WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...

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WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
WHY “LGBTQ-WELCOMING”
WILL SOON BE A
HALLMARK OF THE
MOST SUCCESSFUL
SENIOR LIVING
COMMUNITIES
A PRIMER FOR OPERATORS,
MARKETERS & LEADERSHIP
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
TABLE OF                           INTRODUCTION................................................................................................. 3

           CONTENTS                           KEY MARKET DRIVERS....................................................................................... 4

                                              GROWTH OPPORTUNITY: LGBTQ OLDER ADULTS............................................ 5

                                              READINESS ASSESSMENT: LGBTQ CULTURAL COMPETENCY........................... 7

                                                 	   POLICIES IMPACTING LGBTQ OLDER ADULTS.......................................... 9

                                                      SETTING THE STANDARD WITH THE LEI................................................ 10

                                                      LGBTQ TERMINOLOGY............................................................................ 11

                                              CONCLUSIONS................................................................................................. 13

                                              ABOUT SODEXO.............................................................................................. 14

                                              WORKS CITED.................................................................................................. 15

                                                                                                               OCT. 14, 1979
    LGBTQ-RIGHTS MILESTONES>                                                                                   The National March on                                                                                                               SEPT. 21, 1996
                                                                                                               Washington for Lesbian and Gay                                                                                                      President Bill Clinton signs the
                                                                                                               Rights takes place in Washington                                                                                                    Defense of Marriage Act into

    >1969                                               DEC. 15, 1973           >1978
                                                                                                               and draws more than 75,000
                                                                                                               people demanding equal civil
                                                                                                               rights.                            >1982                                                          >1993
                                                                                                                                                                                                                                                   law, a measure designed to
                                                                                                                                                                                                                                                   oppose same-sex marriage.

    JUNE 28, 1969
                                                        The American
                                                        Psychiatric
                                                        Association removes     NOV. 27, 1978
                                                                                                               >1979                              FEB. 25, 1982                                                    DEC. 21, 1993
                                                                                                                                                                                                                                                   >1996
                                                                                                                                                                                    >1988
    The Stonewall riots kick off after a                                        Harvey Milk, an openly gay                                        Wisconsin becomes                                                Don’t Ask, Don’t Tell -
                                                        homosexuality from
    police raid in the early morning at                                         politician elected one year                                       the first state to ban                                           allowing gays and lesbians
                                                        its official list of
    the popular gay bar the Stonewall                                           earlier to the San Francisco                                      discrimination for                                               to serve in the military
                                                        mental illnesses.
    Inn in Greenwich Village in New                                             Board of Supervisors, is                                          sexual orientation.
    York City. The three days of violent
                                                                                                                                                                                     DEC. 1, 1988                  without discrimination as
                                                                                assassinated in City Hall                                                                                                          long as they stayed in the

                                           >1973
                                                                                                                                                                                     The first World AIDS
    demonstrations marked a major                                               by former city supervisor                                                                                                          closet - becomes official
                                                                                                                                                                                     Day is held.
    turning point in the modern gay                                             Dan White. Mayor George                                                                                                            U.S. policy.
    rights movement.                                                            Moscone is also slain. White
                                                                                served only five years in
                                                                                prison.

