Inclusive Care For LGBT Elders

As 21st century Bay Area residents, it is difficult to understand the reality most of our LGBT elders experienced as a result of sexual orientation and/or non-binary identification. Discrimination affects LGBT seniors at every level – and health care is no exception. That is why you must take such thoughtful care when selecting inclusive home care for LGBT elders and loved ones. 

Compassionate, Non-Discriminatory Care Is Essential For LGBT Elders 

Finding compassionate, non-discriminatory care is essential for LBGT seniors to age independently and as healthy as possible. According to LGBThealth.org: 

LGBT people are more likely to experience certain health issues compared to people who are not LGBT. These health issues are mostly related to the stigma and discrimination experienced by LGBT people in their daily lives—including at school or work, in public places, or in health care settings.  

While this post serves as a very general introduction to a complex topic, we highly recommend downloading the National LGBT Health Center’s Guide, Providing Inclusive Services and Care For LGBT People, to learn more about this important topic. 

In order for seniors to age-in-place, while retaining dignity and independence, they must have caregivers who understand the specific needs of the LGBT senior population. 

Topics To Consider For Creating And Inclusive And Welcoming Space 

The simple act of including a small rainbow flag symbol on employees’ name tags, a symbol of LGBT inclusion, is a big one. However, it must be backed by employees or staff who are truly inclusive and welcoming.  

Inclusivity begins with understanding the damaging impact that can occur as the result of subtle or obvious language/word choices or insensitive questions/comments – as well as how to recover if an error is made. It blossoms when our LGBT clients and patients feel free to be themselves without judgment or criticism.  

While the hope is that care for LGBT clients and patients will become second-nature, there is much work to be done until then. As the National LGBT Health Education Center confirms, “luckily with some training and small changes in protocol, it is possible to provide safe, affirming, and inclusive environments for transgender people.” 

To give you an overview of what being inclusive means, here is a list of some of the topics, considerations, and lessons put forth in the National LGBTQs Guide for Healthcare Staff: 

Understanding the common health issues affecting LGBT elders

LGBT people are at higher risk for depression, suicidal thoughts, STDs and STD-related health conditions, addiction, smoking habits, and social and family isolation. Similarly, they are less likely to observe routine health appointments if they’ve experienced discrimination in the past, and less likely to have preventative cancer screenings. 

Other barriers LGBT seniors have faced include: 

• Limited access to basic health care 
• Negative experiences (discrimination or even abuse) with healthcare providers or those in authority 
• Experiencing health care providers who were not qualified or knowledgeable enough to provide high-quality care to their LGBT patients. 

LGBT clients’ expectations and triggers around honest mistakes from healthcare providers  

As you can imagine, LGBT seniors have experienced a lifetime of discrimination from society, and many have been the victims of hateful or violent verbal abuses from others. Even in the best of cases, an LGBT individual may have experienced uncomfortable or insensitive comments from those they trusted, including health care providers. 

As such, caregivers should know how to respond if they do, unwittingly, illicit a triggered response from an honest mistake, continuing to build trust with clients. 

Communication basics, including pronouns and preferred names/terms 

Caregivers should pay close attention and only use the name/pronoun(s) clients use for themselves. This also includes the terms clients use for themselves, partners, or spouses. For example, if a man refers to himself as gay, you also refer to him as gay rather than “homosexual,” regardless of your intentions to be politically correct. Acceptable vs. derogatory terms for the LGBT population have morphed through the decades and what is appropriate for him and his generation may not seem appropriate to you; our job is to honor the client’s wishes. 

Similarly, a client’s records provided by the family may state s/he is a “him,” when, in fact, she identifies as a “her.” Don’t make assumptions that information from family is correct. It’s always better to check the records provided with the patient to verify his/her preferences. 

How to handle when name/gender records don’t match 

If a client is transgender, you may experience medical, insurance, or other “official” records that do not match your client. Besides the risk of discrimination or a desire to comply with social norms, LGBT seniors may not have wanted to spend the time, energy, and emotional investment required to move through the complicated process of a legal name change. 

By checking in, “Hello there. I see you are listed as Jean, is that your preferred name or do you go by another name,” gives the client a chance to open the door so s/he and the caregivers can establish an honest, honoring, and safe baseline. 

Avoid asking unnecessary questions 

It is understandable to want to get to know your client and to be curious about his/her past. However, caregivers should let clients lead the conversation around personal or sensitive topics, particularly one as potentially heated or triggering as a person’s gender and/or sexual identity. 

Before embarking on a potential emotional land mine, consider: 

• What do I know?  
• What do I need to know?  
• How can I ask for the information I need to know in a sensitive way? 

Remember that gender and/or sexuality can be fluid 

Back in the 70s and 80s, you were more apt to hear about someone being gay, straight, or lesbian – with clear boundaries. In the 90s, the term “bisexual” was used more often to help those who didn’t feel exclusively any one thing. Today, the various terms available to sexual/gender orientation or expression (or even the lack thereof) abound.  

Sexual orientation 

Sexual orientation is not the same as gender expression. A person’s sexual orientation describes their sexual/emotional attraction to others. The following terms apply to sexual orientation: 

• Heterosexual (straight)  
• Lesbian 
• Gay 
• Bisexual 
• Asexual 

Gender identity 

A person’s gender identity is his/her own identity of being male or female. Terms defining gender orientation include: 

• Transgender woman: A man who identifies as a woman 
• Transgender man: A woman who identifies as a man 
• Gender fluid: A person who does not identify, or chooses not to identify, as a single-gender.  
• Many others as accurate vocabulary continues to emerge over time 

Ultimately, LGBT clients deserve to be respected first and foremost as individuals. From there, caregivers can work to create clear, comfortable communication channels that include the correct terms or identifications that are most important or meaningful to the client. 

We Care

Are you looking for home care providers who know how to provide inclusive care for LGBT elders? Consult with multiple local agencies, and ask them directly whether or not they have experience with the LGBT client community as well as what they do to educate and train their caregivers accordingly. These in-home assessments are free and are essential to ensure you hire the right agency for the job.  

Contact HomeAide Home Care to work with a Bay Area home care agency who has years of experience serving our LGBT elders.