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White Papers

Purpose: As a group, Lesbian, Gay, Bisexual and Transgender (LGBT) older adults are members of a minority and historically disadvantaged sector of society. Most have spent the majority of their lives hiding sexual orientation and gender identity to avoid stigmatization and discrimination which continues to impact all facets of their lives. While research on sexual orientation has been identified by the Centers for Disease Control (CDC) as “one of the most pronounced gaps in health disparities research”1 , the absence of information regarding LGBT older adults is profound, with their health and aging-related needs among the least well understood of all groups.2 Given the history of social ostracism and lack of knowledge regarding their global biopsychosocial needs, particularly in comparison to other aging groups, LGBT elders have been rendered a largely invisible population.3

In light of advancing age, those considered among the “Greatest Generation”, “Stonewall Generation” and “Baby Boomers”, LGBT elders will require increasing involvement with physicians and institutions specializing in long-term care. Of paramount importance, yet least well understood, the needs of advanced-aged LGBT elders must be identified to facilitate culturally competent and appropriate care, as well as eliminate disparities in the long-term care environment.

Increased sensitivity and interest in the LGBT elder community has sparked relatively recent financial support to identify and document the unique social and health-related needs of LGBT elders. Given the mandate of the Older Americans Act, several federal agencies (Administration on Aging, National Institutes of Health, and National Institute on Aging)4, as well as private organizations, have allocated recent funding to focus on the unique needs of LGBT elders, recognizing their challenges in accessing appropriate health care and social service needs. Ultimately, it is this groundbreaking research, as well as support by medical and other organizations vested in the work of long-term care, that will integrate and sustain the compassionate, culturally competent, and non-discriminatory care afforded LGBT and all elders at the far end of their life continuum.

Authors: Patricia L. Bach, PsyD, MS, RN; Daniel Bluestein, MD, CMD, AGSF