At Archstone Foundation, we believe models of care should place individuals and their chosen families at the center. That’s why we helped fund the Long-Term Care Equality Index (LEI), the first validated survey of LGBTQ+ inclusion in long-term care and senior housing communities across the country.
LGBTQ+ older people are twice as likely as their heterosexual counterparts to be single and live alone, and four times as likely to have no children. People who are gay, lesbian, bisexual or transgender disproportionately suffer poorer health and socioeconomic outcomes because of societal stigma, discrimination, unconscious bias, and denial of civil rights. These inequities are compounded over their lifetimes, challenging their health and well-being as they age. Their life experience with homophobia and persistent discrimination makes it difficult for some to seek support services from mainstream providers. And so, many maintain caution when selecting a place to live their later years – in part because 9 in 10 LGBTQ+ older people fear they will face bias because of their sexual orientation or gender identity.
That alarming statistic underscores the need for long-term care that is inclusive and welcoming to LGBTQ+ older people – places where they can not only live but also thrive, and be treated with respect and without fear of discrimination.
Promoting Equitable and Inclusive Communities
That has become easier because of a recent collaboration between SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ+ older people, and the Human Rights Campaign Foundation, the educational arm of the nation’s largest civil rights organization working to achieve equality for LGBTQ+ people. They developed the LEI as a way to measure and promote equitable and inclusive care for LGBTQ+ older people in affordable housing, independent living, assisted living, skilled nursing, memory care and hospice residential communities.
Eighteen communities in California and more than 180 others throughout the U.S. participated in the LEI survey.
In addition to assessing LGBTQ+ policies for both residents and staff in these communities, the LEI provides educational resources and technical assistance to put these policies into practice.
Among many of the benefits of participating are:
- Learning best practices for LGBTQ+ equity and inclusion
- Accessing quality training and education
- Gaining assistance in meeting state and federal regulatory requirements, including the new CMS Phase III Requirements of Participation
- Improving the ability to develop culturally appropriate marketing for future staff, clients, and funders
- Receiving public recognition as a leading provider of LGBTQ+ welcoming services
These were two particularly noteworthy findings from the survey:
- 90 percent of participants demonstrated they have updated resident and employee non-discrimination policies to include protections based on both sexual orientation and gender identity.
- 75 percent of participants earned either a “High Performer” or “Leader” designation on the LEI, indicating they have adopted some of the policies and practices outlined in each criteria section.
To learn more about the 2023 LEI and how to participate in future surveys, click here.
Creating a Place to Call Home
In 2022, there were more than 65,600 regulated long-term care facilities in the U.S., and out of that number, only 200 participated in the LEI survey. While that may seem like only a drop in the bucket of progress toward inclusiveness and belonging in long-term care facilities, I’m hopeful more communities will participate in the next LEI survey. Another heartening development: In our home state, SAGE is working with the California Area Agencies on Aging to provide online training in LGBTQ+ aging cultural competency.
There’s a deep sense of urgency because of the well-documented demographic shift taking place: About 10,000 people in the United States turn 65 each day, and they are going to live healthier and longer lives than the generations before.
All of us, especially as we age, deserve to be our full and complete selves — and that starts with being treated with respect regardless of our sexual orientation, gender, racial or ethnic background, or ability.
Archstone Foundation is committed to ensuring that systems of care meet the needs of historically marginalized people, are culturally and linguistically appropriate, and serve to reduce disparities in health and well-being.
The 2023 LEI has created a channel for promoting best practices in care, and it is a resource to help long-term care facilities incorporate inclusive policies that lead to culturally competent and responsive care to LGBTQ+ older people. As the celebration of Pride Month comes to an end, I’m hopeful this valuable new tool helps create more places where my LGBTQ+ family, friends, and neighbors can find a place in their later years to call home.
