Life Matters Media
Quality of life at the end of life

Senior LGBT Community Needs More Caregiving Support

Part Two in a Series


Sexual orientation and gender identity should not be barriers to quality end of life care.

“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. This month, he delivered a presentation about the aging LGBT community for the Coalition for Compassionate Care of California.

There are 1.75 to four million LGBT seniors in the U.S., a population expected to more than double by 2030, according to the Department of Health and Human Services.

“Many people feel like they can’t be themselves at such a critical juncture of their life,” Vincent said.

He spoke with Life Matters Media after his presentation and gave advice to medical professionals and caregivers working with this community.

Why are many in the LGBT community afraid to show their ‘true selves’ to caregivers or others in nursing homes?

For many seniors, it’s like re-experiencing the traumatic experiences that happened to them over their lives.

They fear the same stigma that was leveled at them in their 30s and 40s. They fear the loss of control, especially when it comes to the way their care is delivered. It is anxiety provoking.

Tim Vincent

Tim Vincent

Many older gays and lesbians never married or had children, which makes it difficult for them to find family caregivers. What do they do? 

It’s a significant issue, but I think it will and is changing, especially in the last decade. People are having families and children while in same-sex relationships.

But, the group really aging at this point – people in their 50s, 60s, 70s, 80s, 90s – they did not do that.

We have selected people who become our ‘families of choice.’ Access to people who could be our responsible caregiver is different for many of us who are aging in these communities.

Do transgender people face different challenges in nursing homes?

People who are transgender in nursing homes often wonder what room they will be in or if they can have the name that they want to have, even if it is not their legal name.

It is new territory, so it makes it hard for some to deal with or figure out where to place someone.

It is also hard for some people to understand that they are still sexual beings. Trans issues are newer and less known.

Don’t people nearing death just want to be treated well?

They want to be treated with respect, they want their histories respected, they want to have the people that matter to them around as much as possible, they want to resolve issues to the best of their ability.

For the caregiver, it really takes being able to listen and hear whatever the person is saying and not try to change them. This requires some introspection, really examining our own values and histories.

If you ask people in their 20s and 30s who are LGBT, they are probably not concerned about their end of life. They think they are fine. But people who are older have a whole different experience.

For caregivers, it’s about putting yourself in that place of empathy so you can really give people the best care they deserve.

Vincent runs Advocates 4 Equity, his organization dedicated to building inclusive and supportive services focused on diversity related to sexual orientation and gender identity. Learn more at

– Image: Transgender senior KrysAnne appears in “Gen Silent.”