LGBT Older Adult Care

Sensitivity to the aging Lesbian, Gay, Bisexual, and Transgender community (LGBT) is part of the RCFE Core of Knowledge.  The LGBT community has seen significant gains in civil rights and consequently, more older adults identifying as LGBT. An estimated 2.4 million adults over the age of 65 identify as LGBT, and this number is expected to double by 2030.  This article focuses on considerations for caring for this growing population of older adults.     

Recognize Social Context and Life Experience of LGBT Older Adults 

Similar to other historically marginalized groups, the LGBT community has endured negative social circumstances.  As a result, many LGBT older adults conceal their sexual orientation or gender identity, which plays a role in the population’s aging and health disparities.  Facing social stigma and discrimination over their lifetimes frequently causes stress, long-term health issues, and maladaptive coping mechanisms (2). These disadvantages create disproportionate risk of serious illness and disability compared to heterosexual peers (1).      

Considerations for LGBT Older Adult Care

Start with your staff.  Proper training for staff to care for LGBT residents is essential.  Seek out assistance from local LGBT advocacy organizations that specialize in LGBT training.  The San Diego LGBT Community Center provides programs and services to promote health, wellness, and human rights of LGBT older adults (https://thecentersd.org/about/).    

Expand your LGBT knowledge.  Understanding sexual orientation, gender identity, and LGBT definitions allow RCFEs to provide more inclusive care for residents.  Consider learning the meanings of LGBT terminology.  Below are some terms defined by the University of San Francisco LGBT Resource Center.

• Ally: A person who confronts heterosexism, sexism, homophobia, biphobia, transphobia, and heterosexual privilege in themselves and others out of concern for the well-being of LGBTQIA+ people.

• Sexual Orientation: An enduring emotional, romantic, or sexual attraction. Sexual orientation is fluid. Asexuality is also considered a sexual orientation. 

• Transgender: Used most often as an umbrella term, some commonly held definitions: 1. Someone whose gender identity or expression does not fit (dominant-group social constructs of) assigned birth sex and gender. 2. A gender outside of the man/woman binary. 3. Having no gender or multiple genders.

Create a welcoming environment for LGBT residents.  

• Place your RCFE’s non-discriminatory policy in a visible area.  

• Display symbols of inclusiveness, such as a rainbow flag or pink triangle. 

• Provide unisex restrooms. 

• Use inclusive and gender-neutral language with residents and for resident documentation, such as intake forms. 

• Convey respect for everyone. 

Recognizing and understanding identities of LGBT older adults allow RCFEs to better serve individuals in this community.  Keeping staff up-to-date and properly trained as well as creating a welcoming environment also improve care for LGBT residents.  It is important to maintain and promote inclusion and respect for all to safeguard care equity.

Sources

1. Fredriksen-Goldsen KI, et al. Health Disparities among Lesbian, Gay, and Bisexual Older Adults: Results from a Population-Based Study. American Journal of Public Health. 2013;103(10):1802–1809.[PMC free article] [PubMed] [Google Scholar]Fredriksen-Goldsen KI, et al. Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population. Gerontologist. 2013 Mar 27;Published electronically. [PMC free article] [PubMed] [Google Scholar]

2. https://cjb-rcb.ca/index.php/cjb-rcb/article/view/119/79 

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365932/) (historical context)

https://nurse.org/articles/culturally-competent-healthcare-for-LGBTQ-patients/ (environment)

https://www.apa.org/pi/lgbt/resources/aging (2.4 million)

https://lgbt.ucsf.edu/glossary-terms (LGBT terminology) https://www.lgbtagingcenter.org/resources/resource.cfm?r=64