Aging LGBTQ individuals face unique challenges when it comes to accessing healthcare. They often must decide whether or not to “come out” to providers, worry over providers’ reactions to their identities and/or orientations, experience substandard levels of care, struggle with adequate insurance coverage, and face difficulties finding inclusive resources. Such concerns may be heightened due to recent news coverage of LGBTQ individuals being denied access to care. In January 2019, for example, a federal judge dismissed the lawsuit filed on behalf of an older lesbian couple who were denied admission to a senior living facility (Friendship Village Sunset Hill, St. Louis, Missouri) on the grounds that their 10-year long marriage did not count as a “biblical marriage.”
LGBTQ individuals and communities, however, have long been resilient and resourceful in the face of difficulties. Their successes lead to empowerment and solutions. Below you will find three key areas of concern that often affect LGBTQ seniors along with concrete steps on how to address them.
1.) How to Find LGBTQ-Inclusive Services
Every individual deserves care that is centered on respect and affirmation. Here are some ways to get what you deserve.
- Ask your trusted healthcare provider for a referral. You can also contact your local LGBTQ community center for referrals. Find a center near you at https://www.lgbtcenters.org/.
- Search for advertisements in local LGBTQ newspapers and magazines placed by service providers.
- Review the pamphlets and websites of prospective providers and facilities for inclusive language and imaging. For example, look to see if they use the terms “partner” or “significant other.” Are images of LGBTQ individuals included in their marketing materials?
- Check the SAGECare website for agencies that have received the SAGECare Credential for completing training in culturally competent care for LGBTQ communities: https://sageusa.care/.
- Last but not least, ask prospective providers, facility staff, and caregivers directly if they have experience working with LGBTQ clients.
2.) How to Advocate for Yourself or a Loved One
- Advocacy is needed anytime you access care services, but can be vital if you feel unsatisfied with your experience. For instance, perhaps you feel that a provider is not thorough, rushes through your scheduled time, communicates poorly, fails to make you a top priority, or uses jargon you find confusing. Don’t sit back. Take control and advocate for high-quality care using the steps below.
- Have an open conversation with your provider or caregiver about the kind of care that you want at your first or next appointment. Let them know that you want to be able to ask questions and voice concerns when you have them.
- If you decide that you want to inform this person of your gender identity or sexual orientation, then also let them know of any relevant wishes or concerns you may have, such as a pronoun preference or privacy concern, for example.
- Come prepared to all appointments and meetings with a list of current medications, relevant health records, and insurance information.
- Bring a list of questions and concerns that you want answered that day. This way you don’t need to worry about feeling overwhelmed on the spot.
- Make sure you can access all of your labs, testing, and visit summaries. EMR systems (i.e. electronic medical records) can be helpful in this regard, but don’t hesitate to ask for copies printed on paper if you want them.
- Ask questions if you don’t understand any information on your records or any verbal explanations made by your providers.
- Be proactive. Let’s say, for example, you know continuity of care will be important for you down line as you need to keep medications filled while transitioning into new living situations. Talk to your providers about this ahead of time.
- Take a loved one or friend with you. It is always a big help to have an extra set of eyes and ears as there is a lot to process. This way you have support, too, if you feel something isn’t quite right.
3.) How to Maintain Your Privacy
Confidentiality is a major area of concern for many LGBTQ individuals, as they may not wish to be “outed” within the healthcare system. Likewise, they may not want the details of their care shared amongst providers, caregivers, or their families. All clients and patients have a right to privacy when it comes to their personal medical information according to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
- Advocate for yourself by openly communicating any concerns you have regarding confidentiality up front.
- Sign a HIPAA Acknowledgment and HIPAA Authorization form, both of which can be obtained from your providers. The former indicates your and the provider’s understanding of privacy law while the latter allows your medical information to be shared with only those individuals and/or organizations you specify.
- Request that you receive your own copy of any records that will be shared.
- Keep important health documents in order, including a Do Not Resuscitate Order (DNR), Practitioner Orders for Life Sustaining Treatment (POLST), and Power of Attorney (POA). This way your preferences will be known in the event of an emergency.
- If you believe your information has not been protected, it is your right to file a complaint with the US Department of Health and Human Services: https://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html.
Denver Senior Care consultants can help you or your loved one find LGBTQ-inclusive services in the Denver metro area, act as your trusted advocate when communicating with providers and caregivers, and guide you in matters of privacy regarding your medical information and living situations. They are committed to ongoing professional development in culturally competent care for LGBTQ seniors. Clarice Partee, Denver Senior Care Co-Founder and Consultant, recently completed inclusivity training on “Understanding LGBTQ Older Adults” credentialed by SAGE.
For more information online, visit the National Resource Center on LGBT Aging at https://www.lgbtagingcenter.org/.
Sarah Olivier, Ph.D., is a writer, editor, and educator working and living in Denver, CO. She is passionate about creating content that improves people’s lives.