An estimated 1.1 million seniors in the U.S. self-identify as LGBTQ (lesbian, gay, bisexual, transgender, or queer), according to a gender and sexuality study published in The Gerontologist. These baby boomers form America’s first big “out” generation — they came of age during the Stonewall riots, survived the onset of the HIV epidemic, and laid the groundwork for marriage equality.
Despite increasing advances in gay rights and acceptance, many aging members of the LGBTQ community struggle to find supportive senior living options. Learn more about these difficulties and steps to finding inclusive, affirming senior living.
Challenges for LGBT senior housing
“Many of these folks have been out for a very long time and have no intent to go back in the closet,” says Kimberly Acquaviva, a nursing educator at George Washington University.
“They’re looking for a place where they can be the vibrant people they’ve always been.”
In an AARP survey of 85,000 aging LGBT adults, more than a third of lesbian, gay, or bisexual respondents said they worried they would have to hide their sexuality or gender identity to find good housing. More than half of gender expansive or transgender participants had this fear.
Senior care providers confirm these worries — 54% of hospice and palliative care providers think LGBT seniors are more likely to experience discrimination, and 24% have witnessed discriminatory care first-hand, according to a 2020 study published in the Journal of Palliative Medicine.
“There’s very little LGBT-specific senior housing throughout the country, especially affordable housing,” says Sydney Kopp-Richardson, director of the national LGBT elder housing initiative at SAGE, an organization that provides advocacy and service for LGBT seniors. “It’s important to find senior living that’s elder-affirming — a place where staff, residents, and directors accept and affirm LGBT seniors and they don’t feel the need to go back into the closet.”
9 questions to ask to find LGBT friendly retirement communities
“Any retirement community can be LGBT-friendly,” says Acquaviva. Supportive, caring senior living options exist across the country. Depending on where you live, finding one could take some digging. Consider asking these nine additional questions while filling out our assisted living checklist.
- Do you have an anti-discrimination policy?
An anti-discrimination policy should be readily visible and include gender and sexual orientation, says Kopp-Richardson.
Since sexual orientation is only considered a protected class in 20 states, this isn’t a given. It’s a good sign if a community visibly posts its anti-discrimination policy and discusses it in brochures and on tours.
- Are there LGBT community organizations or clubs?
Many assisted living communities, especially in progressive areas, have resident-led social groups or safe spaces for LGBT seniors. Aging loved ones can express themselves freely and discuss concerns with like-minded individuals.
- What are your employee benefits?
There is a strong connection between employee benefit policies and affirming treatment of LGBT seniors, says Kopp-Richardson. If a community offers equal benefits, support for LGBT staff, and healthcare benefits positively impacting transgender employees, it’s more likely that the community will be affirming toward its residents.
- Does your staff have experience caring for LGBT seniors?
If the community dismisses your question or says they haven’t worked with any, it’s a red flag. Open, candid conversations between LGBT seniors and staff before moving in is a must.
- What are your cohabitation policies?
Some communities only allow married couples to cohabitate and define marriage as between one man and one woman. A 2018 Missouri district court ruling determined that this is not legal discrimination.
- Do you have events that celebrate minorities?
If the community doesn’t have a large LGBT population, ask about treatment of different races and religions. Is there a focus on inclusivity? Are there celebrations of various cultural holidays and events? Maybe you or your senior family member can start a mini pride parade!
- Do personal beliefs affect staff interaction?
If you’re touring a religiously affiliated community, ask about staff and residents, not just community policy. While many religious communities offer safe, supportive housing for LGBT seniors, several providers in the aforementioned palliative care study reported pursuing “saving” end-of-life counseling and mistreatment by dogmatic staff members.
- Have you received cultural competency or anti-discrimination training?
SAGECare offers training to help providers create LGBT-affirming communities. They offer cultural competency resources on their website and have trained more than 87,000 senior care professionals nationwide. “Cultural competency is the idea that LGBT older people are as deserving of compassionate elder care as anyone else,” says Kopp-Richardson.
- Do you respect durable power of attorney and chosen family?
Nearly 20% of assisted living and memory care communities bypassed LGBT residents’ partner/spouse and contacted biological family members in emergencies, according to the 2020 study. Staff should be aware of durable powers of attorney and respect same-sex partnerships.
Discussing these questions will help you and your loved one find a community that makes LGBT seniors feel safe, supported, and comfortable that gender identity and sexual orientation will be respected.
Memory care for LGBT seniors
LGBT seniors with Alzheimer’s disease or another type of dementia can experience a particularly challenging set of circumstances, according to the Alzheimer’s Association and SAGE. A memory care facility that’s well-versed in caring for LGBT seniors, especially those who have transitioned, can help.
Here are three unique challenges LGBT seniors with dementia may face and ways to cope.
- Early memories resurface
As dementia progresses, newer memories are often replaced with experiences from youth. LGBT seniors may regress to a point where they felt uncomfortable with their identity, or had not “come out” yet.
Memory care can be affirming. Caregivers with cultural competency training have the tools to calmly reassure LGBT seniors. Memory boxes with photographs and reminders of important life experiences, like news clippings, can help.
- Reminiscence therapy may be uncomfortable
Reminiscence therapy is a way to encourage seniors to reflect and reconnect with happy, calming memories. This can be hard for minorities who experienced discrimination or prejudice, especially if it came from friends or family.
Find a memory care community that offers one-on-one reminiscence therapy or employs an LGBT friendly geriatric psychologist. While reliving some memories can be painful, joyful reminiscence is good for everyone.
- Transgender seniors may regress to a time before they transitioned
Having to re-experience the dysphoria of assigned gender can be an enormous emotional setback. Lack of familiarity with the body that aligns with a senior’s gender identity can be confusing for everyday tasks, like dressing or going to the bathroom.
Transgender and gender expansive seniors must find affirming memory care. With dementia or other cognitive decline, they may need help administering daily hormones or completing activities of daily living (ADLs) without confusion. Ensure the staff is familiar with caring for transgender seniors.
A growing future for LGBT senior housing
The right senior living fit can improve health and quality of life, benefits that should be accessible to everyone. As the population ages, the number of LGBT-affirming senior housing options grow.
Atria, one of the country’s largest senior living providers and A Place for Mom partner, plans to break ground on a San Francisco senior community designed to cater primarily to LGBT seniors in 2021. But LGBT friendly senior living isn’t only available in large urban areas. SAGE regularly updates this map of LGBT friendly senior living across the country. Cultural competency training is growing nationwide, with credentialed providers in 48 states.
A Place for Mom can help you and your loved one find the perfect senior living fit regardless of gender or sexual orientation. Reach out to our Senior Living Advisors for an open conversation about LGBT-affirming senior living options in your area.