2     us.sodexo.com                                                                                                                                Source: © 2019 POLITICO LLC https://www.politico.com/gallery/26-gay-rights-milestones?slide=0
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
INTRODUCTION
            By 2030, the population of American adults ages 65                          Even as the U.S. celebrates the 50th anniversary of the                                     equitable and inclusive care and provide ongoing
            or older is expected to surpass 70 million according the                    Stonewall uprisings, some of the very same activists                                        LGBTQ cultural competency training for staff and
            U.S. Census Bureau. In approaching that number, the                         who fought so hard for equality and the right to be                                         volunteers.
            senior housing industry continues to face challenges                        out now find themselves compelled to go back into
            that impede its growth and profitability. Inert                             the closet in order to qualify for service or benefits.                                     Developing a marketing strategy that attracts
            occupancy rates, dismal profit margins and shortfalls                       Too many feel forced to make the difficult decision to                                      LGBTQ older adults is the right thing to do. And
            in qualified talent all represent major hurdles.                            endure this each and every day, hiding who they are,                                        it’s good business. Given the opportunity for
                                                                                        because the community or complex they call home                                             senior living operators to advance their growth
            There is, however, one untapped segment of the                              is neither welcoming, informed nor respectful of their                                      agenda, developing a strategic plan that attracts
            market that presents a viable opportunity for senior                        identities. Even lifelong spousal or partner relationships                                  and retains LGBTQ older adults and allies is a vital
            living communities to grow their business—lesbian,                          must be publicly reduced to “friendship” in order to                                        lever to business growth and to improve quality
            gay, bisexual, transgender and queer (LGBTQ) seniors.                       conform to property rules, regulations or perceived                                         of life. Sustained focus on key market drivers,
            Perhaps little known and less understood by the                             expectations (Wheeler, 2016).                                                               exploring new access to growth opportunities, and
            industry, LGBTQ older adults experience a range                                                                                                                         establishing conviction and awareness at all levels
            of unmet needs and discrimination when looking                              The senior living industry has a profound opportunity to                                    of the organization are critical success factors for
            for senior housing. This is especially unfortunate                          rectify this and ensure a better quality of life for LGBTQ                                  organizations seeking to develop a strong LGBTQ
            considering that it is a market poised for rapid growth                     older adults. As this paper will discuss, senior living                                     strategy.
            as a result of increasing numbers of Baby Boomers                           operations of all types can and should create a more
            entering retirement. In fact, the National Gay and                          welcoming and inclusive experience for both current and
            Lesbian Task Force puts the number of LGBTQ seniors                         prospective LGBTQ residents, their families and allies.
            in the U.S. at 3 million and notes that this figure is                      They can openly implement supportive policies, develop
            expected to double by 2030 (Tobijah, 2017).                                 strategic LGBTQ organizational partnerships, prioritize

                                                                                                              FEB. 23, 2010
                                                                                                              The Obama administration

>2003                                                           >2008                                                                         >2011
                                                                                                              announces it will no longer

                                                                                                                                                                                                                                 >2019
                                                                                                              defend the Defense of
                                                                                                              Marriage Act in court.

JUNE 26, 2003
In the Supreme Court case
Lawrence v. Texas, sodomy
                                >2004                           NOV. 4, 2008
                                                                California votes in favor of Proposition 8,
                                                                which changes the state constitution to
                                                                                                              >2010                                                              >2013                                           JUNE 28, 2019
                                                                                                                                                                                                                                 50th anniversary of the
                                                                                                                                                                                                                                 Stonewall uprisings.
laws in the U.S. are ruled         MAY 17, 2004                 say that ‘only marriage between a man                                                                              JUNE 26,2013
unconstitutional.                  Massachusetts legalizes      and a woman is valid or recognized.’                                                                               The Supreme Court struck down the
AP Photos
                                   gay marriage and becomes                                                             SEPT. 20, 2011                                             Defense of Marriage Act, the ban on federal
                                   the first state to give                                                              A year after President Barack                              benefits for same-sex married couples, on
                                   same-sex couples the right                                                           Obama signed legislation                                   a 5-4 vote.
                                   to marry.                                                                            repealing Don’t Ask, Don’t Tell,
                                                                                                                        the policy officially ends.

                                                                                                                                                           WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   3
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
“Promoting LGBTQ inclusion in the
    senior living industry is the right thing   KEY MARKET
    to do. It opens the door to seniors who
    previously have not felt welcome and it     DRIVERS
    offers tremendous growth potential for
    operators.”                                 Among the various residential care and housing options
                                                for seniors, more than 80 percent are private or
    — JOE CUTICELLI                             for-profit, with 40 percent of those affiliated with
     CEO, SENIORS, NORTH AMERICA                national chains (Presbyterian Senior Living, 2016).
     SODEXO                                     As for-profit ventures, these organizations must
                                                prioritize driving return on investment, controlling
                                                costs and ensuring occupancy rates are kept high.

