LGBT elders raise serious fears about long-term care facilities

A majority of lesbian, gay, bisexual, and transgender (LGBT) older adults who answered a national online survey believe that staff of long-term care facilities would discriminate against an LGBT elder who was open about his or her sexual orientation, and more than half believe that staff or other residents would abuse or neglect an LGBT elder.

Released today, the groundbreaking report LGBT Older Adults in Long-Term Care Facilities: Stories from the Field, utilizes survey results for the first glimpse into some of the issues faced by LGBT older adults in long-term care facilities. Of the 769 individuals who completed the survey, 328 people reported 853 instances of mistreatment in such facilities.

The survey, conducted from October 2009 through June 2010, did not use a representative or scientific sample, but includes hundreds of personal comments offered by the respondents, ranging from reports of staff harassment to staff refusals to provide basic services or care. Of the 769 individuals who completed the survey, 284 identified themselves as LGBT older adults. Others said they were family members, friends, social service providers, legal services providers, or other interested individuals.

The survey, Web site, and the report were prepared by the National Senior Citizens Law Center in collaboration with Lambda Legal, National Center for Lesbian Rights, National Center for Transgender Equality, National Gay and Lesbian Task Force, and Services & Advocacy for GLBT Elders (SAGE).

“Administrators and staff members at long-term care facilities should see this report as a wake-up call,” said National Center for Lesbian Rights Elder Law Project Fellow Daniel Redman, Esq. “An extraordinary 89 percent of respondents — from across the country, from a variety of backgrounds — assert that LGBT people cannot come out in a nursing home without risking their safety. Better policies, more comprehensive training, and an aggressive litigation strategy are all needed to bring the nursing home industry into the 21st century. As the report asserts, ‘Good care is possible.’ By following the report’s recommendations and taking affirmative steps to make facilities LGBT-inclusive, long-term care facilities can do a lot to make their services welcoming to all seniors.”

Said National Senior Citizens Law Center Executive Director Paul Nathanson: “Our hope is that this report provokes thought, raises critical questions, and compels future systematic research that can be used to dive deeper into the issues raised by these findings and the many personal stories we received.”

Some of the comments point to possible violations of federal nursing home law, while others signify that far more training and awareness by staff is needed, in addition to enhanced consumer awareness. The report also points to a wide array of policy remedies that could be enacted to support LGBT elders better and improve the facilities where they reside. The report’s recommendations are directed toward policymakers as well as long-term care providers.

“In SAGE’s experience, LGBT older adults often fear that they will encounter providers who might be uncomfortable with, or even hostile, towards them, untrained to work with them or unaware that they even exist,” said SAGE Executive Director Michael Adams. “Even when providers are supportive, fear of discrimination keeps many LGBT elders in the closet and prevents them from seeking the care they need. This speaks to a great need for training on cultural competency and LGBT aging issues, available through outlets such as the National Resource Center on LGBT Aging, for staff at long-term care facilities.”

Said Laurie Young, a specialist on aging and the director of Public Policy & Government Affairs at the National Gay and Lesbian Task Force: “Lesbian, gay, bisexual, and transgender elders remain a highly vulnerable and largely invisible aging population. We know that invisibility leads to greater social isolation, which can lead to increased vulnerability in many areas, such as the discrimination faced in long-term care institutions. This report highlights the issues faced by LGBT older adults in long-term care facilities and offers concrete recommendations on how aging advocates, policy makers, providers and social service agencies can meet them.”

Added Lambda Legal Deputy Legal Director Hayley Gorenberg: “Unfortunately, we are hearing far too frequently, all across the country, from LGBT seniors who are forced into isolation for fear of being out and vulnerable or older LGBT couples who are forced back in the closet when they visit their loved one in long-term care facilities. This report should shock our nation into action. As we continue to make great strides for equality, we cannot leave our elders behind.”

Survey results, comments and personal videos from LGBT older adults can be found, as well as profiles of the authors, at