The Aging LGBT Community and Long-Term Care

This Article is from the NAAP news February 27, 2017.

According to the groundbreaking policy report, Improving the Lives of LGB

T Older Adults, LGBT elders are more likely to be single, childless, estranged from their biological family, and reliant on families of choice such as friends and other loved ones. Without traditional support systems in place, many LGBT elders end up relying on nursing homes or other institutions providing long-term care. This can become problematic for these settings because little information is available about the opinions and experiences of these older adults in the LTC setting. When it comes to activity programming, little needs to be changed to the programs we offered. I am confident that the programs we offer meet all resident’s individual needs. However, what needs to change is the perception we may have of an LGBT elder and the possibility of staff discrimination and/or abuse. In a 2010 study on LGBT Older Adults in Long-Term Care Facilities shares “Stories from the Field.” Some concerns shared were the belief of discrimination against an LGBT elder who opens up about his/her sexual orientation. Some questions to ponder: Do you feel that an LGBT older adult can be open with the staff of a nursing home, assisted living facility, or other long-term care facility about his/her sexual orientation and/or gender identity? What issues do you feel an LGBT older adult faces or might face if open about his/her sexual orientation and/or gender identity? Here are some real-life responses: “Within the next two weeks I will be going into assisted living. Due to my financial situation, I will have to share a room with another man. The thought of going back into a closet is making me ill. Frankly, I’m afraid of telling anyone that I’m gay.” ~Anonymous “Two friends of mine, Vera and Zayda, had been together for 58 years. When Vera’s Alzheimer’s became too much, Zayda moved her to an assisted living facility. Zayda could barely trust family or neighbors with the truth, let alone strangers, so she and Vera became “sisters.” Much later, after Vera’s death, Zayda needed to move into an assisted living facility herself. She had many, many photos of the love of her life, but dared not display them in her new home. The other residents would talk about husbands, children, and grandchildren, but she felt too vulnerable to tell the truth. Zayda was in hiding and terribly isolated.” ~Nina “A gay couple moved into my mother’s facility. The residents kept talking about: “Which one is the man and which one is the woman?” They moved out in a couple of months.” ~Frances “There were known gay and transgender residents at the nursing home where I used to work. Some employees made inappropriate remarks towards the residents, some were spreading rumors, and some were telling other employees that their residents are gay/transgender without a respectful manner. I am also gay.” ~Yoshi “Some tend to discount or conveniently forget that my life partner has medical say-so about my care. I keep our medical directive in the nightstand for easy access.” ~Anonymous Another issue is staff refusal to refer or use preferred name or pronoun. Transgender older adults – including those who have made a gender transition and those who have not – are particularly vulnerable in nursing homes and assisted living facilities. For many, hiding is not an option. Transgender children of a nursing home resident are also likely to experience hostility and mistreatment from the staff as they try to care and advocate for their parents. In some cases, facilities refuse to recognize an individual’s gender identity. This may include refusing to assist a transgender resident in dressing consistently with his/her gender identity, or requiring intimate tasks to be performed by a member of the resident’s birth assigned gender. These can be extremely demeaning and traumatizing experiences for transgender residents. The law is clear regarding the facility’s obligation to provide necessary care in both nursing homes and assisted living facilities. In either type of facility, staff must be able to provide care without regard to individual prejudices. Here are some of the recommendations made: • Nursing home and assisted living facility operators can raise staff awareness and conduct self-assessments of their facility’s culture and quality of care. • Ombudsman programs can develop measures of resident safety and educational programs for facilities and for their programs. • States and local communities, especially those with human rights provisions, covering sexual orientation and/or gender identity can mandate cultural competency training and others steps to promote better care. • States and local communities can pass health or aging services regulations identifying LGBT elders as a vulnerable aging population, and they can mandate cultural competency programs for any agency receiving local funds. • State agencies on aging can help local area agencies examine their long-term care planning programs and add resources for LGBT clients and providers alike. • Aging and Disability Resource Centers (ADRCs), which are designed to provide a single point of entry into the public long-term care system, can assess their programs, the quality of information given, and their intake systems. As the nation moves toward full inclusion of LGBT people, the older adults in nursing homes and assisted living facilities across the country need to be heard and included. For the full article, LGBT Older Adults in Long-Term Care Facilities, please visit the following website: https://www.lgbtagingcenter.org/resources/pdfs/NSCLC_LGBT_report.pdf This report was adapted from the full article by Alisa Tagg, President of NAAP