This year, National Coming Out Day was held on October eleventh, and I cannot help but think of the irony that day brings for thousands of LGBT older adults who require long term services and supports (LTSS). As recently reported in the Washington Post (here), identifying LGBT friendly LTSS providers is ridiculously (and unnecessarily) difficult. All too often, LGBT elders, by their own volition, or by another's encouragement, are forced to choose between their hard-fought identity on the one hand, and the services and supports they need to survive on the other. Consider the following examples of choices that LGBT older adults can face when navigating the LTSS marketplace:
- A gay man living in affordable senior housing, chooses not to attend any activities in the building because he fears his neighbors' reactions if they learn about his sexual orientation
- The daughter of a nursing home resident, asks her wife to present herself as her "cousin" to the facility staff, because the daughter fears retaliation against her mother, if the staff discovers the truth
- A geriatric case manager suggests to a lesbian couple that it might be easier to find a home health aide if they cease sharing the same bedroom and tell prospective aides that they are sisters, rather than reveal the truth of their relationship
I'm not suggesting that there is a lack of resources to address discrimination against LGBT elders when it occurs. Thankfully, numerous organizations such as SAGE, Lambda Legal and the Human Rights Campaign (HRC) offer comprehensive resources to educate the public on its rights when receiving LTSS in the community or in an institutional setting. Many of these organizations also offer training sessions for those LTSS providers who want to become more welcoming to LGBT elders. However, the problem remains that there is currently no easy way for the public to know which providers are LGBT welcoming. Why should finding LGBT friendly LTSS providers be so difficult? As they age, an LGBT elder should never be burdened with fighting the same battles for equality that he or she fought in their youth, let alone when trying to access desperately needed LTSS for themselves or someone they love.
To address this gap in consumer knowledge, I propose the creation of an index for LTSS providers, that is similar in concept to the highly regarded, HRC Corporate Equality Index (CEI). That index allows businesses to publicly demonstrate how their corporate values align with LGBT inclusivity. Similarly, the index I propose, would serve as a benchmarking tool that would give the public an inventory of how well a LTSS provider succeeds at being LGBT positive. It would consist of objective measures that indicate the provider's commitment to welcoming LGBT clients. Possible measures could include: the presence of policies promoting and open and honest workplace, staff training on the needs of LGBT elders and the results of satisfaction surveys of LGBT clients.
Sponsored by one, or more national organizations, participating providers would be able to advertise how well they score on the index (as corporations currently do with the CEI), thus allowing consumers to easily identify providers that are committed to providing services regardless of sexual orientation or gender identity. I am certain that many LTSS providers would quickly opt-in to the index in order to more easily connect with the LGBT consumer and to differentiate themselves in a crowded LTSS marketplace.
No one should be forced to deny their true self, simply because they are older and require assistance with activities of daily living. The LGBT community has the financial resources and institutional capacity necessary affect change, and now is the time for action to resolve this unnecessary barrier to obtaining long term services and supports for LGBT older adults.. What do you think?
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