More work to be done – Challenges in Long Term Care


Canadian research has indicated that discrimination towards gay and lesbian seniors exists on a continuum, from invisibility and ignorance to systematic forms of prejudice, exclusion and hatred, with invisibility being the most commonly expressed difficulty that gay and lesbian seniors faced in regard to the health and social service system.

An American study which compared older adults’ and LTC staff members’ knowledge and attitudes toward sexual expression in older adults found that 13% of staff and 21% of older adults said, ‘We should not allow gays and lesbians to live at our facility’; 55% of staff and 60% of older adults agreed with the statement, ‘Homosexuality is unnatural’

Indeed, an article that appeared in the NY Times in 2007 reported that elderly gay people living in nursing homes or assisted-living centers encountered disrespect or mistreatment. Such discrimination has even led to suicide, which occurred when an elderly gay individual was removed from his floor and placed in a room with patients suffering from dementia or severe disabilities, in order to placate the protests of other residents.


For gay and lesbian seniors, the most common reaction to facing discrimination is to become invisible, to “…retreat back to the invisibility that was necessary for most of their lives, when homosexuality was considered both a crime and a mental illness. A partner is identified as a brother. No pictures or gay-themed books are left around.”

Canadian research supports that seniors are reluctant to ‘come out’ to the health care system, although many service providers indicated that knowing their identity would not change their care strategy for a particular client, and endorse the idea of treating all their clients ‘the same’.


Research conducted at the Brookdale Centre on Aging, in New York, found that compared to the general older population, where less than 33% of individuals lived alone, up to 75% of older LGBT individuals lived alone; 90% had no children (less than 20% for general); 80% aged as single people without a life partner or significant other (less than 40% for the general older population). Conversely, the same study showed that they were 5 times less likely to access senior services, indicating that factors like discrimination, anti-gay bigotry, and ignorance of mainstream providers create barriers to services for the LGBT population.

As indicated above, Canadian research has shown that service providers show a mostly positive intent to treating all their patients equally. However, there is a lack of awareness and willingness to address issues of identity and sexuality openly, which limits their ability to provide a strong support system for gay and lesbian seniors. As well, reluctance on the part of LGBT seniors to declare their identity is mirrored by institutions which rarely make an effort to find out who these seniors are in order to prepare staff and other residents for what may be for them an unfamiliar situation.

Possible Solutions

Possible solutions include the development, implementation and monitoring of policies that relate to anti-homophobia and personal care issues, as well as the education of staff members to work against discrimination and to recognize the needs of LGBT seniors. Other possibilities include asking questions that are more relevant to LGBT seniors on admission forms, such as “Who is important in your life?’ instead of merely asking for ‘marital status’.