LGBT Aging and Long-Term Care Fairness Survey

The National Senior Citizens Law Center, Lambda Legal, Services & Advocacy for GLBT Elders (SAGE), the National Center for Lesbian Rights, the National Gay and Lesbian Task Force and the National Center for Transgender Equality are working together to raise awareness of the issues facing older adults who are lesbian, gay, bisexual and transgender (“LGBT”) and live in nursing homes, assisted living facilities and other long-term care facilities. We hope to identify areas where policy changes will improve care, and to find other older adults, advocates and providers interested in these issues.

Whether you are an older adult living in a long-term care facility or a family member, caretaker, social worker or friend, your answers to these questions will help as we work together to fight discrimination, abuse and neglect against LGBT older adults.

You should fill out this survey if you are:

· A lesbian, gay, bisexual or transgender older adult who lives or has lived in a long-term care facility;

· A caregiver of an LGBT older adult who lives or has lived in a long-term care facility;

· A family member or friend with knowledge of an LGBT older adult’s experience in a long-term care facility;

· A social worker or other helping professional who works with older adults.

Long-term care facilities include nursing homes, assisted living communities and senior living facilities.

If you would like to manually fill out this survey, you can print it out and mail it to:

Nancy Arevalo
National Senior Citizens Law Center
1330 Broadway, Suite 525
Oakland, CA 94612

The deadline for responding to the survey is December 15, 2009.

Thank you so much.

1. Confidentiality:

Confidentiality: I wish to remain anonymous.

You have my permission to use my name.

You have my permission to contact me about my/my loved one's/my client's experience.

2. Background Information:

Background Information: Name:
Organization (if applicable):
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

3. I am (check as many as apply):

I am (check as many as apply): An LGBT older adult

Legal services provider

Social service provider

Family member or friend of an LGBT older adult

Other (please specify)

4. If you answered "I am an LGBT older adult" in question 3, please tell us your age.

If you answered "I am an LGBT older adult" in question 3, please tell us your age.

5. Have you, a loved one or a client ever experienced any of the following because of actual or perceived sexual orientation and/or gender identity?

Have you, a loved one or a client ever experienced any of the following because of actual or perceived sexual orientation and/or gender identity? Refusal of admission

Abrupt discharge

Attempted discharge

Refusal of readmission back into the facility

Restriction of visitors

None of the above

Other/Comments:

6. Do you feel that an LGBT older adult can be open with the staff of a nursing home, assisted living facility or other long-term care facility about his/her sexual orientation and/or gender identity?

Do you feel that an LGBT older adult can be open with the staff of a nursing home, assisted living facility or other long-term care facility about his/her sexual orientation and/or gender identity? Yes

Not sure

Comments:

7. If you answered "No" or "Not Sure" to question 6, what issues do you feel an LGBT older adult faces or might face if open about his/her sexual orientation and/or gender identity? List all that apply:

If you answered "No" or "Not Sure" to question 6, what issues do you feel an LGBT older adult faces or might face if open about his/her sexual orientation and/or gender identity? List all that apply: Discrimination by staff

Discrimination by residents

Abuse and/or neglect by staff

Isolation from other residents

Other/Comments:

8. If you, a loved one or a client lives in a nursing home, assisted living facility or other long-term care facility, does the facility properly recognize your/his/her sexual orientation and/or gender identity?

If you, a loved one or a client lives in a nursing home, assisted living facility or other long-term care facility, does the facility properly recognize your/his/her sexual orientation and/or gender identity? Yes

Comments:

9. Has the staff of a long-term care facility that you, a loved one or client has lived in ever done any of the following? Please check all that apply:

Has the staff of a long-term care facility that you, a loved one or client has lived in ever done any of the following? Please check all that apply: Refused to provide basic services and care to you, a loved one or a client because of your/his/her actual or perceived sexual orientation and/or gender identity.

Verbally or physically harassed or ostracized you, a loved one or a client because of your/his/her actual or perceived sexual orientation and/or gender identity.

Refused to refer to a transgender resident with his or her preferred name or pronoun.

Refused to let the spouse, partner, or person with the medical power-of-attorney or other health care directive make decisions for an LGBT resident.

None of the above.

10. Have you, a loved one or a client experienced verbal harassment or other abuse by residents because of your/his/her actual or perceived sexual orientation and/or gender identity?

Have you, a loved one or a client experienced verbal harassment or other abuse by residents because of your/his/her actual or perceived sexual orientation and/or gender identity? Yes

Comments:

11. Do you, a loved one or a client feel comfortable self-identifying as LGBT to the medical providers in the facility that treats you/him/her?

Do you, a loved one or a client feel comfortable self-identifying as LGBT to the medical providers in the facility that treats you/him/her? Yes

Explain you answer, whether it was yes or no:

12. Do the medical providers in the facility treat you, a loved one or a client with dignity and respect when delivering medical services?

