Think ‘Significant Other’, Not Just Relative

Last week I met with 84-year-young Pat, the former carer of my late uncle Illtyd.

Illtyd was a gay man whose partner Christopher died having had 50-year relationship. Pat got to know Illtyd through helping with some cleaning and making breakfast/lunch for him.

Visiting him nearly every day, Pat got to know Illtyd better than many others – almost like a wife, despite his sexuality – that is how close they became. She was the only person (other than me) that Illtyd would allow to help him with personal care when he had bouts of incontinence

After a brush with cancer and a nasty fall, Illtyd briefly spent time in a care home to recuperate. Understandably, the home wanted to know who Illtyd’s next-of-kin was – his brother, who lived many miles away. The home would naturally expect to consult Illtyd’s brother about his life history, care needs etc.

However, even though I was incredibly close to Illtyd (being gay myself, there were many things he’d discuss with me rather than others) I would say that Pat knew him best.

Therefore, I always suggest asking about ‘significant others’ and not just about close relatives when people come into our care. It can often be a close friend, neighbour or (unmarried) partner who knows more about the person that the assumed ‘next of kin.’

This is especially true for people who are LGBT+ in care-settings today. Many older people who are LGBT+ may have moved away from their hometown to a city to have a degree of anonymity.

Some LGBT+ people may have been rejected by their family and therefore count their friends (‘significant others’) as the people they are closest to.

Indeed, research by the UK charity Stonewall found 81% lesbian/bisexual women and 69% gay/bisexual men say they view their friends as family.

Of course, this is not just an LGBT+ issue. Families have changed a great deal over the years, some become estranged, people divorce or following a bereavement a neighbour or close friend may be a key partner in knowing about someone in our care.

This also has implications for end-of-life care. For example, when Illtyd was reaching the end of life and was hospitalised, doctors wanted to know about Illtyd’s wishes about resuscitation.

Illtyd and I had many conversations about this, as had Pat. When the doctors asked Illtyd’s brother, he couldn’t answer. Illtyd asked everyone to leave his bedside so he could be alone with Pat. He then confirmed to her what he wanted.

Five years on, Pat and I discussed this when we met up last week. We both miss him terribly and always will. Yet, we agreed that it was her as a ‘significant other’ who really understood Illtyd and his wishes.


Some questions for learning and practice development

  • Do we ask the people we care for about ‘significant others’? If not, what are the barriers to us doing so and how can we overcome them?
  • Do we ask whether people we care for are LGBT? If we don’t ask, will they tell us?
  • How could ‘significant others’ help us in getting to know a person’s life story, like/dislikes, interests etc.?
  • What can we do to involve ‘significant others’ in the day-to-day life in our care-setting?
  • How might we update our end-of-life care planning after reading this blog? (For example, how would you support a ‘significant other’ like Pat, to be at Illtyd’s side during the final days of life?

MIKE PHILLIPS
Associate Trainer
MCM
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