Why Senior Living Operators Must Do More to Win Over LGBTQ Older Adults

Senior living operators have an opportunity – and a societal obligation – to offer the kind of lifestyle and healthcare options that gay and trans older adults want.

The rise of older adults in the LGBTQ demographic is “exploding,” and senior living providers must take note by updating care, lifestyle, and wellness offerings, Hinshaw and Culbertson Partner David Alfini said during a webinar this week.

According to recent data from nonprofit Services and Advocacy for LGBTQ+ Elders (SAGE), by 2030, there could be up to 7 million LGBTQ people over the age of 50 living in the U.S. At the same time, older adults in that group are less likely to have support from caregivers, which could impact health outcomes, leading to healthcare inequities.

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Since 2023, SAGE and the Human Rights Campaign noted 200 communities in 34 states that are affirming of LGBTQ older adults, based on various metrics. But that still leaves a wide swath of the industry that could do better.

“This presents a great opportunity for senior living,” Alfini said. “This is a new demographic, a new consumer, and a new possibility of residents. However, this demographic is new to senior living, and providers are not always confident in addressing their needs at this point in time.”

Meeting needs and lifestyles

Alfini cited the cultural events an LGBTQ person born in 1959, now 65 years old, lived through as critical context for senior living operators to understand the lived experience of gay and trans older adults.

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He referenced the 1969 Stonewall riots and the 1973 action by the American Psychiatric Association removing homosexuality as a mental disorder, to the legalization of same-sex marriage in all 50 states in 2015.

“This is someone who has faced institutionalized discrimination regarding healthcare, legal status, employment, housing, and most of their young and adult life,” Alfini said. “Everyone has had different experiences, but generally, there’s a sense of vulnerability and discrimination by authority figures and institutions—that is a historic experience for many in the LGBTQ community.”

In recent years, some senior living operators have taken small steps toward LGBTQ inclusion, including incorporating gender identity and sexual orientation into discrimination policies. From mixed-use developments marketed toward LGBTQ older adults to operators capitalizing on creating affinity communities, some senior living providers have tried to tap into the growing demographic of LGBTQ individuals considering senior living.

Between 2021 and 2023, 65% more senior living operators reported having a nondiscrimination policy that includes both gender and orientation-specific language, according to the 2023 Long Term Care Equality Index.

But there is much more ground to cover ahead. Gay and trans older adults can face increased stigmatization, isolation, and a lack of identity-affirming care, which can lead to chronic stress and isolation, according to SAGE.

If operators want to welcome them into their communities in the future, they will need to make sure they feel not only safe, but included and welcome.

Operators can start by taking simple steps to help combat loneliness and isolation, like asking about and using a resident’s correct pronouns, connecting with residents to learn about health needs and lifestyle activities, said Westmont of Carmel Valley Executive Director Chad Boeddeker. It’s also key for operators to understand that some LGBTQ older adults have a “chosen family” due to interpersonal and discriminatory conflicts with relatives, Alfini added.

It’s important for operators to do more than lip service or basic affirmation. They must also understand the human behind their residents, and get to know their hobbies, lifestyles, and culture to truly create an inclusive senior living environment, Boeddeker said.

“As we all age, values change, attitudes change, so we want to make sure that we address all of those things when speaking with and catering to LGBTQ elders,” Boeddeker added.

He noted that while some operators take actions to support LGBTQ residents, it does not truly support their needs and wants. And merely participating in Pride each year doesn’t necessarily mean operators have “a sense of what your potential resident needs,” he said.

At the community in San Diego where he works as executive director, Boeddeker said staff receive annual training and organize events with local LGBTQ support organizations. While community conversations regarding gender, gay and trans rights may require operators to get out of their comfort zones, doing so is required if they hope to attract and adequately house those residents in the future, Alfini said.

He noted a past meeting at a senior living community on transgender rights where residents had “light bulb moments” of understanding that can build meaningful relationships between residents and staff. Those could be as simple as residents and staff, alongside LGBTQ residents participating in Mother’s Day, Father’s Day and other celebrations, regardless of gender identity and sexual orientation.

“It’s recognizing everybody, and people learn from those things,” Boeddeker said of creating a safe and welcoming environment for all people.

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