                                                RESIDENTIAL
                                                CARE AND
                                                HOUSING                                                    Another executive forecast on senior living (Mullaney,

                                                                   80%
                                                OPTIONS                                                    2019) adds:
                                                FOR SENIORS
                                                                  PRIVATE OR                               “Changes in the U.S. economy and healthcare
                                                                  FOR-PROFIT
                                                                                      40%
                                                                                      ARE AFFILIATED
                                                                                                           system could alleviate some pressures and
                                                                                      WITH NATIONAL        create business opportunities. However, to take
                                                                                      BRANDS               advantage of opportunities, providers might
                                                                                                           need to ‘detonate’ standard practices.”
                                                A recent study reviewing skilled nursing communities
                                                occupancy over a five-year period showed a consistent      In other words, what might have worked in the past
                                                fall in rates. From 2013 through 2017 occupancy            is not necessarily a wise growth strategy today. That
                                                rates in U.S. skilled nursing communities fell from        same trends report also polled senior living industry
                                                83.1 percent to 80.2 percent (Marcum LLP, 2019). The       CEOs regarding what they see as key pressure points for
                                                report notes that during the same time skilled nursing     2019. Labor and cost controls remain top of mind, with
                                                communities were also managing through reduced             one CEO stating:
                                                reimbursements. Smaller independent communities
                                                were struggling to hang on, while still smaller groups     “…senior living companies will have to maintain
                                                questioned their viability.                                a meaningful focus on attracting, engaging,
                                                                                                           developing and retaining key talent. And we believe
                                                To stay in the market, these businesses had to adapt       that providing high quality care and personalized
                                                to the changing demands of their clients. It is as true    service to residents and their family members,
                                                for skilled nursing communities as it is for independent   making a difference one relationship at a time,
                                                living, assisted living communities, continuing care,      will allow senior living providers to earn trust and
                                                memory care or others.                                     endorsements from those they serve.”

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WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
GROWTH OPPORTUNITY:
LGBTQ OLDER ADULTS
Ironically, the very market that the senior living industry seems to have
overlooked—and in some instances put off—now holds potential for being a
growth driver. However, to bring about that success, senior living operators,
marketers and program directors must remain attuned to the insights noted
earlier: (1) a need to adapt to the changing demands of clients, (2) a willingness
to “detonate standard practices,” and (3) an ability to attract, engage and
develop key talent. All are particularly important as it relates to LGBTQ older
adults. Why?

Not all cities in the U.S.. are
LGBTQ-friendly and only a                      THE                               Black & Latino LGBTQ                                       A growing number of affordable senior living communities
few select providers actively                  3 MILLION                         adults have compound
                                                                                 discrimination concerns
                                                                                                                                            exist that welcome LGBTQ older adults, however the supply
                                                                                                                                            is far from adequate and few referral agencies are seriously
promote a safe, welcoming
community. (Kozuch, 2018)                      LGBTQ                             about the quality of their
                                                                                                                                            looking at the unique needs of this demographic. One
                                                                                                                                            nationwide survey of 320 area and state units on aging found
                                               OLDER                             health care as they age.                                   that less than 8 percent offered services targeted to LGBTQ

