Senior Care Recognizes LGBT Elders' Needs


illustration by darren gygi

Former Olympian Bruce Jenner’s recent gender transition, to become Caitlyn Jenner at age 65, is perhaps the most visible tip of a demographic iceberg: There are currently an estimated 1.5 million lesbian, gay, bisexual, or transgender (LGBT) adults over the age of 65 in the U.S., a number expected to double within the next 15 years. For many LGBT seniors, these years represent a highly fraught time of life. At the same moment they grow increasingly in need of care, their deeply entrenched fears arise about trusting they will be treated with sensitivity and dignity.

“A lot of older LGBT people grew up in a time when homosexuality was seen as a mental disorder that was treated with electric shock therapy,” says Rajean Moone, executive director of Training to Serve, a local organization dedicated to providing tools and education to service providers for improving LGBT adults’ quality of life. “They were banned from some employment, and hiding was key to their survival. They carry a lot of that with them. There’s a huge fear factor, and when they need services, they hide who they are.”

When a gay or lesbian person moves into a nursing home, they may present their longtime partner as a sister or cousin. A transgender man who transitioned decades ago might revert to his gender of origin. “People are concerned that they’ll be abused or neglected because of who they are,” says Moone.

Training to Serve was founded in 2009 after an earlier survey of Twin Cities service providers revealed that almost none had received tutelage on the unique needs and circumstances of older LGBT adults—who are at greater risk for physical and mental illness than the general population, and less likely to seek out professional services and programs. They are also more likely to live alone, and less likely to have children or other caregivers.

A 2012 survey of older LGBT adults in the Twin Cities revealed that a majority expressed preference for LGBT-welcoming housing and services (as opposed to LGBT specific), suggesting a desire for acceptance rather than separation, and highlighting the importance of creating inclusive environments in existing general-population nursing homes and assisted living residences.

In 2012, Training to Serve partnered with the Minnesota office of Volunteers of America National Services to instruct 500 employees—from nursing assistants and maintenance people to administrators—across each of VOA’s six Minnesota senior facilities on meeting the unique needs of LGBT seniors. The program was such a success that VOA asked Training to Serve to conduct education at the rest of their facilities across the country.

Proactive long-term care facilities have taken thoughtful steps toward more inclusivity in image as well as deed. “It’s not about repainting your building with a rainbow flag,” says Moone. Strategies include using images of same-sex partners in marketing materials, changing intake forms to use terms such as “relationship status” instead of “marital status,” and allowing “other” as an option when asking about gender. Staff promote and enforce a respectful environment for all residents, and administrators create mechanisms for clients to report bullying or discrimination from other residents or staff.

Moone also says that there’s room for the LGBT community to improve in embracing its more senior members. “The LGBT community is immensely youth-focused,” he says, though he cites Boomer Town at the Pride festival (a space sponsored by the AARP), local social clubs for older LGBT adults such as PrimeTimers and GLEAM (Gay and Lesbian Elders Active in Minnesota), and Lavender Magazine’s annual aging issue as positive resources and developments toward inclusion. With both the LGBT community and eldercare providers working toward addressing the needs and concerns of LGBT seniors, there’s ample reason to hope that isolation, fear, and hiding will no longer have to be a part of anyone’s golden years.

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