Long-term affirmative care for older LGBTQIA+ adults: protocol for a concept analysis

Purpose Older LGBTQIA+ adults are becoming increasingly visible due to advancements in cultural and legal norms. However, they continue to face unique challenges in accessing long-term care (LTC) that affirms their identities and addresses their specific needs. Many lack traditional family support, as they tend to be single, childless and often alienated from biological families. Chosen families provide crucial support but usually weaken with age due to shared generational aging. In this context, affirmative care emerges as a critical approach to ensuring that LTC settings validate and respect the identities of older LGBTQIA+ adults. This study aims to examine and clarify the concept of affirmative care for older LGBTQIA+ in the context of LTC. Design/methodology/approach A hybrid model will be employed, integrating concept analysis and scoping review. The concept analysis will be performed using Rodgers’ method, which involves seven steps: 1) identify the concept of interest, 2) identify surrogate terms and uses of the concept, 3) select an appropriate sample for data collection, 4) identify concept attributes, 5) identify the antecedents and consequences of the concept, 6) identify related concepts and 7) identify a model case of the concept. A scoping review will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews and will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. This review will constitute Step 3 of Rodgers’ method, informing the selection of an appropriate sample for data collection. Searches will be conducted in six scientific databases: MedLine, Web of Science, Scopus, SciElo, PsycInfo and Nursing & Allied Health. Findings The search for relevant studies for the scoping review was performed on February 12, 2025, resulting in 340 records after duplicates were removed. The results of the concept analysis will be submitted for publication by July 2025. Originality/value This work will contribute to a deeper understanding of affirmative care for older LGBTQIA+ adults in LTC facilities, providing a conceptual foundation for research, practice and policy development.