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LGBT is a short form for the sexual orientation of the lesbians, gay, bisexual and transgender people. According to Winfeld (2010) this term is used to represent diversity of sexuality and is often used to refer to non-heterosexuals instead of referring to the specific groups. This is different from the persistent emotional and sexual attraction of men to women or the vice versa called heterosexual.  Lesbians are women with sexual attractions to other women; a gay man is sexually or emotionally attracted to other men while bisexual refers to sexual or emotional attraction to both sexes.  On the other hand transgender is an umbrella word that describes people whose gender expression is different from that of their birth sex.  Old LGBTs are a marginalized group (Ewton & Lingas, 2015).
Despite the existence of significant literature on health and social needs of aged citizens (DeWitt & National Association of School Psychologists, 2012), little contextual texts of old LGBT’s health and social needs exist. The most fundamental issues relate to social work practices and social policies that include residential care, health promotion of LGBT elders, social work training and education and the participation of service users. 
 The new legislation by the New Labour in UK is intended to bring to an end all inequalities and discriminatory practices both in the social care services and health.  McDermott & Russell (2010) emphasizes that the old LGBT populaces in the society remain largely invisible which makes their specific needs that may differ from those of the general population unknown and policy initiatives and progress are not tailored specifically to helping understand or to meet their concerns.  Their invisibility in society is the result of homophobia and can only be overcome by anti-oppressive practices and a culture change that will have the will to fight homophobia and developing policies that includes them (Ewton & Lingas, 2015). 
Lack of their participation has led to lack of contribution in initiatives and programs that support them and this is seen in many cases like assessment and review processes and in referrals that discriminate against LGBT. According to DeWitt & National Association of School Psychologists (2012), this is demonstrated in the use of unsuitable language in questions on the marital status where their sexual orientation is not indicated and one can only fill the marital status by putting the tick in the ‘single’ box status which dismisses their sexual and romantic status. 
It is the responsibility of the government at the national level to tackle this exclusion through laws that confront this exclusion and oppression, and locally; departments of social services have that responsibility of finding inclusive methods that prevent alienation of these service users. This could be achieved through several ways that include having extensive training and programs that seek to inform and make the staff understand how professional practices and social policies have strengthened marginalization of LGBT (Miller, Vandome, & McBrewster, 2009).
 These comprehensive trainings will help social workers to improve their services to the users by ensuring the services reflect each individuals need and choices though their inclusion in their care plans.  As an example, it would be of little help to a social worker advising a lesbian or a gay person to join a day centre to relieve lonesomeness where they cannot open up about their lives. Their important life aspects will differ largely from majority of the people attending who are most likely will be heterosexual and this only further exacerbates their loneliness. Awareness of the reasons that might cause more anguish to this group by the practitioners is very crucial (Miller, Vandome, & McBrewster, 2009)
There has also been an emergence of new notion on social inclusion and citizenship that respects different lifestyles and cultures (Ewton & Lingas, 2015). The New Labour has paid substantial attention to empowering service users through making them have more control.  The 1996 Community Care Act on direct payments allowed local authorities to make direct payments to service users which ensured that service users can procure the service of their choice (Ewton & Lingas, 2015), which makes sure that personal needs are met more creatively and the well-being of the recipients is better.  This empowers the service users by making them have more control.  Direct payments provide better efficiency and flexibility in meeting individual needs.
 According to Winfeld (2010), through direct payments, old LGBTs can choose who to employ and have control in their homes which provides an option for employing personal aids through the gay press and LGBT organizations that enable them support their community and this has significantly improved their quality of life with huge impacts in their emotional and physical health.  This transfer of purchasing power to the users of the service can revolutionize the care of these people and is in line with the New Labour’s vision of enhancing independence, bettering the quality of life and promoting social inclusion (Ewton & Lingas, 2015). It is very clear that this method should be encouraged and extended. In the social services nonetheless, direct payments is yet to become regular mainstream amenity and this is attributed to heavy workloads and time pressures (McDermott & Russell, 2010).
 There is also the rise of advocacy organizations in UK that have started to recognize the disregard of LBGT elders (Winfeld, 2010). Age Concern is such an organization in UK that is concerned with addressing fears and hopes of LGBT by bringing out their health and social needs. Winfeld (2010) states that one of the main objectives of this organization is to challenge the way the government social policies have excluded old LGBT citizens.  The argument they bring forth is that empowerment gives them a voice on the issues that affect them such as matters of partnership rights, death and grief, health, provision of care, and legal issues. According to McDermott & Russell (2010), Age Concern believes that involvement of users in consultations that affect them is an essential objective to promote needs of LGBT elders. They realize this by providing opportunities for these groups in policy making boards to ensure the group influences the decisions made. 
Another such Advocacy organization is SAGE (Senior Action in a Gay Environment) in USA whose one of its founding principles is to fight isolation, discrimination and oppression of LGBT elders with the view that this community can handle its own needs. It has become one of the largest advocacy organizations for LGBT in USA (McDermott & Russell, 2010)
   In the UK, legalization of the same-sex marriages by the Civil Partnership Act in 2005 and legalization in other States in USA has given way for introduction of civil unions that gives civil partners rights that are similar to married heterosexual partners. This is undoubtedly a milestone in acknowledgment of same-sex marriages (Miller, Vandome, & McBrewster, 2009).  Statistics show emerging take-up of the civil partnerships in old gay men and lesbians and this number is expected to rise greatly in the next few decades and health care providers are not ready for the needs of this older LGBT.  
 Several research studies however shows the services that they might need will be different (Ewton & Lingas, 2015). For example, they would need specifically tailored services like separate housing. These research findings have shown that for organizations in future to respond to individual’s choices there will have to be advent of new ways of scheduling and service delivery. According to McDermott & Russell (2010), LGBTs view the provision of services in the traditional way as problematic because there is no understanding of their lifestyles and that is the reason tailor-made services to them are essential.

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