Bloomington, Ind. — In a recent academic journal article, researchers from the University of Indiana shed light on the obstacles confronting LGBTQ+ older adults residing in nursing homes across the United States. The comprehensive report, titled “Postacute Care and Long-Term Care for LGBTQ+ Older Adults,” offers crucial insights into the experiences of LGBTQ+ individuals in these care facilities and proposes actionable steps for nursing homes to ensure equitable and unbiased treatment for their LGBTQ+ residents.
THE IMPORTANCE OF INCLUSIVE CULTURE IN NURSING HOMES
Published on November 9 in the peer-reviewed journal Clinics In Geriatric Medicine, the article is co-authored by Jennifer L. Carnahan, a geriatric physician affiliated with the Regenstrief Institute, and Andrew C. Picket, an assistant professor at Indiana University’s School of Public Health in Bloomington. Carnahan, also an assistant professor of medicine at the Indiana University School of Medicine, emphasizes the importance of cultivating an inclusive and LGBTQ+ culturally competent nursing home culture. The report advocates for specific training for all staff and clinicians, allocating time to reduce staff burden.
NAVIGATING DISCLOSURE, AUTONOMY, DEMOGRAPHICS, & LGBTQ+ RISKS
The article points out that while some LGBTQ+ older adults fear being forced into the closet in nursing homes, others worry about the unwanted disclosure of their sexual orientation or gender identity status. The report stresses the need to respect the autonomy of residents regardless of their disclosure preferences.
There are over 15,000 nursing homes in the U.S. providing rehabilitative and skilled nursing care, with residents falling into two categories: post-acute care residents and long-term care residents. The latter group, constituting individuals no longer able to care for themselves, often includes those with dementia or cognitive impairments.
PROMOTING INCLUSIVITY THROUGH STANDARD PRACTICES & TRANSGENDER CHALLENGES
The report recommends adopting standard practices such as asking about sexual orientation and gender identity for every new resident during admissions to normalize and address the invisibility and health disparities faced by LGBTQ+ nursing home residents.
Challenges faced by transgender individuals, emphasize the importance of providing supportive care without causing unintentional outings, for example during bathing, which may potentially lead to microaggressions and psychological harm between the patient and nurse.
LEGAL ADVICE & DECISON-MAKING
In an interview, co-author Jennifer L. Carnahan emphasizes the significance of legal advice for LGBTQ+ nursing home residents in assigning legal authority for healthcare decisions. LGBTQ+ individuals, often estranged from biological families, may have chosen families, making it essential to designate a trusted surrogate to make medical decisions.
PERSISTENT CONCERNS & THE NEED FOR CHANGE
While progress has been made, the article highlights the persistent fear among LGBTQ+ older adults of neglect, abuse, refusal of services, harassment, and being forced back into the closet when considering entering nursing homes. The report cites a 2018 AARP survey reflecting these concerns.
FOSTERING INCLUSIVE ENVIRONMENTS FOR LGBTQ+ NURSING HOME RESIDENTS
In conclusion, the article recommends widespread adoption of LGBTQ+ supportive credentials, such as those advocated in the SAGECare program. Training staff on LGBTQ+ competency issues is crucial for fostering inclusive and welcoming environments in nursing homes, ensuring that every LGBTQ+ resident can age with dignity and respect.
This blog post is based on the article “Postacute Care and Long-Term Care for LGBTQ+ Older Adults” published in Clinics In Geriatric Medicine by Jennifer L. Carnahan and Andrew C. Picket.
