How LGBT-friendly is your LTC community?

Cultural sensitivity toward all individuals is probably part of your organization’s staff training procedure. But how welcoming is your long-term care facility to LGBT seniors? Not as friendly as you might think, according to several recent surveys and government reports.

The National Gay and Lesbian Task Force (NGLTF) estimates there are 1.5 million seniors in the United States who are lesbian, gay, bisexual or transgender (LGBT). By 2030, that number will triple, as today’s baby boomers join the over-65 demographic. In addition, approximately 500,000 Americans living with HIV, a disease often associated with homosexuality, will be 50 or older by 2015.

In a recent survey of 2,560 LGBT seniors, 20 percent have not revealed their sexual orientation or gender identity to their primary physician. Most participants said they have experienced depression and isolation, discrimination in housing, poor economic security, and even denial of access to healthcare services. Most reported being victimized at least once because of their sexual orientation.

“While services and programs assisting older adults are readily available in many communities, they are most often geared toward the general population and fail to take into account the unique circumstances facing

LGBT older adults such as fear of discrimination and, often, the lack of children to help them,” notes the NGLTF’s Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults.

Perhaps partially because of this, requests are rising for LGBT-centric senior housing, while some LTC companies are seeing its potential as a service niche. But, the members of “Generation Silent,” as some call them, are standing up against disparity in healthcare delivery and the issues experienced by LGBT seniors in the LTC industry.

It’s crucial for senior care facilities to take proactive initiative to prepare caregivers and administrators for this growing population, according to the NGLTF’s factsheet on the Outing Age 2010 report.

“Cultural competency refers to the ability of care providers to interact sensitively with members of different cultural groups. Such care generally involves not only an acceptance of and respect for difference, but also a degree of understanding of community norms, vulnerabilities and practices. LGBT advocates have developed cultural competency programs that improve service to LGBT elders, but there is no funding or mandate by state and federal aging agencies to train caregivers.”

For LTC organizations that wish to educate their staff and residents, the Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) organization offers dozens of deep resources on LGBT aging issues and even provides on-site trainers in many states, said Hilary Meyer, director of SAGE’s National Resource Center for LGBT Aging, in a webinar Thursday.

SAGE is the oldest and largest U.S. organization dedicated to advocacy and education on issues that affect LGBT seniors. In most states, its National Resource Center can provide cultural competency trainers for senior care facilities and senior organizations.

Meyer gave webinar attendees a tour through the National Resource Center for LGBT Aging website, which contains 500+ resources and articles on current topics, many of which are translated into Spanish, Chinese and other languages.

The site’s 24 topic areas include:

• Legal support: Information on what the LGBT community needs to know about healthcare power of attorney, advanced directives, wills, housing discrimination and other issues.
• Caregiving: Resources for professional and family-based caregivers.
• Financial planning: Crucial financial planning tips and guides to prepare for long-term care.
• Healthcare access: Ways for LGBT seniors and their caregivers to bridge the service gaps and receive quality healthcare services.
• HIV & Aging: As the HIV epidemic turns 30, the survival rate has surged via modern medication and care regimens, providing those with HIV a quality life well into their golden years.
• What’s New: A collection of new research and news of interest to the LGBT community.

More information about the healthcare service delivery and LTC issues affecting LGBT seniors can be found in several key publications, especially the Aging and Health Report. “It’s the first national, federally funded program to look at the health disparities of LGBT individuals over the age of 50,” Meyer said. “The research highlights several things that we thought we knew, but it gives us scientific backing to things that are happening right now to this population.”

These resources (see sidebar) can help LTC administrators and caregivers embrace cultural awareness, including a broader definition of family relationships. With no offense intended, the first questions caregivers often ask a new resident—“Are you married?” “Do you have kids?” and “Who is your next-of-kin?”—can get the care relationship off on the wrong footing, Meyer explained.

“The most important thing is to have respect and common understanding of how that person would like to be treated,” Meyer said. “Respect their choices of names and gender identities, which people are most important in their lives, and who should be involved in the care decision-making process.”

LTC organizations need to get on board with cultural awareness by educating their own staffs and residents on the importance of a welcoming environment for LGBT seniors, or suffer the consequences that discrimination can cause on reputation and branding, LGBT senior advocacy groups agree.

No LGBT cultural competency training is currently required for LTC providers on a federal or state basis, although California has made attempts toward state rules, Meyer noted. “But some agencies have taken it upon themselves to make it a requirement and have decided it’s important to have their staff trained in these issues.”

Pamela Tabar

Pamela Tabar was editor-in-chief of I Advance Senior Care from 2013-2018. She has worked as a writer and editor for healthcare business media since 1998, including as News Editor of Healthcare Informatics. She has a master’s degree in journalism from Kent State University and a master’s degree in English from the University of York, England.