It can be challenging to navigate the social services and medical care that we need at various stages of life. We have to find the right professionals who can effectively address our social, emotional, financial, and healthcare needs. As LGBTQ+ people, we face the added element of needing to pick providers who affirm our LGBTQ+ identities and who understand the needs of our communities.
Concerns around finding LGBTQ+ friendly professionals often create barriers to receiving the care and services that we need. Navigating the healthcare system, for example, can be complex enough even before adding in anti-LGBTQ bias. According to data from the 2020 Pennsylvania LGBTQ+ Health Needs Assessment, 39% of Pennsylvanians reported barriers to medical care due to a lack of LGBTQ-affirming providers or these providers being too far away or not covered by their insurance.
For LGBTQ+ older adults seeking services and support from the aging services network — a similarly complex system to navigate — the barriers to finding LGBTQ+ friendly providers lead many to forgo or delay seeking important services. In other cases, it may force LGBTQ+ people to conceal their identities out of fear of mistreatment and discrimination. Finding LGBTQ+ affirming services may feel like a daunting task if one is searching for services in a time of crisis or after a loss.
In Pennsylvania, the aging services network has made great strides over the past decade to improve the LGBTQ+ sensitivity of its services for older adults. While there are surely still organizations out there that have quite a way to go in their commitments to serving LGBTQ+ people, there are many agencies and professionals who have been putting in the work to more effectively serve LGBTQ+ elders. Unfortunately, the responsibility most often falls on the older adult seeking services to be the one trying to determine the LGBTQ-friendliness of a provider, organization, or facility.
So how do we find organizations that are culturally sensitive? LGBTQ-friendliness can be difficult to measure. What it means to be an inclusive agency is rather subjective and may look different from person to person. Still, there are some objective criteria that we can look for when evaluating options for care.
One approach is to find agencies whose staff have undergone LGBTQ+ cultural sensitivity training. Completing this type of training does not mean that everyone at the organization is suddenly an expert in LGBTQ+ care, but it does signal a commitment to serving LGBTQ+ people with dignity and respect. The organization SAGE is the preeminent training organization when it comes to LGBTQ+ aging issues. Organizations that complete the SAGECare training program are credentialed depending on the amount of training given to the agency, both in terms of the number of hours completed and percentage of staff trained.
Through the SAGECare website — www.sageusa.care — community members can search for senior centers, homecare agencies, nursing homes, senior housing communities, and long-term care facilities whose staff have received SAGE’s cultural sensitivity trainings.
There are a number of resources available when searching for medical providers who have training in LGBTQ+ care. Many of our large medical systems in the Philadelphia region have offices or initiatives to connect LGBTQ+ patients with affirming medical care, such as the Penn Medicine Program for LGBTQ Health, the Einstein Pride Program, Temple LGBTQ Health, and the Jefferson LGBTQ+ Health Program. When deciding on a medical facility, the Healthcare Equality Index (HEI) is another great resource. The HEI is a benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBTQ+ patients, visitors, and employees. Facilities are scored on a 0-100 scale. The HEI is searchable so one can view a facility’s scores before deciding where to receive their care.
There are efforts now underway to similarly vet long-term care facilities on their LGBTQ+ inclusivity. SAGE and the Human Rights Campaign launched the Long-Term Care Equality Index (LEI) in 2021 following the model of the HEI. The next edition of the LEI will be published this spring and for the first time will assign scores to participating facilities. Much like with the HEI, community members will be able to go to the LEI’s website to find how long-term care facilities rate in their staff training, organizational policies, and support to LGBTQ+ residents.
There has been progress in the ways that the healthcare system and the aging services network are improving in their ability to provide culturally sensitive and inclusive care to LGBTQ+ elders. Continuing to develop ways for community members to easily assess the LGBTQ+ cultural sensitivity of available services will help to ensure that all older adults can receive support and care that is inclusive and affirming of their identities.