LGBTQ seniors fear being pushed into the closet in nursing hunt

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While caring for his aging mother, Donald M. Bell, a 72-year-old gay man, began to ponder where he would spend his twilight years.

“While mom and I were [in her long-term community], we were just mother and son and I was taking care of her,” he said. “And even though we enjoyed the community and she died there, I quickly realized that it was just not an environment where it was possible to say who I was, because you just did not know how people would react and we didn’t need the extra burden of dealing with life’s problems anyway. So you could say it’s marked kinda when I thought about my own situation because, look, if you’re in what you perceive to be your final life situation, and it’s not a pleasant situation, then it doesn’t give you anything to to hope.

As the generation of LGBTQ+ people forged by the AIDS epidemic and the drastic cultural shifts of the 1980s and 1990s enter their retirement years, nursing homes are demanding that nursing homes take extra steps to ensure safety and increasing compassionate care. More than 60% of LGBTQ+ older adults surveyed expressed concerns about treatment in long-term care facilities, such as independent residences or assisted living facilities. Among their concerns are fear of being denied or receiving limited care, neglect, abuse, harassment or being pressured to hide their identity.

A few years before Bell’s mother died, he found Town Hall Apartments, Chicago’s first affordable housing development for LGBTQ seniors, which he says changed his life.

“Living here has given me a center of safety and community, as well as support and understanding that I wouldn’t have had had I continued to live in my old home environment,” Bell said. “What’s happening here is that we can go about our lives without having to edit or filter what we do or what we say, and that’s a huge bonus for any social situation you live in.”

The Human Rights Campaign Foundation and SAGE, which advocates for LGBTQ+ older adults, have urged nursing homes and long-term care communities to develop and include specific anti-discrimination protections for older LGBTQ+ residents through the 2021 Long-Term Care Equality Index (LEI). Less than 30% of long-term care communities have policies in place to prevent discrimination against residents because of their orientation or identity, according to Tari Hanneman, director of the health and aging program at the Human Rights Campaign.

Extension of protections

President Joe Biden spurred these efforts with a recent executive order, calling on the Department of Health and Human Services to develop guidelines on preventing discrimination in long-term care facilities. There are regulations that Medicare-funded nursing homes must adhere to, but Biden’s order is the first to explicitly include LGBTQ+ seniors.

“That’s not to say there aren’t meaningful rights in regulation and there aren’t protections because there are, but based on the president’s announcement, there will be guides that cater specifically to those populations and that’s just a really positive step,” said Eric Carlson, managing attorney at Justice In Aging.

For example, Marie King, a 79-year-old transgender woman, in October was denied a room by Sunrise Assisted Living in Maine because of her identity. She and the facility reached a settlement on June 13 at the Maine Human Rights Commission. Adult Family Care Homes of Maine, which operates Sunrise Assisted Living and eight other communities, has agreed to follow a transgender non-discrimination policy accordingly.

Addressing bias will take more than an executive order, said Carey Candrian, an associate professor of internal medicine at the University of Colorado School of Medicine and an expert in LGBTQ eldercare.

“There needs to be a link between those broader overarching policies and protections, and then the actual training of staff and leadership, so that the protections go all the way. It’s good for staff to have a non-discrimination policy, but if you still have so many residents who fear being bullied, harassed or abused at this critical time in their lives and Unless these communities do the work to become more inclusive, the protections really aren’t going to do much.

Benefits of training

Long-term communities are already seeing the benefits of creating more inclusive environments, embracing the principles of person-centered care with the help of SAGECare training and certification.

“We wanted to be better informed and we wanted to be better able to speak to and serve the people who are not just here now, but arriving,” said Andy Eick, executive director of the Battery Park Independent Living Community. City at Brookdale. The community is one of nearly 640 SAGECare accredited organizations, according to the group’s site.

“It’s been a wonderful addition for us and our certificate is in the hall,” Eick said. “People appreciate the fact that we have the visible certificate. Four families have moved here since our certification and still live here, and I am sure they will tell you that they have a wonderful quality of life here in the community.

As part of the settlement with King in Maine, all employees and directors of Adult Family Care Homes of Maine will complete SAGECare training and post a transgender non-discrimination statement on the company’s website.

The goal of efforts like the Long-Term Care Equality Index is to fight stigma and help residential care providers better serve their clients.

“LGBTQ seniors are the ones who fought for our rights in the beginning. So for them to feel like they might have to go back to the closet is really, really sad and that’s why we’re doing this work,” Hanneman said.

Training, education, and policy must work in tandem, so other LGBTQ seniors can experience what Bell says they have.

“I’m really enjoying being where I am, and it’s given me the opportunity to do community outreach efforts, culturally confirming learning experiences for institutions and agencies, and community developments. housing and all that so that there is an expansion of safe places for LGBTQ+ seniors to be. It’s not something we can get away with,” he said.

“I really, really want it for others like me, because we deserve to feel safe.”

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