An activist educates senior care staff about welcoming LGBTQ+ elders

Older LGBTQ+ adults make up one of the fastest-growing segments of the U.S. population 55 and up. How to care for their specific needs is essential to ensuring their well-being as they age in place at home, in retirement communities, and in nursing facilities across the country.

Tim R. Johnston is the author of a tutorial on the subject called “Welcoming LGBT Residents: A Practical Guide for Senior Living Staff,” aimed at staff or facilities caring for aging LGBTQ+ adults. The licensed social worker is an author and activist dedicated to elder justice, with a specific focus on aging LGBTQ+ adults.

Related:

This gay man’s job is to recruit blood donors. New FDA rules mean he can finally donate himself

Tom King just wanted to help people, but his long-term monogamous relationship with another man prevented him from doing so for years.

Johnston took time out from presentations of his work at senior care facilities to answer questions about the book and the state of care for older LGBTQ+ Americans in 2023.

Never Miss a Beat

Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights.

Daily

Weekly

Good News

LGBTQ NATION: Describe the kind of person you wrote the tutorial for.

Tim Johnston: The audience is anyone who works with older people in a resident setting. That could be a retirement community, assisted living, skilled nursing, or even in some rehabilitation and hospital settings. That said, the book has useful information and suggestions for anyone working with LGBTQ+ older people, so I hope that professionals in other fields, as well as general readers interested in LGBTQ+ information, will find it useful. 

LGBTQ NATION: What’s the most common misperception about LGBTQ+ older adults among senior living staff?

TJ: The most general misperception is that things are much better today, so people don’t have a reason to be cautious or fearful about sharing their identity. It’s important to remember that we all carry our history with us into every interaction, and for many LGBTQ+ folks, that can be years of being guarded and protective as a matter of safety for themselves and their loved ones. 

Another misperception is that you can “tell” if someone is LGBTQ+. That idea is often based on stereotypes and does not take into account that many people are very skilled at hiding their LGBTQ+ identity. 

LGBTQ NATION: What are some of the biases that senior living staff bring to their interactions with LGBTQ+ residents? Are some staff, because of religious reasons or other beliefs, just not qualified to work with LGBTQ+ older adults?

TJ: We all make assumptions about other people, and I see folks assuming that their residents are not LGBTQ+. For example, asking a male resident if he has a wife or making assumptions about someone’s gender identity or pronouns. Catching ourselves before we make those assumptions is an important part of the work. 

I have worked with many deeply religious providers who deliver excellent and compassionate care to their LGBTQ+ clients. For me, the question is whether or not someone can affirm a person for who they are and treat them with respect and person-centered care. 

LGBTQ NATION: What are some examples of things that staff should be sensitive to with LGBTQ+ residents, that they may not be aware of before reading your book?

TJ: Many people respond by saying, “Wow! I never even thought about LGBTQ+ people getting older!”

In addition to this general awareness and knowledge building, I think it’s important to gain the skills that will let you see each resident in their uniqueness. The book contains a lot of general information about different members of the LGBTQ+ community, but the ultimate goal is to give people the information and skills that they need to connect authentically.

In terms of specific sensitivities, it’s important to not make assumptions, to have a sense of which terms are OK and which are disrespectful, to ask open-ended questions, and to remember that each person’s personal history impacts how comfortable they are sharing and connecting.  

LGBTQ NATION: What are some of the fears that LGBTQ+ adults experience when moving into senior living, and how can senior staff help residents overcome them?

TJ: Common fears are needing to go back into the closet, being bullied or excluded, being physically or verbally attacked, or being afraid they’ll receive poor care. Staff training is essential to prevent these things from happening: clear and consistent messaging that LGBTQ+ people are welcome in the community and that any hurtful or discriminatory behavior will be taken seriously and addressed quickly. 

LGBTQ NATION: What are some examples of bullying and conflict between straight/cis and LGBTQ+ residents that you’re aware of, and what are the keys to that kind of conflict resolution?

TJ: It could be anything from physical or verbal violence on one extreme, all the way to creating a chilly or unwelcoming atmosphere that negatively impacts the resident on the other extreme. Effective conflict resolution involves making expectations clear so that everyone knows what is and is not acceptable. And also addressing the deeper roots of the conflict. Lots of bullying or hurtful behavior is rooted in something else, like fear, anxiety, a desire for control — all things that need to be addressed to get at the root of the hurtful behaviors.  

LGBTQ NATION: What kind of LGBTQ+ programming is appropriate in a setting with both straight/cis and LGBTQ+ residents?

TJ: I suggest two approaches: providing LGBTQ+ versions of popular programming (for example a Pride Month Bingo), and also creating programming specifically about LGBTQ+ topics, like an educational session or discussion. The key is to provide engaging and popular activities that are open to all residents and to start a conversation.  

LGBTQ NATION: How do you approach the subject of sexuality and sexual health of LGBTQ+ residents with senior living staff? What are the differences vs. addressing straight/cis sexuality and sexual health?

TJ: The main difference is that LGBTQ+ people may be prevented from expressing their sexuality, or judged more harshly for doing so. For example, a different-sex couple is allowed to have private space and time together, but a same-sex couple may not be.

LGBTQ NATION: How would you assess the quality of senior LGBTQ+ resident care today and how does it compare with care in the past? What do you attribute the change to?

TJ: There is much more awareness about LGBTQ+ inclusion than when I started this work a decade ago. This is due to the tireless activists who have been working on this for decades, as well as the family members, allies and staff who push for positive change.

Don't forget to share: