Majority of LGBT adults concerned about social support and discrimination in long-term care


By Mike Festa, State Director, AARP Massachusetts

 When it comes to aging-related concerns, older LGBT (lesbian, gay, bisexual and transgender) adults worry most about having adequate family and other social support to rely on as they age, discrimination in long-term care (LTC) facilities, and access to LGBT-sensitive services for seniors, according to a new AARP survey. Black and Latino LGBT adults report the greatest concern about future family and social supports, and a greater number worry about potential abuse in LTC facilities because of their race/ethnicity and sexual orientation/gender identity.

The survey, “Maintaining Dignity: Understanding and Responding to the Challenges Facing Older LGBT Americans,” found gay men and lesbians have similar concerns about whether they’ll have enough family and/or social support. However, gay men are more likely than lesbians to be single, live alone, and have smaller support systems, which may put them at higher risk for isolation as they age. Transgender adults also report smaller support systems and are at an increased risk of isolation, while bisexuals are least likely to be “out” within health systems.

Older LGBT Americans live in cities and towns of all sizes. Just under one-third of those surveyed live in big urban cities, while the rest reside in suburbs, medium-sized cities, or small towns and rural areas. Survey responses suggest that community size is less important than LGBT-friendliness when it comes to living in a supportive community.

Nevertheless, the share of residents with access to LGBT community resources is significantly higher in bigger cities compared to smaller and more rural areas, but health and senior services still lag everywhere. Just 48 percent of big city residents surveyed and as few as 10 percent of rural and small town residents say they have access to LGBT senior services in their community.

Housing access is another dimension significantly impacted by the LGBT-friendliness of the community. When asked if they are worried about having to hide their LGBT identity in order to have access to suitable housing options as they age, 34 percent of all LGBT survey respondents reported being at least somewhat worried, as did half (54 percent) of transgender and gender expansive participants.

Older LGBT adults often have serious concerns about aging with dignity, compounded primarily by fears of discrimination and lack of social support. Most LGBT adults want but don’t have access to LGBT-sensitive care and services.

Over half (52 percent) of LGBT adults said they fear discrimination in health care as they age. A majority are especially concerned about facing neglect, abuse, and verbal or physical harassment in LTC facilities, with black LGBT adults reporting the highest level of concern.

Despite concerns about prejudice affecting future quality of care, most LGBT survey respondents are relatively satisfied with their current health care. Eighty-seven percent of respondents have at least a good relationship with their healthcare provider.

The survey found high demand for long-term care providers who actively welcome the LGBT community and demonstrate awareness and knowledge of the specific needs of LGBT adults as they age. More than eight in 10 survey respondents say they would feel more comfortable with providers who are specifically trained in LGBT patient needs (88 percent), use advertising to highlight LGBT-friendly services (86 percent), have some staff members who are LGBT themselves (85 percent), or display LGBT-welcoming signs or symbols in facilities and online (82 percent).

These data underscore the importance of federal and state anti-discrimination laws to protect all LGBT Americans wherever they live as well as the desire for safe housing. The survey found very high levels of interest in LGBT-welcoming older adult housing developments:  90 percent of respondents were extremely (35 percent), very (27 percent) or somewhat (28 percent) interested in that option.

With well over a million LGBT seniors in the U.S., a number that will double by 2030, this is an opportunity for the health care and housing industries to step up and meet the needs of this growing demographic that aspires to thrive, not hide, as they age.