Policy recommendations to increase lesbian, gay, bisexual and transgender inclusiveness among Massachusetts assisted living communities

Abstract

There is fear among LGBT aging adults that moving into an assisted living community will require them to hide their sexual orientation or gender identity.LGBT aging adults fear assisted living communities will not offer an inclusive environment that would make them feel safe and accepted. Research literature suggests several factors that have the potential to increase safe and welcoming environments for LGBT aging adults. Of those factors, creating cultural competency through education and training within an assisted living community was paramount.However, there is a knowledge gap of what best practices an assisted living community could implement in order to increase inclusiveness of LGBT aging adults. Using a multiple case study approach, this study examined three assisted living communities, including one LGBT-specific community to identify best practices.The results presented in this study revealed that the non-LGBT specific traditional assisted living communities were less prepared to care for the LGBT aging population. This claim is evident through four main themes that emerged from the interviews with staff of these two assisted living communities. The themes identified suggested a lack of awareness of LGBT challenges and a lack of knowledge in methods to increase understanding of cultural competency. Also demonstrated was an absence of understanding of the protection of LGBT aging adults and participants were unable to articulate the factors that create inclusiveness. TheLGBT-specific community was more prepared to care for the LGBT aging population and staff displayed an awareness of challenges faced by LGBT aging adults. While the community was able to articulate factors that increase understanding, there was a lack of formalized education and training programs to achieve this. Staff reported their community was inclusive due to their status of being an LGBT-specific community.

Access to Long-Term Care for Minority Populations: A Systematic Review

“…We screened 191 studies at the full-text stage and selected 59 studies for inclusion. Of the 60 studies, 42 were conducted in the United States (Ahmed, Ali, Lefante, Mullick, & Kinney, 2006;Ahmed, Allman, & DeLong, 2003;Akamigbo, 2007;Akamigbo & Wolinsky, 2006Andel, Hyer, & Slack, 2007;Angel, Angel, Aranda, & Miles, 2004;Angel, Douglas, & Angel, 2003;Angelelli, Grabowski, & Mor, 2006;Aykan, 2002;Baxter, Bryant, Scarbro, & Shetterly, 2001;Berridge & Mor, 2017;Cai, Salmon, & Rodgers, 2009;Duffy, Jackson, Schim, Ronis, & Fowler, 2006;Feng, Fennell, Tyler, Clark, & Mor, 2011;Friedman, Steinwachs, Rathouz, Burton, & Mukamel, 2005;Gandhi, Lim, Davis, & Chen, 2017;Gaugler, Kane, Kane, & Newcomer, 2006;Gaugler, Leach, Clay, & Newcomer, 2004;Goodwin, Howrey, Zhang, & Kuo, 2011;Harris, 2007;Harris & Cooper, 2006;Iwasaki, Pierson, Madison, & McCurry, 2016;Jackson, Johnson, & Roberts, 2008;Jang, Kim, Chiriboga, & Cho, 2008;Kersting, 2001a,b;Liu, Wissoker, & Swett, 2007;McCormick et al, 2002;McLaughlin, Elahi, Ciesielski, & Pomerantz, 2016;Miller, Schneider, & Rosenheck, 2011;Min, 2005;Putney, Keary, Hebert, Krinsky, & Halmo, 2018;Quigley, 2017;Riley, 2019;…”

“…We screened 191 studies at the full-text stage and selected 59 studies for inclusion. Of the 60 studies, 42 were conducted in the United States (Ahmed, Ali, Lefante, Mullick, & Kinney, 2006; Ahmed, Allman, & DeLong, 2003; Akamigbo, 2007; Akamigbo & Wolinsky, 2006, 2007; Andel, Hyer, & Slack, 2007; Angel, Angel, Aranda, & Miles, 2004; Angel, Douglas, & Angel, 2003; Angelelli, Grabowski, & Mor, 2006; Aykan, 2002; Baxter, Bryant, Scarbro, & Shetterly, 2001; Berridge & Mor, 2017; Cai, Salmon, & Rodgers, 2009; Duffy, Jackson, Schim, Ronis, & Fowler, 2006; Feng, Fennell, Tyler, Clark, & Mor, 2011; Friedman, Steinwachs, Rathouz, Burton, & Mukamel, 2005; Gandhi, Lim, Davis, & Chen, 2017; Gaugler, Kane, Kane, & Newcomer, 2006; Gaugler, Leach, Clay, & Newcomer, 2004; Goodwin, Howrey, Zhang, & Kuo, 2011; Harris, 2007; Harris & Cooper, 2006; Iwasaki, Pierson, Madison, & McCurry, 2016; Jackson, Johnson, & Roberts, 2008; Jang, Kim, Chiriboga, & Cho, 2008; Kersting, 2001a,b; Liu, Wissoker, & Swett, 2007; McCormick et al, 2002; McLaughlin, Elahi, Ciesielski, & Pomerantz, 2016; Miller, Schneider, & Rosenheck, 2011; Min, 2005; Putney, Keary, Hebert, Krinsky, & Halmo, 2018; Quigley, 2017; Riley, 2019; Rodriguez, 2004; Sharma, 2017; Spillman & Long, 2009; Stein, Beckerman, & Sherman, 2010; Stevens et al, 2004; Temple, Andel, & Dobbs, 2010; Yaffe et al, 2002), seven in Canada (Brotman, Ryan, & Cormier, 2003; Forgues, Doucet, & Noël, 2011; Gui & Koropeckyj-Cox, 2016; Kortes-Miller, Boulé, Wilson, & Stinchcombe, 2018; Lai, 2004; Metz, 2007; Qureshi et al, 2021), three in Norway (Arora, Rechel, Bergland, Straiton, & Debesay, 2020; Czapka & Sagbakken, 2020; Hanssen & Tran, 2018), two in Australia (Basic, Shanley, & Gonzales, 2017; Waling et al, 2019), two in Sweden (Heikkilä & Ekman, 2003; Innes, 2020), and one each in Belgium (Ahaddour, van den Branden, & Broeckaert, 2016…”