Compared to older heterosexual
                           GROWTH/
                                               ADULTS                                                                                       older adults and only 12 percent reported outreach efforts to
                                                                                                                                            this population (Knochel, Croghan, Moone, & Quam, 2010).
                           DEVELOPMENT IN THE U.S. WILL                                                         42%
couples, LGBTQ* older adults                                                         BLACK
are twice as likely to live
                          CULTURE
                                      DOUBLE
                                           31%                                                                 38%
                                                                                                                                            Moreover, several studies indicate a fear of mistreatment or
alone and half as likely EMPLOYEES BY      34%  2030.                                LATINO
                                                                                                             27%                            distrust among LGBTQ older adults in terms of the service
to have a partner.                                                                                                 42%                      they might receive in many senior living communities if they
(Adams, 2011)
                          COMPENSATION     14%
                                      (TOBIJAH, 2017)
                                                                                                                                            were open about their sexual orientation or gender identity
                                                                                                        3%                                  (SOGI). One report (The Equal Rights Center, 2014) found that
                                                                                     WHITE                         40%                      48 percent of same-sex couples were not treated the same
                                                                                                                                            as heterosexual couples in terms of housing deposits, fees,
       LGBTQ* older adults tend to be caregivers and are                                    RACE/ETHNICITY    SEXUAL ORIENTATION
                                                                                                                                            availability and the application process. This is especially
                four times lessGROWTH/
                                    likely to have                                                                                          concerning given that only 21 states or localities currently
                   children toDEVELOPMENT
                                  help them.  30%                                    (Houghton, 2018)
                                                                                                                                            offer fair-housing protections based on SOGI (Abrahms, 2019).
                            (Adams, 2011)
                                 CULTURE      24%
                                   EMPLOYEES       19%
                                   COMPENSATION    27%
                                                                                                                       WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   5
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
Statistics around these various areas of concern
              for LGBTQ older adults can be eye-opening:

                                                                               32 percent LGBTQ
                              Only                                             older people
                                                                               have concerns about being lonely and
                              22%                         32%
                                                                               growing old alone as compared to
                                                                               19 percent for
              feel they can be open about
              their sexual orientation with                                    non-LGBTQ people.
                                                                    19%
              care staff.                                                      (Family Caregiver Alliance, 2016)
                                                         LGBTQ     NON-LGBTQ
              (Adams, 2011)

              89%
              expect staff members would
                                                        43%
                                                        reported instances of
                                                        mistreatment.
              discriminate against them.                (Adams, 2011)
              (Adams, 2011)

           Any organization with a mission to serve the nation’s                  next 20 years aging populations will have different        nursing communities, for example, are expected to
           aging population would do well to explore ways to                      requirements for how they live (PGIM, 2016). It can        address the issue by repurposing or converting units as
           improve outreach and accommodation of LGBTQ older                      already be seen taking place as LGBTQ Baby Boomers         low-income apartments, memory care units or assisted
           adults. For-profit senior living organizations in particular           begin to seek services. Once this cohort begins to fully   living according to Health Dimensions Group (Health
           should view the aforementioned challenges as an                        enter the pipeline of prospects, the demand for senior     Dimensions Group, 2018).
           opportunity—not just an opportunity to provide much                    living accommodations of all types will be tremendous.
           needed services to a deserving market segment, but an                  In fact, the American Seniors Housing Association          In the longer term, at the peak of Baby Boomer
           opportunity to address competitive business challenges                 estimates that production of senior housing will need to   retirement, the bigger challenge will be ensuring providers
           as well.                                                               grow from 25,000 per year between 2015 and 2020 to         are taking advantage of every market segment to
                                                                                  96,000 units per year between 2030 and 2035.               include LGBTQ older adults. However, efforts to prepare a
           Seniors have historically opted for assisted living                                                                               residential community, or staff to present a welcoming
           communities and long-term care facilities as they age,                 In the short term, several senior living operators will    and inclusive environment need not wait.
           but lately researchers have predicted that within the                  continue to struggle with occupancy rates. Skilled

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WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
LGBTQ* CONCERNS
                                                                                                                                                               ABOUT LONG
READINESS ASSESSMENT:                                                                                                                                           TERM CARE

LGBTQ CULTURAL COMPETENCY
                                                                                                                                                                           67%
For senior living communities interested in attracting LGBTQ older adults, plenty   These insights only scratch the surface of what                                        Neglect
of informative research is available. A more recent AARP survey of LGBTQ adults     embodies cultural competency for older LGBTQ
(Houghton, 2018) offers ideas on ways to immediately create a more welcoming        people. The organization SAGE, which provides
impression:                                                                         advocacy and services for LGBTQ older adults,
                                                                                    defines it this way:

