As we age, we encounter challenges of many kinds and for LGBT seniors, those challenges can be magnified.

All of us, as we get older; have to deal with the ramifications of not being able to take care of ourselves or our loved ones anymore. But lesbian, gay, bi and transgender seniors also have to deal with specific factors such as societal oppression, loss of family and isolation.

Coming out stories can be joyful or frightening.

Tales of family abandonment, persecution by religious groups and loss of home are still common today. But for our current LGBT elders, they had to face much more.

At one time, in both Canada and the U.S., homosexuality was considered criminal. People had to hide for fear that they would lose their jobs and homes and be ostracized from their communities. As it was considered a psychiatric disorder up until 1974, ‘treatments’ such as electroshock therapy were used.

Here in Canada we even had the ‘fruit machine,’ a test to determine homosexuality which was used in the 1950s and 60s to remove LGBT individuals from civil service, the RCMP, and the military.

With these past experiences, LGBT seniors are less likely to share pertinent information with their doctors and other medical professionals and are much more resistant to being placed in long-term care. In fact, research shows that LGBT seniors are five times less likely to use services such as long-term care when compared with their straight counterparts.

Further complicating matters these seniors were frequently ostracized from their families, cast out and left without a support network.

Stu Maddux, director of a film about LGBT seniors, notes that LGBT individuals are ‘much more adaptive. They are trained to gauge a situation and react silently.’ And as a result there is an element of fear within them when dealing with situations such as their own healthcare or that of a partner.

Maddux’ documentary, which focuses on LGBT elders in the US, notes that some care providers have tried to convert residents at bedside or avoided the subject completely. He notes that there is also much more resident on resident attacks, meaning that care facility staff has to be able to recognize the problems and provide assistance when needed.

As Maddux states so eloquently, “The bullies that are there at the beginning of life we found are there at the end of life too.”

For transgender (trans) individuals, the fears are even greater. Maddux notes that trans seniors have it much worse. Some have been denied housing, refused their hormone therapy treatments, and not allowed to live at a facility.

Most people transition (MTF, Male to Female or FTM, Female to Male) after they retire and are usually spurred by a life change. This usually brings with it substantial adversity and so the fear is that if they are unable to take care of themselves, will they be looked after by those who look down upon them.

A UK study on the treatment of LGBT elderly in nursing homes revealed some interesting information. The attitudes and opinions were mostly positive but the knowledge was not there. 78% of respondents in the study had no specific LGBT training.

As one of the researchers, Dr. Paul Simpson stated in an article in the “Most respondents reported: ‘We don’t have any LGBT people at the moment’ but that can’t be true. We’re not critical of care homes, as attitudes appear positive, but we do feel many may simply not be able to recognize people who are LBGT.” The conclusion was that there is an unintentional result which is to force residents back into the closet.

Equality does not mean sameness and by throwing the ‘we treat everyone the same’ blanket over the problem, it is not resolved and you are left with residents who do not feel comfortable in what is supposed to be their home.

There has been a move towards LBGT-specific housing for seniors. In Philadelphia in February, a housing development specifically for low-income LGBT seniors was opened, and while it’s a great idea, Maddux notes that it’s “absolutely impossible, as your readers know, to recreate the long-term care system for gay people.”

And therefore facilities must step up.

What are some of the ways care facilities should approach this issue? Toronto Long-Term Care Homes and Services put together a tool kit for facilities and LGBT seniors. They mention several areas in your facility that can be inclusive for everyone.

For example, are your programs and services able to meet the needs of LGBT residents? Are your anti-discrimination and anti-harassment policies cognizant of everyone in your community? Another area to focus on is within your human resources department. They recommend having a hiring policy that welcomes and promotes people from the LGBT communities so there is representation.

And it needs to be in your written and graphic materials as well. It’s not just enough to have it tucked away in your anti-discrimination policy. You need to aptly convey that you welcome all residents and have supports and programs in place for everyone.

Maddux notes that LGBT seniors want to know that a facility will be, “not just accepting, but fun and enjoyable and I’m going to be able to express myself.”

Even a simple pride flag sticker on the corner of your front door, indicates that your facility is a place of welcome.

One of the best strategies that both Maddux and the Toronto Long-Term Care Homes and Services suggests is to develop a Gay-Straight Alliance (GSA) within the home to benefit not only residents but family members, volunteers and staff. This can help with the development of programs and services as well as creating a safe space environment for issues such as gender identity, harassment, etc to be discussed. As per the LGBT Tool Kit, a GSA consists of ‘queer friendly, gay and straight individuals and/or group that consists of residents, family, partners, volunteers, staff, and community members.’

It also provides education to everyone in regards to LGBT-related issues.

Facilities can also provide LGBT training for staff so that everyone is aware of the concerns and issues that LGBT seniors face. Knowledge is always a good thing and helps to make your staff more comfortable. People can be hesitant for fear that they will do or say the wrong thing and training allays that concern.

This year, Toronto is the host of World Pride, a great opportunity to mark this important event is by working to improve the daily lives of your LGBT residents and staff.