With the U.S. Supreme Court’s decision this year to make same-sex marriage legal in all 50 states, and the emergence of high-profile figures like Caitlyn Jenner, home healthcare agencies are changing how they engage and connect with seniors in the lesbian, gay, bisexual and transgender (LGBT) community who may be in need of services.
While many LGBT seniors have been out and vocal about their orientation, being placed in the care of individuals who may not be open to—or educated in dealing with—the LGBT community places them at greater risk for discrimination, isolation and abuse.
A 2011 report by the National Senior Citizens Law Center found that 90 percent of LGBT seniors feared being open about their sexual orientation and identity in a care facility, while about 50 percent had either faced discrimination in a care facility, or knew others who had.
Services & Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE), an organization that advocates for LGBT seniors, found in a 2010 nationwide survey of 320 area and state units on aging that less than eight percent offered services targeted to LGBT older adults. Only 12 percent reported outreach efforts to this population.
It may not be surprising, then, that many of the people in this community opt for in-home care.
Tim Johnston, manager of education and training for SAGE, said that, “Home is often the only place that [LGBT individuals] feel comfortable.”
He also stated that the challenge in finding competent, compassionate, nondiscriminatory care lies in finding home-health aides and agencies with the right attitude about caring for someone with a different sexual orientation.
“LGBT seniors,” he said, “have had to contend with home-health agencies and caregivers that have refused care, provided substandard services, been abusive, or tried to convert them—a disrespectful and harmful action. They are less likely to report abuse to law enforcement or adult protective services agencies because they fear being “outed” by their caregivers.”
According to SAGE, few senior-service providers are trained in LGBT cultural competence and few conduct outreach to the LGBT community—and few are prepared to address acts of discrimination aimed at LGBT elders by staff or other residents when such situations arise.
Home healthcare workers are often untrained in how to deal with the LGBT community. That leads to discriminatory actions and, at times, a hostile environment that can lead to physical and emotional abuse.
Some LGBT seniors have felt it necessary to remove art work, photos or other signs pointing to their orientation from their home in order to receive services without fear. “[Home-health] agencies should make LGBT seniors feel welcome and cared for,” Johnston said.
At the same time, he said that agencies and caregivers should be able to engage and communicate respectfully with LGBT family members who are caring for parents or other loved ones who are straight.
The cultural competency aspect is vitally important. According to the National Institutes of Health, cultural competency “has a positive effect on patient care delivery by enabling providers to deliver services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients.”
Furthermore, it is “critical in reducing health disparities and improving access to high-quality health care that is respectful of and responsive to the needs of diverse patients.”
So how do seniors and families in the LGBT community find home healthcare agencies sensitive to their needs?
Johnson said that families should seek agencies that:
- Provide staff training on how to engage with the LGBT community, including cultural competency courses.
- Give seniors the opportunity to state their sexual orientation on applications.
- Include “gender identity or expression” (or “gender identity”) and “sexual orientation” as protected classes, in addition to other federally-protected classes, in non-discrimination policies.
“That’s a clear sign they want to be responsible,” Johnston said.
In addition, agencies should include LGBT images on their website and in marketing literature to let families know they are welcome.
Johnston said his organization provides home healthcare agencies with online and in-person training to educate home healthcare staff about LGBT issues and concerns.
For more on this topic, read about why the “LGBT question” isn’t, and never has been, at Care for You.
And as always, we can be reached by phone at 301-650-4169. Or, if you’d prefer, visit our Contact page to schedule a free, in-home assessment.
We look forward to hearing from you.