                                                                                    “Cultural competency is the idea that                                             60%
                               MORE THAN EIGHT OF TEN                               LGBT older people are as deserving of
                                                                                    compassionate eldercare as anyone
     88%                       RESPONDENTS
                                                                                    else. The LGBT senior population—a                                      verbal or physical
                               say they feel more comfortable with
                               providers who are specifically trained               large and growing one—has                                                  harassment
                               in LGBTQ residents’ needs.                           unique needs due to a lifetime of
                                                                                    discrimination and harassment. LGBT

                                                                                                                                                                         61%
   Use of advertising to highlight LGBTQ-friendly services
                                                                                    elders should not be fearful when
   WAS NOTED AS FAVORABLE BY 86 PERCENT                                             seeking health care or long-term care.”
   OF RESPONDENTS.                                                                  SAGE makes clear that the LGBTQ community is
                                                                                    not a monolith. This must be kept in mind when
                                                                                                                                                                limited access
                                                                                    addressing the needs of LGBTQ older adults as well,                           to services
                      Having staff members who happen to be LGBTQ                   who have a totally different set of life experiences
                      WAS SEEN AS PREFERABLE BY 85                                  than younger LGBTQ people. The former grew
                                                                                    up in a time that was far less welcoming, when
                      PERCENT OF RESPONDENTS.
                                                                                    LGBTQ people guarded their sexual orientation and
                                                                                    gender identity as a dangerous secret that could
                                                                                    cause them to lose their homes, jobs, families and                        52%
       Displaying LGBTQ-welcoming signs or symbols in                               freedom. They risked being labeled anything from                          will be forced
       facilities and online WAS NOTED AS IMPORTANT                                 criminal to mentally ill. That generation still carries
                                                                                                                                                              to hide/deny
       TO 82 PERCENT OF RESPONDENTS.                                                a lot of this baggage today as they attempt to
                                                                                    navigate issues related to housing and health care.                       identity
   (Houghton, 2018)                                                                                                                                                                (Houghton, 2018)

                                                                                                WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES        7
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
“Why would you just rule out
    a whole segment? LeadingAge,
    which represents many non-                        In addition to considering generational differences               “[Communities] that have received the
                                                      when developing LGBTQ cultural competency, it is                  training say it has made a difference. The New
    profit retirement communities,                    important to also note other areas of diversity within
    encouraged members to better                      the LGBTQ community.                                              Jewish Home, a facility on New York City’s
    serve the LGBT community, and                                                                                       Upper West Side with over 500 residents,
    interest has picked up in the last                •   LGBTQ older people of color                                   began working with SAGE before it started
    three or four years. There are a few              •   Transgender older people                                      offering the credential. While there were
    communities that cater primarily to               •   Older people living with HIV/AIDS
                                                                                                                        always LGBTQ residents, it is now taking a
                                                      •   LGBTQ Baby Boomers
    the LGBT population, but more hope                                                                                  more active approach to making them feel
                                                      •   LGBTQ older people and families
    for a diverse mix of residents.”(Burling, 2018)                                                                     comfortable, said Rabbi Jonathan Malamy, its
    — KEVIN BRADLEY                                   In developing a culturally competent and welcoming                director of spiritual care and religious life and
      ASSOCIATE DIRECTOR, ONLINE LEARNING,            environment it is important to address a number of factors        a co-chair of its LGBTQ welcoming initiative.
     LEADINGAGE                                       including language, inclusive visuals in company materials,
                                                      LGBTQ programming and outreach efforts. One of the                There are now rainbow flag decals on the front
                                                      simplest ways to cultivate both understanding and respectful      door and on the doors of key administrative
                                                      relationships with LGBTQ older adults is through appropriate      offices, and some staff members wear
                                                      use of language. Keep in mind, however, that some terms           rainbow pins on their ID badges.”
                                                      still used by older LGBTQ people may be seen as outdated
                                                      by younger LGBTQ people. Become familiar with key                 A data-driven strategy supporting the realities of aging for
                                                      terminology and pay close attention to how residents use          LGBTQ older adults must also establish governance and
                                                      terms and how they refer to themselves and others.                accountability. Without firmly establishing organizational
                                                                                                                        policies and procedures to instill behaviors that drive a
                                                      SAGE is an excellent resource for guidance and training. It can   culture of respect, inclusion and safety, it is impossible to
                                                      offer counsel across a full spectrum of cultural competencies     bring about real change. Staff at all levels of the organization
                                                      to help organizations address bias or identify and manage         need to be aware of and committed to a philosophy of a
                                                      needs unique to the LGBTQ older adult. In responding to           welcoming and inclusive environment for LGBTQ adults.
                                                      concerns from the LGBTQ community about a way to find
                                                      competent senior care providers, and in response to concerns      A clear strategy for attracting and retaining older LGBTQ
                                                      from the providers that they are unclear how to make their        adults and allies will be rooted in the market drivers, open
                                                      services fully competent, SAGE launched SAGECare, the             doors to new growth opportunities, and incorporate ongoing
                                                      only national LGBTQ Aging Competency credential                   training and professional development that reflect the vision
                                                      (www.sageusa.care).                                               of LGBTQ inclusion. Embedding measures of governance
                                                                                                                        and accountability will ensure the outcomes necessary
                                                      Companies earn the nationally recognized credential based         to continually grow a culture of inclusion that is visible to
                                                      on the amount of training their staff receives. A 2018 article    residents and family members as well as employees and the
                                                      in the Washington Post (Bahrampour, 2018) reported on the         broader community.
                                                      training by SAGECare.

