LGBTQ Older Adults in Long-Term Care Settings: An Integrative Review to Inform Best Practices

ABSTRACT

Objectives

To synthesize literature about lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults in long-term care (LTC) facilities and provide recommendations for best practice guideline development to inform practice, research, and policy.

Methods:

Four electronic databases were searched in June 2019 for studies conducted between 2000– 2019 related to caring for LGBTQ older adults in LTC settings. An integrative literature review was conducted on the twenty eligible studies.

Results

LGBTQ participants fear discrimination in LTC settings leading to the invisibility of their identities. They recognize a need for increased staff training and the importance of community networks and facility preferences. LTC staff have mixed experiences with inclusive practices and complex views of LGBTQ older adults. LTC staff experience training deficits and require more expansive modalities.

Conclusions

LGBTQ participants and LTC staff both advise that LTC facilities revise forms and policies to ensure all sexual orientations and gender identities are affirmed and protected in addition to providing widespread training.

Clinical Implications

This review calls to attention the need for LTC settings to uniformly follow best-practices. Clinical recommendations to promote equitable healthcare include: staff training at all levels and communication that does not assume heterosexuality or cisgender identity.

KEYWORDS:

• Aging
• older adults
• international aging
• elderly
• gay
• lesbian
• bisexual and transgender
• LGBT
• sexuality
• long term care
• residential care
• evidence-based practice

Clinical implications

• Staff training is integral to improving the care of LGBTQ older adults in LTC settings and should be required for staff at all levels of the organization.

• Communication practices within LTC settings that do not assume heterosexuality or cisgender identity are important in affirming and protecting LGBTQ residents.

• LTC facilities should afford LGBTQ residents the ability to create, maintain, and safeguard their community networks and families-of-choice.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.