LGBTQ+ Advance Directives and Long-Term Care Facility Resources

Family Caregiver Alliance (FCA) understands that LGBTQ+ caregivers and older adults face unique challenges. For example, members of the LGBTQ+ community may have additional considerations when choosing a Long-Term Care Facility or creating an advance care directive based on concerns about discrimination, and/or treatment of heterosexual or cisgender identities as the default. Additionally, members of the LGBTQ+ community are more likely to care for chosen family, a very close relationship that is not related by marriage or blood that lacks legal status without further intervention.

At FCA we are proud to advocate for and support LGBTQ+ caregivers everywhere. We’d like to extend a special thanks to Ames Simmons, Senior Lecturing Fellow at Duke Law who identified the following resources that support inclusivity and cultivate respect for all sexual orientations, gender identities, and gender expression.

Advance Care Planning

Advance care planning is preparing for your future healthcare and life decisions. It is the ongoing process of making your wishes and values known to your providers and caregivers.

Planning for Lifelong Care: Guiding Questions for Transgender & Non-Binary People to Plan for Dementia and Other Serious Illness, developed by SAGE & Transgender Law Center, is a resource that is designed to assist transgender and non-binary people with creating clauses for their advance directive to ensure that their gender identity continues to be affirmed by care providers even during cognitive changes.
LGBTQ+ Advance Care Planning Toolkit, developed by SAGE, is a step-by-step guide for the LGBTQ+ community to prepare for healthcare needs and end-of-life decisions. It includes advice on extra protections to ensure dignity and avoid conflict or discrimination.
Life Planning Documents for Transgender Communities, from the Transgender Law Center, explains basic information about steps transgender people can take to ensure that their identities will be respected, their loved ones will be able to see them, and their wishes are carried out even if they are unable to communicate those wishes themselves.

Finding a LGBTQ+ Friendly Long Term Care Facility

To help improve access to LGBTQ+ welcoming long-term care communities, the Human Rights Campaign (HRC) Foundation and SAGE developed the Long-Term Care Equality Index (LEI). The LEI created the first index for inclusive LGBTQ+ policies and practices for senior housing and residential long-term care communities. LGBTQ+ people might have some common questions and concerns when choosing a long-term care community. The Consumer Guide for finding an LGBTQ+ inclusive Long Term Care community will guide you to get answers to those questions and concerns and help you select a long-term care community that is right for you or a loved one. Topics covered include LGBTQ+ welcoming policies, practices, and environments.

Additionally, you can find FCA’s LGBTQ+ specific Fact Sheets, information about FCA’s LGBTQ+ Caregiver Support Group, and other organizations that provide support and community to LGBTQ+ caregivers and older adults here.