Life Matters Media
Quality of life at the end of life

The End Of The Rainbow: Part 1


Lesbian, gay, bisexual and transgender people deserve respect at the end of life.

“What matters most to (LGBT) people is really what matters most to almost everyone: that they’re treated with dignity and have their life experiences, histories and accomplishments acknowledged,” said Tim Vincent, manager of the National Capacity Building Program with the California Prevention Training Center to a group of physicians and nurses this week for the Coalition for Compassionate Care of California.

“They want to have friends, family, loved ones, partners – legal or otherwise – represented and have really great, compassionate caregivers and providers. That can be challenged by sexual orientation and gender identity.”


Tim Vincent

Vincent has spent much of his professional life helping to connect people living with HIV/AIDS and other diseases with palliative care services and educational resources. He doesn’t want gay people to die alone or spend their final years hiding who they really are.

“History matters,” Vincent said during his presentation on the LGBT community. “A lot of things have happened in the last ten to 15 years that have changed some of our abilities, rights and privileges as LGBT people.”

It’s important to remember, he said, that a 90-year-old lesbian may have experienced “McCarthyism,” a period when homosexuals were unfairly targeted by government officials. A 75-year-old gay man may have faced jail time in Texas for engaging in sex with another man.

Although many young people now view homosexuality as “normal,” it wasn’t until 2003 when the nation’s last law criminalizing same-sex conduct was struck down with the Lawrence v. Texas ruling. In 2015, the Supreme Court ruled state-level bans on same-sex marriage to be unconstitutional.

The history of prejudice and intolerance toward gays and lesbians is a reason many remain estranged from their biological families and never had children.


About 80 percent of long-term care provided to U.S. seniors is provided by family members, but LGBT seniors are half as likely as heterosexual seniors to have close relatives they can call for help. They are also about twice as likely to be single, and about three times more likely to be childless.

There are 1.75 to 4 million LGBT seniors in the U.S., a population expected to more than double by 2030, according to recent findings by the Department of Health and Human Services. As the 65 and older population grows, many LGBT seniors will become more vulnerable to discrimination.

“In 2030, we’re believing there may be as many as seven million people who would be 55 plus,” Vincent said. “It is happening.”

He recommends that health care providers learn to provide tailored, person-centered care through honest, open-ended conversation with LGBT patients. He also hopes that nursing homes and hospitals hire more LGBT-friendly staff.

Shared by Vincent during presentation 

A gay couple moved into my mother’s facility. The residents kept talking about: “Which one is the man and which one is the woman?” They moved out in a couple of months.”

My lesbian friend, whose given name is “Hazel,” has gone by the name “Rusty” her entire adult life (she is in her 80s). The staff in the skilled nursing facility insists on calling her “Hazel.” Mentally, she is very astute, but it is rare that other residents or staff interact or make conversation with her. I feel that she has been excluded or isolated often. My friend has been transferred from place to place several times.

My partner was in the long-term skilled nursing facility for 30 days— it was a difficult time for both of us, but particularly because of some staff who seemed to “resent” our relationship and my advocacy on his behalf.

SEE ALSO: Gen Silent, a 2011 documentary exploring fears many seniors in the LGBT community have about end of life care.