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Carol is a 72-year-old woman with multiple health issues. Her partner, Susan, has been diagnosed with early stage Alzheimer’s disease. A home care social worker suggests they move to an apartment at a local assisted living center. Even though they recognize that support would benefit them, they do not want to move. 

“I need more help than Susan can give me,” says Carol. “And I want her to feel safe. But after 43 years as partners, we don’t want to have to pretend to be roommates at this time of our lives.” 

Patricia, an 82-year-old woman, was in a car accident. As part of her discharge plan from the hospital, the doctor has recommended short-term rehabilitation at a local nursing home. Patricia is adamant that she doesn’t want to go, and is becoming anxious and defensive with staff. It’s having an impact on her recovery, as she begins to experience increased pain and loses weight.

“What will happen when I move to the nursing home and all my paperwork says my legal name is Dan,” Patricia explains. “Who will be my roommate? Will they help me with makeup and wearing the clothes I like to wear?”



These are individuals who came of age well before gay marriage was legal, and before LGBT celebrities were visible and public about their lives. Many people like Carol and Patricia are afraid to access health services because of fear of discriminatory treatment. 

It wasn’t until the June 1969 “Stonewall Rebellion” that the gay rights movement and pride celebrations began. Until the mid-1970s, it was legal to discriminate against LGBT in employment and housing. It wasn’t until 1994 that the American Medical Association removed sexual orientation and related disorders from its list of mental health conditions. 

The health risks and needs of aging LGBT are real. Older lesbian women have higher rates of obesity and cardiovascular disease than heterosexual women, and are at greater risk of living in poverty.

Bisexuals sometimes report feeling left out of the LGBT community, and equally misunderstood by the heterosexual community. Risk factors include isolation, a lack of supportive friendships, and fear of accessing health care. 

In spite of barriers, older LGBT also tend to have resiliency. They have faced discrimination through their lives and, sometimes as a result, have reached an older age with strong coping skills. They often rely on intentionally constructed families: groups of friends who have supported each other for many years. 

Person-centered care has become an important feature of long-term care centers and older adult services. Training for staff is available to help them understand that all should be treated with respect and dignity. 

Suggestions from LGBT assisted living clients of the future: include them in anniversary celebrations, offer LGBT magazines along with other publications, use diverse photos in marketing materials, offer wider options for describing intimate partners on forms, fly a rainbow flag during June’s gay pride month, ask about and use the pronouns the individual uses. 

It’s all about having each older adult feel included, respected, and cared for. 


Editor’s Note: Training to Serve reflects an older population that felt minimized decades ago by the term queer, and thus does not use the “Q” in its acronym. In more recent years, the term has been reclaimed by younger generations, which is why it is normally used in Women’s Press style. 


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