Do the medical providers in the facility treat you, a loved one or a client with dignity and respect when delivering medical services? Yes

Comments:

13. Has the staff of a long-term care facility denied you, a loved one or a client medical treatment because of actual or perceived sexual orientation and/or gender identity?

Has the staff of a long-term care facility denied you, a loved one or a client medical treatment because of actual or perceived sexual orientation and/or gender identity? Yes

Comments:

14. We welcome any further details about any of your answers above:

We welcome any further details about any of your answers above:

15. I am interested in staying in touch (check all that apply and provide your contact information on Question 16):

I am interested in staying in touch (check all that apply and provide your contact information on Question 16): I would like to know more about issues facing LGBT people in long-term care. Please add my information to your mailing lists so that I can receive updates.

I am willing to discuss my/my loved one's/my client's experience.

16. Here is my contact information:

Here is my contact information: Name:
Title, if applicable:
Organization, if applicable:
Address:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

Thank you for responding.

Resources:

National Senior Citizens Law Center (NSCLC):
Since 1972, the National Senior Citizens Law Center has worked to promote the independence and well-being of low-income elderly and disabled Americans, especially women, people of color and other disadvantaged minorities. To guarantee fair treatment, we work for greater access to federal courts for citizens and for better enforcement of consumer’s legal rights in safety net programs. Information on the rights of long-term care residents for consumers and advocates is available from our website at www.nsclc.org.

Lambda Legal:
Lambda Legal is a national organization committed to achieving full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people and those with HIV through impact litigation, education and public policy work. For legal information and assistance with discrimination related to sexual orientation, gender identity and expression and HIV status please contact our Help Desk at 212-809-8585 or 1-866-542-8336 or visit www.lamdbalegal.org.

Services & Advocacy for GLBT Elders (SAGE):
Incorporated in 1978, SAGE is the nation’s oldest and largest organization dedicated to serving and advocating for LGBT senior citizens. SAGE’s mission includes four goals: To improve the overall quality of life for LGBT seniors; to support and advocate for the rights of LGBT seniors; to foster a greater understanding of aging in all communities; and to promote positive images of LGBT life in the later years. SAGE provides advocacy, education, and technical assistance programs both nationally and locally, and direct and supportive social services, social and recreational activities, and community building programs throughout New York City. SAGE is the country’s preeminent incubator of service and advocacy strategies for LGBT older people. For more information visit our website, www.sageusa.org.

National Center for Lesbian Rights (NCLR):
Please visit our website at www.nclrights.org to download a copy of our groundbreaking publication, Planning With Purpose: Legal Basics for LGBT Elders.

National Gay and Lesbian Task Force (NGLTF):
The National Gay and Lesbian Task Force builds the political power of the lesbian, gay, bisexual and transgender (LGBT) community from the ground up. We do this by training activists, organizing broad-based campaigns to defeat anti-LGBT referenda and advance pro-LGBT legislation, and by building the organizational capacity of our movement. The Task Force provides research and policy analysis to support the struggle for complete equality. As part of a broader social justice movement, we work to create a nation that respects the diversity of human expression and identity and creates opportunity for all. For more information visit our website, www.thetaskforce.org.

National Center for Transgender Equality:
The National Center for Transgender Equality is a national social justice organization devoted to ending discrimination and violence against transgender people through education and advocacy on national issues of importance to transgender people. By empowering transgender people and our allies to educate and influence policymakers and others, NCTE facilitates a strong and clear voice for transgender equality in our nation's capital and around the country. For more information visit our website, www.transequality.org.

Dear Advocate:

1. Confidentiality:

2. Background Information:

3. I am (check as many as apply):

4. If you answered "I am an LGBT older adult" in question 3, please tell us your age.

5. Have you, a loved one or a client ever experienced any of the following because of actual or perceived sexual orientation and/or gender identity?

6. Do you feel that an LGBT older adult can be open with the staff of a nursing home, assisted living facility or other long-term care facility about his/her sexual orientation and/or gender identity?

7. If you answered "No" or "Not Sure" to question 6, what issues do you feel an LGBT older adult faces or might face if open about his/her sexual orientation and/or gender identity? List all that apply:

8. If you, a loved one or a client lives in a nursing home, assisted living facility or other long-term care facility, does the facility properly recognize your/his/her sexual orientation and/or gender identity?

9. Has the staff of a long-term care facility that you, a loved one or client has lived in ever done any of the following? Please check all that apply:

10. Have you, a loved one or a client experienced verbal harassment or other abuse by residents because of your/his/her actual or perceived sexual orientation and/or gender identity?

11. Do you, a loved one or a client feel comfortable self-identifying as LGBT to the medical providers in the facility that treats you/him/her?

12. Do the medical providers in the facility treat you, a loved one or a client with dignity and respect when delivering medical services?

13. Has the staff of a long-term care facility denied you, a loved one or a client medical treatment because of actual or perceived sexual orientation and/or gender identity?

14. We welcome any further details about any of your answers above:

15. I am interested in staying in touch (check all that apply and provide your contact information on Question 16):

16. Here is my contact information: