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LGBTQ+ Elders

NORC Resources

Voices for Equality: Advocating for LGBTQ+ Residents (August 11, 2022)


Residents’ Rights and the LGBTQ+ Community: Know Your Rights as a Nursing Home Resident (Updated June 2022)
This factsheet highlights federal residents' rights and nursing home requirements that may be of particular importance to lesbian, gay, bisexual and transgender (LGBTQ+) residents and provides options for complaint resolution, information for reporting abuse and resources regarding long-term care and LGBTQ+ advocacy.

Introduction to LGBTQ+ Aging: What You Need to Know about Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults (October 2014)
Tim Johnston, PhD, Manager of Education and Training for SAGE (Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders), provides an introduction to LGBTQ+ aging discussing the culture, needs and concerns of LGBTQ+ older adults, why LGBTQ+ older adults are less likely to access health and social services and sharing best practices and tools for helping LGBTQ+ older adults to feel more included. SAGE usually charges for the content of this webinar. Since the content is proprietary, NORC could not record the webinar, but the public version of webinar slides are available.

Advocating for LGBTQ+ Long-Term Care Consumers: Resources for Long-Term Care Ombudsmen (October 2011)
This webinar addressed challenges faced by LGBTQ+ long-term care consumers and current initiatives to bridge barriers between consumers, ombudsmen and other advocates. Speakers identified existing resources and models of support for LGBTQ+ long-term care consumers and highlighted the importance of ombudsmen advocating on behalf of/with LGBTQ+ long-term care consumers.

Webinar speakers included:

  • Hilary Meyer, Director, National Resource Center on LGBTQ+ Aging;
  • Sue, Resident in a Continuing Care Community, Colorado;
  • Eric Carlson, Directing Attorney, National Senior Citizens Law Center; and
  • Jennifer Solms, Ombudsman, Denver Regional Council of Governments, Colorado.

Additional Resources

Long-Term Care Equality Index (LEI) (June 2022)
The Long-Term Care Equality Index (LEI) is a joint project of SAGE and the Human Rights Campaign Foundation designed to promote equitable and inclusive care for LGBTQ+ older adults in residential long-term care and senior housing. Watch an overview webinar on the LEI survey that is launching in August 2022. This webinar provides an overview of the survey process, survey criteria, what documents to upload, and steps for making an action plan.

Human Rights Campaign and SAGE: Long-Term Care Equality Index (June 2021)
The Long-Term Care Equality Index (LEI) is the first-ever nationwide assessment of LGBTQ+ inclusivity and inclusion at long-term care communities in the U.S. This national benchmarking tool evaluates long-term care communities based on the equity and inclusion of their LGBTQ+ residents and patients. This initial report does not score long-term care communities, but instead includes research data on how many long-term care communities currently have LGBTQ-inclusive policies and lays out how organizations can participate in the LEI and improve their policies.

NCEA Fact Sheet: A Spotlight on Two Spirit Elders and Elder Justice (June 2021)
This  factsheet is based on findings from the Two Spirit Elders Resource and Information Guide. The term “Two-Spirit” is an attempt to embrace the ways in which distinct American Indian/Alaska Native (AI/AN) communities had and continue to practice sexual and gender expressions that exist outside of the European binary labels imposed on tribal communities through the process of colonization.  

Fact Sheets from SAGE and Justice in Aging (October 2016)

These fact sheets can help consumers learn how changes may affect them, whether they are LGBTQ+ individuals married to someone of the same sex, or transgender individuals needing to access health care. These fact sheets were produced by Justice in Aging in partnership with SAGE (Services & Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders), the SHIP National Network (State Health Insurance Assistance Programs), and Administration for Community Living (ACL). 

Project Visibility (August 2016)
“Project Visibility: Person-Centered Care for LGBTQ+ Older Adults” is now available 24/7 as a web-based training. This free 30-minute interactive course is designed for managers and employees of nursing and assisted living homes, and home health care agencies. The goal of Project Visibility is to co-create an aging services community that is informed, sensitive to, and supportive of LGBTQ+ elders. 

Inclusive Questions for Older Adults: A Practical Guide to Collecting Data on Sexual Orientation and Gender Identity 
This guide was created to help service providers ask questions about sexual orientation and gender identity in safe and respectful ways. Relying on research, real-world knowledge, and experience, the guide outlines:

  • Why collecting data on LGBTQ+ older adults is important for service delivery;
  • How to incorporate sexual orientation and gender identity questions into client forms; and
  • Helpful suggestions for discussing sexual orientation and gender identity with older clients.

Mistreatment of Lesbian, Gay, Bisexual, and Transgender (LGBTQ+) Elders (October 2013)
This research brief from the National Center on Elder Abuse (NCEA) details the high risk of elder abuse, neglect and exploitation facing LGBTQ+ older adults.  Among its findings are fear of homophobia or transphobia keep LGBT elders from seeking help and services, and elder gay men and lesbians place high value on self-sufficiency and may be reluctant to accept help and more.

Inclusive Services for LGBTQ+ Older Adults: A Practical Guide to Creating Welcoming Agencies - National Resource Center on LGBTQ+ Aging  (March 2012)
This guide was created to help providers to understand the unique barriers that LGBTQ+ older adults face, as well as the many ways to improve and expand the continuum of care and services available to these older adults.  Written with suggestions, tips and practical ideas from mainstream aging providers in the field, along with SAGE and the National Resource Center on LGBTQ Aging’s partners. Visit the Resource Center website to obtain a copy.

National Resource Center on LGBTQ+ Aging
The National Resource Center on LGBTQ Aging is the country's first and only technical assistance resource center aimed at improving the quality of services and supports offered to LGBTQ+ older adults. Established in 2010 through a federal grant from the U.S. Department of Health and Human Services, the National Resource Center on LGBTQ+ Aging provides training, technical assistance and educational resources to aging providers, LGBTQ+ organizations and LGBTQ+ older adults. 

Stories from the Field: LGBTQ+ Older Adults in Long Term Care Facilities
This resource The National Senior Citizens Law Center (now called Justice in Aging), in collaboration with Lambda Legal, the National Center for Lesbian Rights, the National Center for Transgender Equality, the National Gay and Lesbian Task Force and Services & Advocacy for LGBTQ+ Elders (SAGE), includes hundreds of stories and comments from a survey about experiences of LGBTQ+ individuals receiving long-term care.


Ombudsman Program Examples

View Ombudsman program examples on LGBTQ+ elders


Information to Share with Consumers

A Guide to Finding an LGBTQ+ Inclusive Long-Term Care Community

Residents' Rights and the LGBTQ+ Community: Know Your Rights as a Nursing Home Resident

Accessing Information on Medicare Benefits for LGBTQ+ People

Marriage, Medicare and Medicaid: What Same-Sex Couples Need to Know

Medicare Changes for Transgender Older Adults



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Policy to Practice: CMS Guidance and Proposed Rules to Ensure Rights of Same-Sex Spouses
CMS has issued guidance and proposed regulatory revisions that provide equal treatment to all spouses, regardless of sex, of a valid marriage, even if the state where the individual lives or receives services does not recognize same sex marriage.  Both the proposed rules and revised language for the State Operations Manual, Appendix PP – Guidance to Surveyors for Long-Term Care Facilities (Appendix PP) were issued December 12, 2014.  This policy to practice brief provides more information and details how ombudsmen can use the new guidance in their advocacy efforts.

Addressing Health Disparities Among Diverse Older Americans - American Psychological Association/National Gay and Lesbian Task Force 
The American Psychological Association in conjunction with the National Gay and Lesbian Task Force held a discussion titled, “Addressing Health Disparities Among Diverse Older Americans” on May 24, 2011. The discussion focused on health disparities among aging Americans, integrating mental health into primary care settings to reduce disparities and the affect of health disparities on Lesbian, Gay, Bisexual and Transgender elders. The research and statistics support the need for increased advocacy and awareness in order to reduce the health disparities present among varying populations of older Americans. James S. Jackson, PhD of the Institute of Social Research at the University of Michigan, Patricia A. Arean, PhD a Clinical Psychologist from the University of California, San Francisco and Laurie M. Young, PhD the Director of Public Policy and Government Affairs for the National Gay and Lesbian Task Force were the distinguished speakers at the presentation.

Supporting Direct Care Workers in Caring for Aging Lesbian, Gay, Bisexual, Transgender Individuals (September 2010)
This is the fourth in a series of policy briefs about the direct care workforce in long-term care issued by the Direct Care Alliance (DCA). This series was conceived at a meeting of labor economists, lawyers, long-term care researchers and other experts convened by the DCA and funded by the Russell Sage Foundation.


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