An Examination of the Lesbian, Gay, Bisexual, and Transgender Friendly Designation Process From the Perspective of Assisted Living Facility Administrators

Lesbian, gay, bisexual, and transgender (LGBT) older adults have been recognized as a vulnerable minority population facing a lack of safe and welcoming senior housing, which is especially urgent for frail and disabled LGBT persons in need of residential long term care (LTC). LGBT older adults have described a safe and welcoming environment as a place where they feel acceptance and a sense of belonging. Senior housing is housing suitable for older adults, and ranges from independent living to 24-hour supervised care. Types of senior housing include adult family homes, assisted living, residential care, independent living, subsidized housing, skilled nursing facilities, and continuing care retirement communities. The urgency of the lack of residential LTC able to provide a safe and welcoming environment for LGBT older adults arises from the cumulative effects of lifelong discrimination that place LGBT older adults at greater risk of needing LTC. In support of Meyer's postulation of a minority stress model (2003), in which stigma acts as a chronic stressor, the stigmatization of LGBT individuals has contributed to significant health, financial, economic, and aging disparities. An aging LGBT population and the growing need for residential LTC such as assisted living facilities (ALFs) and skilled nursing facilities (SNFs) that LGBT older adults perceive as safe and welcoming is increasingly receiving attention. One strategy in response to the lack of safe and welcoming housing for LGBT older adults has been to plan and build affordable senior housing that caters to low-income LGBT older adults. However, the strategy of building subsidized senior housing that caters to LGBT older adults will not be able to accommodate the rising demand for a safe and welcoming environment from the growing number of LGBT older adults. More importantly, this strategy does not address the needs of a growing population of frail and disabled LGBT persons who are no longer able to live independently and require residential LTC. What has become clear is that the growing need for LTC facilities able to provide a safe and welcoming environment for LGBT residents must be met by existing LTC providers. Strategies to increase the availability of safe and welcoming housing for LGBT older adults must therefore take into consideration existing LTC facilities such as skilled nursing facilities (SNFs) and assisted living facilities (ALFs). Individuals and their families are increasingly turning toward ALFs as preferred LTC settings. This move toward ALFs for residential LTC is expected to continue. Thus more attention is warranted toward strategies for creating safe and welcoming environments for LGBT residents in ALFs. Therefore, the purpose of this research project is to learn from administrators of ALFs that have undergone a review process and been identified as LGBT friendly about the motivators, facilitators, challenges, and sustainability issues involved in creating a safe and welcoming environment for LGBT residents. An inquiry into the experiences involved in an LGBT friendly designation process from the perspective of ALF administrators could serve as a valuable resource and guide for LTC providers and for LGBT organizations working in partnership with LTC providers