Helping the LGBT Community in Their Home

Helping the LGBT Community in Their Home

For too many of the estimated 3 million lesbian, gay, bisexual and transgender Americans aged 55 and older, fear of stigma and judgment creates barriers to health care. At the same time, these individuals face greater health risks as they age, according to SAGE (Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders). Older LGBT Americans are also more likely than their non-LGBT peers to feel vulnerable and isolated.

The home care industry is ideally positioned to bridge this gap in care for older LGBT adults. We are committed to helping vulnerable, isolated people remain safe, connected and on the path to health in the place most Americans say they want to grow old: at home. We also care for people in the midst of their day-to-day lives — in their homes, rather than in a doctors’ office or hospital — and attend to more than just physical symptoms. In doing so, we know that we are first and foremost guests in our clients’ homes. Their rules are our rules, and their cultural and personal customs are ones that we follow without question or judgment. This includes being respectful and understanding of their sexual orientation and/or gender identification.

No group of home care providers plays a more important role in upholding that trust than home health aides (HHAs). These dedicated paraprofessionals are, in many ways, the front line of care for their clients. They help with activities of daily living such as cooking, dressing, laundry, toileting and bathing — work that is deeply personal and must be delivered with compassion and without judgment. I remember, for example, hearing a story about a man recovering from knee surgery who was assigned a home health aide from a local agency. The aide was subpar in many ways, but one thing the client was particularly bothered by was the fact that the aide made suggestive comments about women — assuming the client was heterosexual. He was not, but now, in the sanctity of his own home, he was afraid as a result of these comments that if he revealed his sexual orientation the HHA would become hostile.

To ensure that members of the LGBT community feel secure in their home and in their care, my organization, Partners in Care, teamed with the SAGECare educational initiative to bring special training to our nearly 9,000 home health aides, as well as our nurses and other staff, making sure the entire team understands cultural issues, sensitivities and best practices around sexual orientation and gender identification, particularly for older New Yorkers. Among other guidelines, the training emphasizes the importance of approaching each person in a nonjudgmental fashion, using respectful language, and never making assumptions about anyone’s sexual orientation or family structure.

As part of training, Home Health Aides need to learn to pay special attention to and adopt the words that our LGBT clients use. If clients refer to the person they live with as their roommate, we honor that term. Similarly, if they use the term partner or spouse, so, too, do we. Speaking a “common language” in this way helps put our clients at ease and helps us have more authentic, productive conversations. We want our clients to feel free and safe to be open about their sexual orientation and gender identity with their home care team. At the same time, we also fully respect our clients’ desire to keep their sexual orientation and/or gender identity private.

As with so many challenges in health care today, helping older LGBT adults age with grace and dignity depends on forging partnerships — in this case, with the excellent nationwide educational program SAGECare. 

This is a vitally important message: It means that across the continuum of home health care, and as an individual ages, members of the LGBT community can welcome healthcare providers into their homes without hesitation — secure in the knowledge that those caring for them will identify and deliver the right care with compassion, dignity and respect.

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