Preferred Settings of Care and Preferred Type of Home Care Among Heterosexual and Sexual Minority Individuals

The purpose of this study was to investigate the preferences for long-term care services among heterosexuals and sexual minority individuals. This was a large nationally representative cross-sectional study. Data from a survey (Health care research in old age: sexual orientation and long-term care preferences in Germany) conducted in Germany in December 2021 were used. Altogether, 4000 individuals 40-70 years of age participated. The average age was 55.0 years; 49.8% were female. Preferences for the following 5 long-term care settings were assessed: own home, home of relatives, assisted living, nursing home, and care abroad. Furthermore, we analyzed the preferred type of home care, namely informal caregivers, professional home care services, a mix of both, and a round-the-clock caregiver from abroad. To assess the differences in preferences, we used Firth logistic regression models. Altogether, data on sexual orientation were available for 3951 individuals (98.8%). In our sample, 3618 individuals (91.6%) were heterosexual, 195 (4.9%) were homosexual, and 138 (3.5%) were bisexual. Overall, regardless of sexual orientation, 89.2% of individuals preferred being cared for at their own home, 59.4% considered moving to assisted living facilities, and 26.2% to a nursing home. More homosexuals and bisexuals (17.6% and 16.3%, respectively) preferred care abroad than heterosexuals (12.1%; P < .05). Regarding home care, a mix of professional home care and informal care was the most preferred option (77.3%), followed by professional home care (71.1%) and informal care (53.3%). In the adjusted analysis, the differences in preferences regarding sexual orientation among all analyzed outcomes were no longer significant. Regardless of sexual orientation, receiving care at home was the most preferred option, followed by moving to an assisted living facility. In terms of the type of home care, professional home care and a mix of formal and informal care were the most preferred options. Surprisingly, informal care was preferred by only 53.3% of people. Our results revealed that preferences for care settings (eg, own home, nursing home) and preferences for type of care (eg, informal care, professional home care) did not differ significantly between heterosexuals, homosexuals, and bisexuals. We showed that participants' health, age, gender, income, living situation, whether they had children, and social network had a greater influence on long-term care preferences than sexual orientation.