Inclusivity in skilled nursing facilities is part of delivering quality care. It has been more than 50 years since the Stonewall Uprising paved the way for equal rights for the LGBTQ+ community. However, the battle for equality and inclusivity continues in many areas, including long-term care. LGBTQ+ residents deserve the assurance that their physical, emotional and social needs and desires will be met without any discrimination or bias. 

Long-term care providers are in a unique position to cultivate inclusivity, facilitate healing and promote positive health outcomes for adults who have historically been made to feel ignored and undesirable. They can provide culturally competent and inclusive care that improves the quality of life for elderly and disabled LGBTQ+ residents.

Lingering discrimination and worries

According to SAGE, 7 million LGBTQ+ people will be 65 or older by 2030. As this population ages and becomes more prone to infirmity, many will need to rely on the help of long-term care facilities. Due to lingering discrimination and disparities in healthcare, many older LGBTQ+ adults face uncertainty and lack of adequate care when they are most vulnerable. One of the most significant concerns many older LGBTQ+ people have about living in long-term care is the freedom to openly share their identity. 

In 2018, AARP completed a survey of 1,762 LGBTQ+ adults age 45 and older. The survey stated that about half of respondents were concerned about being forced to hide their identity. These seniors may feel like they have to live “in the closet” for a number of reasons such as past discrimination, fear of abuse or neglect, feelings of vulnerability or lack of a supportive environment.

According to SAGE, “LGBTQ+ older adults often experience victimization based on their perceived or actual sexual orientation and gender identity.” One of the organization’s surveys found that 43 percent of LGBTQ+ residents reported mistreatment, and more than 80 percent predicted discrimination by staff and other residents. Long-term care facilities have a responsibility to protect residents while promoting fairness and dignity. Staff and management teams can be change agents who cultivate a respectful environment free from discrimination and harassment.

Culturally competent care

Training for providing culturally competent care is an important part of cultivating a respectful environment. As part of the SAGE National LGBT Housing Initiative, the organization offers some guidance on increasing LGBTQ+ cultural competence. SAGE recommends that training include discussion of appropriate terminology, history of the LGBTQ+ experience and unique culture of LGBTQ+ adults. This information can be obtained at agencies such as the Diverse Elders Coalition, National Resource Center on LGBT Aging and the U.S. Department of Health and Human Services’ Administration on Aging. 

To show dignity and respect for all LGBTQ+ people, the National Resource Center on LGBT Aging suggests asking about residents’ sexual orientation, gender identity and preferred gender pronoun in a safe and confidential manner. These questions could possibly be added to admissions materials or residents could be asked during private, dignified conversations. However, the organization also cautions that sexual orientation and gender identity are just two aspects of a person’s background and that facility operators and staff need to recognize that LGBTQ+ adults have diverse experiences and interests and they should not be generalized or only defined by their sexual orientation or identity.

LGBTQ+ rights are resident rights

Finally, facilities should be intentional in affirming their commitment to the rights of all residents and a culturally-inclusive environment. Resident Rights and anti-discrimination policies need to be posted in the facility in highly visible areas as well as on the company website. Ongoing monitoring systems for discrimination or mistreatment should be put in place that include safe and confidential ways for residents and staff to report incidents. 

In addition to culturally competent care training, staff must be made to feel comfortable in having honest, yet respectful conversations about how to provide unbiased care and address discrimination among residents or co-workers. Above all, long-term care communities should not only recognize the existence of diversity among residents, but welcome it. 

Let Us Help

The Compliance Store has several resources to aid facilities in ensuring dignified and inclusive care for residents, including LGBTQ+ adults. We have policies about non-discrimination, information on health issues specific to LGBTQ+ populations and links to training. To learn more, contact us here.