October 4, 2023

Why a Family of Choice Is Important for LGBTQ+ Patients’ Health

About Brookdale Senior Living

It is estimated that 2.7 million older adults identify as LGBTQ+. Some believe that this figure should be doubled, as many do not disclose their identity due to social stigma and fear of discrimination. Tragically, this fear of discrimination extends to medical care. Many seniors are fearful of publicly identifying as LGBTQ+ and will therefore not disclose their identity to medical professionals. In fact, 40% of LGBTQ+ older adults say their healthcare providers don’t know their sexual orientation. A fear of self-disclosure can in turn, adversely impact their quality of care.

During its Optimum Life® Continuing Education Series, Brookdale talked with Dan Stewart, MSG, the Associate Director of the Aging Equality Project at the Human Rights Campaign Foundation (HRCF), about disparities in LGBTQ+ healthcare and how providers can better understand LGBTQ+ individuals’ network of support.

The HRCF is the educational arm of the country’s largest LGBTQ+ civil rights organization. Through programming across the country since 1984, the HRCF has worked toward building a country in which LGBTQ+ people can fully participate in the systems that shape their daily lives. It does so by developing an understanding of LGBTQ+ people and shaping the public debate through public education, research and resources.

According to Stewart, LGBTQ+ older adults accumulate a lifetime of:

Legal discrimination
Invisibility
Medical trauma and barriers
Resiliency

“Family of Choice”: Alternative Networks of Support

Most heterosexual cisgender individuals have two forms of familial ties: family of origin and family of procreation. But family rejection and laws that prohibit same-sex marriage have left many LGBTQ+ individuals with limited biological or legal family ties. These individuals are often forced to receive support outside of their family of origin.

Therefore, for many LGBTQ+ individuals, bonds are formed through a “family of choice,” which is a non-biological network of social and familial support. The family of choice (aka “chosen family”) has become a key component of support and survival for this population, notes Stewart.

When it comes to caregiving:

54% of LGBTQ+ elder care recipients receive care from their partner.
24% of LGBTQ+ elder care recipients receive care from a friend.
21% of older LGBTQ+ adults have provided care to friends, compared with only 6% of their heterosexual counterparts.

A family of choice may include:

Current partner
Ex-partner
Neighbors
LGBTQ+ community members
Friends
Biological cousins
Biological siblings

Best Practices for Supporting Your Patient’s Family of Choice

In healthcare settings, it’s important for providers to recognize that LGBTQ+ older patients may have a broader definition of family support than is traditionally understood. Appreciating the nuances of a patient’s chosen family is integral to providing equitable, person-centered care. Several steps can be taken to help providers understand the complexity — and significance — of families of choice.

Acknowledge a resident’s support network may include an expanded definition of family.
Use gender-inclusive language and open-ended questions. (Ex.: spouse or partner rather than husband or wife)
Support the search for LGBTQ+ inclusive care.
Become an LGBTQ+ inclusive provider and organization.
Show outward visibility of inclusion and support.
-Include an LGBTQ+ inclusive non-discrimination policy or Statement of Inclusion on your website.
-Provide staff training on working with the LGBTQ+ population.
-Display a pride flag and rainbow imagery.
-Participate in the Long-Term Care Equality Index.

Questions to Inquire About Regarding LGBTQ+ Older Adults’ Families of Choice

Who is important to you in your life?
Whom might you call first for support and assistance?
Who do you consider to be closest to you?
Is there anyone you can rely on for help if needed? If so, in what way is that person connected to you?

At Brookdale, we are passionate about celebrating and supporting all our residents, no matter their gender or sexual orientation. This includes being considerate of our residents’ family of choice, whom our residents have chosen to be a part of their support network. We strive to keep our residents, their clinicians and, as allowable, their loved ones informed of their progress throughout their residency.

Our Continuing Education (CE) Series allows us to provide insights into many senior health topics to health and caregiver professionals nationwide. To view Brookdale’s CE schedule and to request registration options, please click here.

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