LGBT Older Adults in Long-Term Care Facilities

What are LGBT older adults experiencing in long-term (LTC) care facilities?  That was the question asked by a coalition of LGBT and/or aging organizations in a national survey answered by 769 people, 284 of them LGBT older adults.

Altogether, 328 of the respondents  reported a total of 853 instances of mistreatment of LGBT residents of long-term care facilities.  The types of mistreatment reported were:

  • Verbal or physical harassment from other residents: 200 (23% of reported incidents)
  • Refused admission or re-admission, attempted or abrupt discharge:  169 (20%)
  • Verbal or physical harassment from staff:  116 (14%)
  • Staff refused to accept medical power of attorney from resident’s spouse/partner:  97  (11%)
  • Restriction of visitors:  93 (11%)
  • Staff refused to refer to transgender resident by preferred name or pronoun:  80  (9%)
  • Staff refused to provide basic services or care: 51 (6%)
  • Staff denied medical treatment:  47 (6%)

Fear of mistreatment was much more pervasive.  Although the number of respondents reporting incidents of actual mistreatment was 43%, the number who feared LTC staff would discriminate against an out LGBT elder was 89%.  81% would expect discrimination from other residents; 77% said other residents would isolate an out LGBT resident, and more than half (53%) feared staff would abuse or neglect an older LGBT resident.

The report includes a number of stories of discrimination and abuse.  Some were heartbreaking.  A floor nurse told the story of a lesbian couple partnered for more than 50 years.  The family stepped in when one had a stroke and entered a nursing home, and got a restraining order against the partner, barring her from seeing the love of her life.  “She would call the nursing home occasionally on the night shift to see if a kind nurse would be willing to break the rules and tell her if her partner was still alive and how she was doing.”

To provide a little balance, the report also includes the story of how a hospice helped a transitioning MTF come out to her 100-year-old mother.

The rest of the 31-page report includes policy recommendations, demographics of the respondents, legal rights of facility residents, a short glossary of terms, and resources.  The website also three includes YouTube videos – one of long-time activist Phyllis Lyon; one of Page Faegre, a woman contemplating finding a long-term care facility, and one of several LGBT LTC advocates.

Because we as a field need to learn as we go, I was appalled that the report gave so much detail on individual respondents.  Although no last names were used, some respondents were identified not only by first name and last initial, but also by their city and/or age.  I actually recognized one respondent, and learned that his partner is FTM, which I – as a trans advocate who has had significant contact with this person – didn’t know.  As we know, outing people is dangerous business, and I wish the report authors had thought more carefully about why readers needed to know as much data about the identity of those whose personal stories were quoted.  In my opinion, the stories are strong enough to stand on their own, and didn’t need any names associated with them at all.  If respondents had consented to having that much personal data published, I wish the report had noted that.

The report, videos, and other resources are all available at

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