“…Of the 60 studies, 33 studies were rated as being of excellent quality (Akamigbo, 2007;Akamigbo & Wolinsky, 2006Arora et al, 2020;Basic et al, 2017;Berridge & Mor, 2017;Brotman et al, 2003;Cai et al, 2009;Chui et al, 2019;Chung et al, 2008;Czapka & Sagbakken, 2020;Friedman et al, 2005;Gandhi et al, 2017;Gaugler et al, 2006;Gui & Koropeckyj-Cox, 2016;Harris, 2007;Harris & Cooper, 2006;Heikkilä & Ekman, 2003;Liu et al, 2007;McCormick et al, 2002;Metz, 2007;Miller et al, 2011;Min, 2005;Putney et al, 2018;Quigley, 2017;Qureshi et al, 2021;Riley, 2019;Rodriguez, 2004;Sharma, 2017;Spillman & Long, 2009;Stein et al, 2010;Stevens et al, 2004;Yaffe et al, 2002), 22 were rated good quality (Ahmed et al, 2003(Ahmed et al, , 2006Andel et al, 2007;Angel et al, 2003Angel et al, , 2004Aykan, 2002;Forgues et al, 2011;Gaugler et al, 2004;Goodwin et al, 2011;…”

“…Twenty-seven studies evaluated expectations and preferences of different populations with regards to future long-term care placement (Table 3) (Ahaddour et al, 2016;Akamigbo & Wolinsky, 2006;Arora et al, 2020;Chui et al, 2019;Chung et al, 2008;Czapka & Sagbakken, 2020;Duffy et al, 2006;Forgues et al, 2011;Gui & Koropeckyj-Cox, 2016;Hanssen & Tran, 2018;Heikkilä & Ekman, 2003;Herat-Gunaratne et al, 2020;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;Kortes-Miller et al, 2018;Lai, 2004;McCormick et al, 2002;McLaughlin et al, 2016;Metz, 2007;Min, 2005;Putney et al, 2018;Quigley, 2017;Rodriguez, 2004;Stein et al, 2010;Travers et al, 2020;Waling et al, 2019). Fourteen studies were conducted in the United States (Akamigbo & Wolinsky, 2006;Duffy et al, 2006;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;McCormick et al, 2002;McLaughlin et al, 2016;Min, 2005;Putney et al, 2018;Quigley, 2017;Riley, 2019;…”

“…Fourteen studies were conducted in the United States (Akamigbo & Wolinsky, 2006;Duffy et al, 2006;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;McCormick et al, 2002;McLaughlin et al, 2016;Min, 2005;Putney et al, 2018;Quigley, 2017;Riley, 2019;Rodriguez, 2004;Stein et al, 2010;Travers et al, 2020), six in Canada (Brotman et al, 2003;Forgues et al, 2011;Gui & Koropeckyj-Cox, 2016;Kortes-Miller et al, 2018;Lai, 2004;Metz, 2007), three in Norway (Arora et al, 2020;Czapka & Sagbakken, 2020;Hanssen & Tran, 2018) and one each in Australia (Waling et al, 2019), Belgium (Ahaddour et al, 2016), Hong Kong (Chui et al, 2019), Sweden (Heikkilä & Ekman, 2003), Taiwan (Chung et al, 2008), and the United Kingdom, England (Herat-Gunaratne et al, 2020). Eleven studies used quantitative analyses (i.e., surveys or questionnaires) (Akamigbo & Wolinsky, 2006;Chung et al, 2008;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;Kortes-Miller et al, 2018;Lai, 2004;McCormick et al, 2002;McLaughlin et al, 2016;…”