Recent news about a senior living facility in Boston vandalized with hate speech, as well as a story of a 79-year-old transgender woman who was discriminated against by a nursing home in Maine, highlight the need to support lesbian, gay, bisexual, transgender and queer (LGBTQ+) elders.
The Human Rights Campaign (HRC) Foundation, the educational arm of the nation’s largest LGBTQ+ civil rights organization, and SAGE, the world’s largest organization dedicated to improving the lives of LGBTQ+ elders, recently released the 2023 Long Term Care Equality Index (LEI).
The LEI is the only-of-its-kind national benchmarking tool promoting LGBTQ+ inclusive policies and practices in long-term care and senior housing communities. This year, 200 senior housing communities across 34 states and territories participated in the LEI, with 75% of participating communities earning either the High Performer or Leader designation.
Many older LGBTQ+ people are fearful of living their authentic selves or faced with outright discrimination against them and their families simply because of who they are. In a study by AARP, 76% of older LGBTQ+ people expressed concern about having adequate social support to rely upon as they age. The same study found that 73% of LGBTQ+ older people do not have access to LGBTQ+-specific services for older people. In response, the HRC Foundation’s Health & Aging program and SAGE created the LEI. The tool also formally recognizes those communities that lead the field in LGBTQ+ inclusion.
This formal recognition helps LGBTQ+ older people connect with senior housing providers that have committed their inclusivity to policy and practice.
Participating in the LEI means that we have not only implemented policies but have taken actionable steps that support those policies.
“We wanted a database that we could search to find the information [HRC Foundation and SAGE] are beginning to put together. We had to do this search “door-to-door” and there was no way we could get a sense without immersing ourselves in it,” shared couple Norma Long and Jan Carver. Long and Carver found a welcoming community in Edenwald, a Continuing Care Retirement Community and LGBTQ+ Long-Term Care High Performer in Towson, Maryland.
Long and Carver met in 1986 and have been together ever since. Like many people, the couple want to spend their retirement years near friends and family, while ensuring their future care needs are met. See why an LGBTQ+-inclusive community is so crucial in a video featuring the couple: www.youtube.com/watch?v=Hn5N8nx--fw&t=2s.
“Edenwald’s participation in the LEI is important because it affirms our unwavering commitment to embrace every individual for who they are, regardless of sexual orientation or gender identity,” said David Brown, Chief Information and Diversity Officer at Edenwald.
“The benefit of participating in the LEI is that our community knows that we have not only implemented policies, but we have taken actionable steps that are supportive of these policies, which reinforce and celebrate LGBTQ+ inclusion.”
Modeled after the successful Healthcare Equality Index, the LEI asked participants a series of questions about LGBTQ+ inclusive policies and practices in senior living. Those questions are divided into four criteria sections.
- Criteria 1: Non-Discrimination and Staff Training
- Criteria 2: Resident Services and Support
- Criteria 3: Employee Benefits and Policies
- Criteria 4: Resident and Community Engagement
“Participating in the LEI is important because it gives us the opportunity to gauge how well we are ‘walking the talk,’ ” said Jeremy Lemon, administrator at Trinity Community at Fairborn in Fairborn, Ohio. The Trinity Community at Fairborn received the top designation of LGBTQ+ Long-Term Care Leader.
“While working through this process, it occurred to us that while we have been on this journey for years and have made great progress in serving LGBTQ+ older adults, family members of our residents who are part of the LGBTQ+ community, and our LGBTQ+ staff members as an open and affirming organization, there was still work to be done. The LEI is an important measuring stick as well as a compass for us as we continue to improve our ability to care for this special population.”
Highlights from the report include:
- 90% of LEI participants documented that they include “sexual orientation” and “gender identity” in their employment non-discrimination policy.
o In the 2021 LEI, only 36% of communities published an enumerated employment non-discrimination policy that included “sexual orientation” and “gender identity” in the policy.
- On the question of equal visitation policy: 95% of the LEI participants for which this question was applicable documented that they have written equal visitation policies in place.
- 84% of LEI participants met the staff training requirement by having 80% or more of key executives either complete the LEI Executive Briefing training module or training provided by SAGECare as part of their platinum-level SAGECare credential.
- Percentage of LEI participants that have inclusive intake forms that collect the following data:
o Chosen Name: 89%
o Pronouns: 11%
o Sexual Orientation: 55%
o Gender Identity: 54%
o Inclusive Relationship Options: 83%
- Only 5% have an abuse and neglect policy that explicitly protects LGBTQ+ residents.
- Only 7% have a policy or policies that specifically outline procedures and practices aimed at eliminating bias and insensitivity, and ensuring appropriate, welcoming interactions with transgender residents.
The 2023 LEI Report represents the first validated survey on LGBTQ+ inclusion in long-term care and senior housing communities. All 200 participating communities deserve to be commended for their commitment to LGBTQ+ inclusion and their efforts to adopt the policies and practices that will make their LGBTQ+ residents, visitors and employees feel safe, welcomed and supported.
“We feel validated when we are in an environment that people know we are a couple and it’s talked about, not danced around, but talked about in constructive ways,” said Long. “It feels very validating to be in a community where you know you are an integral part of it.”
For more information on the LEI and to view the 2023 report, click here.
Dan Stewart is the associate director of the Aging Equality Project at the Human Rights Campaign Foundation in Washington, DC.
Photo credit: Courtesy of HRC.
