Senior Living and Social Services LGBTQ+ Equity and Inclusivity

Risk, Senior Living & Social Services

Senior living and social services organizations are doing great things to live their mission of uplifting and honoring and celebrating the diversity & inclusivity of individuals who are a part of the LGBTQ+ community. While it is important to create a safe culture and support for employees, organizations must also remember to ensure that the residents and clients they serve require just as much support.

An estimated 1.1 million adults aged 65 and older in the United States identify as LGBTQ+. Many who identify as LGBTQ+ have experienced social stigma, discrimination, and trauma their entire lives. Those who identify as LGBTQ+ are five times less likely to access care and social services supports.

Organizations should review both state and federal laws which uphold rights to individuals based on sexual orientation and/or gender identity. In addition, senior living and social services organizations should take the opportunity to review current policies and practices to ensure that they not only meet the current state and federal laws, but to ensure the culture of safety and equity is at the forefront of their communities.

Fair Housing Act Considerations

According to an Equal Rights Center report, 48% of older same-sex couples have experienced discrimination while applying for elder housing. Consider reviewing the marketing materials and intake forms that your organization uses. Does your advertising include same-sex couples? Does the language on the intake form only refer to male and female genders or married vs. single language? Many older adults in the LGTBQ+ community may have a significant other or partner and may not be legally married.

Affordable Care Act Considerations

Under the Affordable Care Act Section 1557, health care organizations such as skilled nursing facilities, assisted living facilities, group homes, and social services organizations who receive federal funds (Medicare or Medicaid) are prohibited from discrimination against individuals based on race, color, national origin, age, disability or sex – this is interpreted to include discrimination against gender identity and sexual orientation.

Abuse and Neglect Policy

It is important to review your organization’s Abuse and Neglect policies and procedures to ensure that language includes prohibition of abuse or neglect of any kind towards all residents or clients, which include members of the LGBTQ+ community. Abuse and Neglect policies should include verbiage that residents will not be abused or neglected based on race, religion, gender/gender identity, and sexual orientation. There should be open communication to residents in the LGBTQ+ community and their responsible parties as to where they can report abuse and neglect without fear of retaliation.

Non-Discrimination Policy

Many states have started passing legislation to include specific protections for LGBTQ+ residents and requiring that organizations update their policies for protections. Organizations can still put protections in place within their communities, even if their states have not passed legislation. Examples would be to include language such as “gender identity or gender expression” and “sexual orientation” in your policies.

Broadly communicating the culture of non-discrimination to staff, visitors, volunteers, residents/clients, and potential residents/clients is also a big step to foster the culture of inclusivity and safety. Posting the Resident Non-Discrimination policies in public spaces within buildings and advertisements allow for those in the LGBTQ+ community looking for housing and care to make informed choices. If there is any report of discrimination or harassment, the organization should take the necessary steps of reporting these instances of discrimination and harassment to leadership and investigate immediately.

Staff/Volunteer & Resident Training

Organizations should also review and update training to go beyond training on Abuse, Neglect, and Non-Discrimination, but also provide emphasis on Cultural Competencies to better understand the LGBTQ+ community. Organizations should consider reaching out to local LGBTQ+ support groups and community organizations to develop training and invite these groups to assist with the in-person trainings. Staff/Volunteer training on policies and cultural competency should be routinely completed upon hire, annually, and as needed throughout the year.

Resident training through groups such as the Resident Council is also vital to creating a culture of safety. Many residents share living spaces (i.e., rooms, apartments, shared bathrooms) – it is important to ensure that a culture of safety and non-discriminatory behavior is also fostered amongst resident populations. Education provided to residents should be included on the abuse and neglect policies, non-discrimination policies, and resident rights especially as it pertains to the rights of the LGBTQ+ community. These topics of education should also be routinely covered annually and more often as needed.

Family councils and family organizations should also be invited to education opportunities to learn about how the senior living or social services organization serves the LGBTQ+ community. Inviting LGBTQ+ resource groups from the community to speak to resident and family councils also furthers the culture of inclusion. Making efforts to include celebrations or activities on the activity calendars surrounding LGBTQ+ activities will also allow a resident to feel welcome. Residents who have not yet openly identified as LGBTQ+ may also feel more comfortable communicating with staff and volunteers if there is visible, active support built into the senior living or long-term care setting.

Many residents who openly identify as being in the LGBTQ+ community have not always had family and friend support or even medical care supports due to their gender identity or sexual orientation. It is important that staff continue to assess each resident individually and include the resident in the development of the plan of care.

Organizations should make strong efforts to assist LGBTQ+ residents with accessing health care services and providers that can meet their physical and psychosocial needs. This can be achieved by working with the facility Medical Director or local health system to find primary care that is accepting of the LGBTQ+ community. Addressing a resident’s psychosocial needs can be achieved by offering support services through psychology or therapy providers as well as engaging and inviting in local community LGBTQ+ support groups.


Several national organizations founded to support the LGBTQ+ community often provide excellent training resources and local state advocacy groups that can be used to assist your organization with supporting LGBTQ+ residents.


The LEI is a joint project between SAGE and the Human Rights Campaign Foundation.  The LEI is designed to promote equitable and inclusive care for the LGBTQ+ older adults residing in residential senior living and long-term care settings.  Senior Living organizations who are committed to serving the LGBTQ+ community in a safe and equitable manner can pledge to be part of the LEI.  The LEI provides organizations with self-assessments and tools.


SAGE serves as an advocacy organization for LGBTQ+ elders.  This organization provides an array of resources and training for senior living and social services organizations to access for staff and residents.


The Movement Advancement Project (MAP) tracks over 50 LGBTQ-related policies and laws by state.  Review your state laws and policies here to ensure your policies are aligned.

Key Takeaways:

Senior living and social services organizations would be well-served to review current policies and practices to ensure that they not only meet the current state and federal laws, but to make sure the culture of safety and equity is at the forefront of their communities. For additional guidance, reach out to your M3 account executive.

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