many report the results of surveys (not all of which permitted narrative responses) and/or community-based programs with few, if any, quotes from older people themselves.  Yet this eclecticism, combined with the fact that all of the authors and subjects are from the UK, can be a strength.  I flagged many pages with data or quotes I expect to use again, including these:

  • Intake processes usually seek to provide “the facts,” whereas a narrative approach seeks to establish what those facts mean to the individual concerned, including how they have shaped their lives, values, and goals.  (p. 48)
  •  A 2007 study of trans people in Britain found that 72^ had experienced harassment in public, “with the result that 21 per cent avoid going out in public due to fears for their safety….”  (p. 53)
  • “People who expect prejudice will not recognize acceptance or goodwill unless it is overt and lived out.”  (p. 81) 
  • “Many participants in Polari’s project work (some in their seventies and eighties) were long-standing campaigners for equality and have struggled on various levels to be heard and taken seriously, not least by health and social care providers.  Yet older cohorts of LGB people have been cast as hidden and invisible and this collective labelling has often served to excuse policy makers and providers from seeking to meet their needs.”  (p. 144) 
  • “Even where staff have displayed [LGBT aging materials], we have had reports of posters being ripped down and bundles of leaflets being removed by other service users.  Our response to that is to give a good supply of promotional material, and replacing a poster every day soon becomes a weekly task until it gets left alone, and it becomes an accepted part of the service offered.”  (p. 153) 
  • “…even if there were a locally accessible group in every area, many older LGBT people would prefer to travel outside of their area for fear of being ‘outed’ in their own communities.”  (p. 155)

 Two of the chapters deserve special note because of their rarity.  “Imaging the Unimaginable: Bisexual Roadmaps for Ageing” reports on a workshop at a bisexual conference in which participants illustrated and narrated how they imagined their own old age, and a chapter on trans aging that included the sad statistic that three of 25 trans people of various ages answered the question, “What preparations, if any, are you making for later life?” by saying they planned to commit suicide before they got old, and a fourth hoping they died before then.  (p. 62)

 Despite that last statistic, this is a hopeful book that would make a great addition to any LGBT aging professional’s library.  If you order the book before the end of April 2013 by calling 1-866-416-1078 or going to and using the code LGBT13, you will receive a 20% discount.


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