While long-term care facilities like assisted living centers or nursing homes are not likely a preferred housing option for aging Americans, a new national study released this month outlined many unique concerns facing LGBT elders considering such options.
The studyentitled "LGBT Older Adults in Long-Term Care Facilities: Stories from the Field"was based on responses to a survey conducted online from October 2009 to June 2010 and featuring input from 769 respondents including LGBT elders; social services providers; and friends and family members of LGBT elders.
The report specifically indicated a common belief ( 89 percent of respondents ) that facility staff would likely discriminate against an openly LGBT elder living under their care. More than half ( 53 percent ) predicted staff would abuse or neglect an out resident. Their fears also extended to other facility residents who are perceived as likely to both discriminate against ( 81 percent ) or isolate ( 77 percent ) an openly LGBT resident.
Many respondents further reported instances of mistreatment of LGBT elders, most commonly verbal or physical harassment from other residents ( 23 percent ) or staff ( 14 percent ) or refused admission or re-admission or an attempted or abrupt discharge from a facility ( 20 percent ) . Other respondents reported they were aware of instances where staff refused to accept medical power of attorney from a resident's spouse or partner ( 11 percent ) or restricted visitors ( 11 percent ) .
LGBT elder advocates in Chicago said the report's findings were consistent with the fears of the Windy City's aging LGBT population.
Hope Barrett, Center on Halsted senior director of public programs, acknowledged that while some facilities in the city are working to be sensitive to the concerns of their LGBT residents, many elders remain leery that all facilities provide an atmosphere where they can be welcomed as their full selves. Particularly at risk of harassment, Barrett added, are HIV-positive and transgender elders.
"We've known about people having to go back in the closet because they're now in assisted living facilities with staff that are not culturally competent and are discriminatory in how they serve them," Barrett said.
Paula Basta, director of the Chicago Department of Family and Support Services' Northeast ( Levy ) Regional Senior Center, described the report as "not surprising" but indicative of much work lying ahead for those working to ensure long-term care providersincluding frontline staff, administrators and case managersare LGBT-friendly. Further research and education, she said, will be key to progress.
"On some levels, this is a wake-up call and a charge to action," Basta said. "I want to believe that [ care providers ] don't want to be bigoted or biased and think they want to do a good job but that they don't have the tools yet to be able to go through with those sorts of efforts."
Barrett indicated she is hopeful that cultural competency will soon become the rule, rather than the exception. Under the Obama administration, the U.S. Department of Health and Human Services has lent an unprecedented level of attention to the health concerns of LGBT Americans and have actively included elders in those efforts. That support, she hoped, will trickle down to more research and training at the local level.
"It is the responsibility of the staff to make sure the environment in their facility is one where everyone is respected and not discriminated against," Barrett said.
The study, available in full at www.lgbtlongtermcare.org, was co-authored by the National Senior Citizens Law Center, National Gay and Lesbian Task Force, Services & Advocacy for GLBT Elders ( SAGE ) , Lambda Legal, the National Center for Lesbian Rights and the National Center for Transgender Equality.