title: Older lesbian women's health and healthcare: A narrative review of the literature.
abstract: OBJECTIVE
  The purpose of this narrative review is to locate, evaluate and synthesise the evidence presented in contemporary literature, related to the experiences of older lesbian women.
  
  
  BACKGROUND
  Lesbian women have been identified as having unique health needs. In conjunction with the usual challenges associated with ageing, lesbian women are burdened with additional complications because of their lesbian orientation. To promote optimal health, the distinct needs of older lesbian women need to be identified and considered by those responsible for planning and delivering culturally competent services/care and allocating resources to support healthy ageing.
  
  
  METHODS
  Narrative review is typically used to evaluate and synthesise health-related literature and involves the critical evaluation of included, empirical studies to form innovative conclusions and perspectives.
  
  
  METHODS
  Database searches using relevant keywords and applying specific limits yielded 55 articles for initial review. Eventually, 45 articles were excluded and 10 qualitative, empirical articles were then appraised using the Critical Appraisal Skills Program tool. Subsequently, seven articles were identified as meeting the inclusion criteria and formed the basis of this narrative review.
  
  
  RESULTS
  Data were extrapolated from the included articles and three themes emerged: support, resilience and disclosure. These themes formulate the findings of this article.
  
  
  CONCLUSIONS
  Remarkably, very little contemporary literature exists that addresses the health and well-being of older lesbian women, and this cohort remain positioned on the peripheries of research and society. Older lesbian women continue to be marginalised because of their lesbian identity and actively cultivate support systems, negotiate disclosure and develop resilience to minimise the effects of their marginal position.
  
  
  CONCLUSIONS
  Recognition that older lesbian women often create, and draw on, a family of choice for support is imperative. In addition, the clinical environment should be safe for older lesbian women to disclose their sexual orientation and other sensitive information.
authors.affiliation: Western Sydney University, Penrith, NSW, Australia.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hayman
authors.affiliation: Western Sydney University, Penrith, NSW, Australia.|Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Wilkes
mesh_terms: D000368:Aged; D005260:Female; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged; D006801:Humans; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D016387:Women's Health
keywords: crisis competence; cultural competence; health; lesbian; narrative synthesis; nursing; qualitative methods; resilience; women