The following is a de-identified case study from the Acute to Residential Care Transition Service which aims to showcase how knowing the person can sometimes be the best support we can provide.

Sally is 86 years old and diagnosed with Lewy Body Dementia. Although assigned male at birth, Sally identifies as female however alternates between presenting as male and preferring to be called ‘Barry,’ and presenting as female and preferring to be called ‘Sally.’ Whilst in hospital, and due to medical identification, Sally was addressed as Barry and he/him, however on transfer to residential aged care, and in-depth discussions with her husband, Sally has informed staff that she is to be addressed as female and Sally.

How DSA helped:

• Understanding the importance of Sally’s identity, preferences and pronouns.
• Due to complexities, the DSA Consultant and Dementia Coach worked closely with the DSA Family Liaison Officer to ensure Sally’s personal history and wishes were correctly represented.
• Emphasising the importance of Sally’s identity with the care home.
• Collaboration with the LGBTIQ Health Alliance to providing training and educational resources to the care home.
• Providing appropriate engagement resources, such as music and books for Sally, to support staff to build rapport and get to know Sally.

As a result, the care home staff had:

• An openness to communication on Sally’s identity and history.
• An openness to ‘going with the flow’ with no judgment from staff regarding Sally’s preferred identity.
• Adjusted and adapted quickly as staff’s knowledge of the situation grew, such as ensuring the right name on Sally’s bedroom door, moving her to another room to enable a shared bathroom with another female resident (as was Sally’s preference), and ensuring that when staff supported Sally’s hygiene care they used the female assigned bathroom area.
• Staff regularly provide Sally with a range of clothing choices each day.

Sally had been in hospital for almost 80 days with care homes previously hesitant due to a previous history of vandalism and gender identity concerns. She now continues to live in her new home and is being well supported by both the staff and her husband.