LGBTQ+ individuals may be more likely to need long term care as they age, but also face increased risk of discrimination, according to a review article from the Regenstrief Institute.
Jennifer Carnahan, a researcher with the Regenstrief Institute on Aging and co-author of the article, looked at studies and information gathered on long term care for sexual and gender minorities.
Factors that influence care
She said several factors influence someone’s likelihood to need long term care, including economic limitations.
At least a third of LGBTQ+ older adults report an annual income less than 200 percent below the poverty level– about $29,000, according to study published in American Journal of Public Health. This means some people might delay healthcare needs until they cause significant impairment to physical functions.
“A lot of a lot of older adults, the way that they are able to age in place at home is they access home health aides, who help to support some of their instrumental activities of daily living," Carnahan said. "If you can address that early on, you can address function early on, then then people are able to age in place.”
Carnahan added limited support systems are also a factor that increases someone's likelihood for long term care.
The American Journal of Public Health study said older lesbian, gay and bisexual adults are less likely to be married, less likely to have children and more likely to experience conflict with their family of origin.
More sexual and gender minority people anticipate need for long term care in the future compared with heterosexual individuals, according to the study.
Needs to address include more research, better data
These gaps in support are accompanied by gaps in data, according to Carnahan. Most research with Medicare data doesn’t ask gender identity or sexual orientation questions.
“When you go to those data sets, you're unable to find out who they are," she said. "And I do think that that does a disservice to those patients.”
Carnahan hoped to focus on nursing homes in the United States in her article for Regenstrief, but had to expand out and look at information collected in Canada and the United Kingdom. And she also had to include research done with assisted living facilities, because so little research is available.
The article said nursing home leadership should set aside protected time for staff to receive training on care for LGBTQ+ elders.
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Carnahan said everyone should be asked gender identity or sexual orientation identifier questions, to normalize the collection of data and avoid stigmatizing individuals.