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WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
Senior living providers can further elevate visibility
of their communities through strategic partnerships
                                                             OLICIES IMPACTING LGBTQ
                                                            P
with organizations like Out & Equal—which recognizes
companies with strong workplace equality for members
                                                            OLDER ADULTS
of the LGBTQ community, SAGE—which provides                 Many public and private senior programs do not recognize or support LGBTQ families.
community programs, social services and more to LGBTQ       It may come as a surprise to know:
older adults, and Human Rights Campaign Foundation
(HRCF)—which together with SAGE have launched the           • Social Security does not pay survivor                    • State laws vary regarding LGBTQ people,
first ever Long-Term Care Equality Index (theLEI.org). In       benefits to unmarried, same-sex partners.                    with over half carrying no laws to protect
addition, the FORGE Transgender Aging Network, GRIOT                                                                         against discrimination based on sexual
Circle, LGBTQ Aging Network and the LGBTQ Aging Project     • Medicaid does not protect unmarried,                         orientation when applying for housing,
all have local presence across the country and assist in        same-sex partners’ assets and homes                          insurance or employment.
providing more information on aging and LGBTQ older             when a partner enters a long-term care
adults.                                                         community.                                               • Some tax laws, pensions and 401K
                                                                                                                             regulations may discriminate against
                                                                                                                             unmarried, same-sex partners
                                                                                                                            (SeniorLiving.org, 2017).

“Three out of four adults age 45 and
older who are lesbian, gay, bisexual or
transgender say they are concerned about
having enough support from family and
friends as they age. Many are also worried
about how they will be treated in long-
term care facilities and want specific
LGBT services for older adults.”
— ANGELA HOUGHTON
  AARP RESEARCH

                                                                                             WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   9
WHY "LGBTQ-WELCOMING" WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES - A PRIMER FOR OPERATORS, MARKETERS & LEADERSHIP ...
SETTING THE                                                “Assessment is a critical first step in helping
            STANDARD WITH THE                                           residential long-term care communities adopt
                                                                        policies and best practices that provide culturally
            LONG-TERM CARE                                              competent and responsive care to LGBTQ older
                                                                        adults. To effect real change, however, efforts must
            EQUALITY INDEX                                              also provide targeted resources and technical
                                                                        assistance that bring these policies and practices
            (Edited excerpts from Why the LEI? and theLEI.org.          to life.”
            Reprinted with permission from HRCF & SAGE)
                                                                        — HUMAN RIGHTS CAMPAIGN FOUNDATION & SAGE

            SAGE, the world’s largest and oldest organization
            dedicated to improving the lives of LGBTQ older people,                                                                 WHERE YOU
            and the Human Rights Campaign Foundation (HRCF),                                                                        CAN BEGIN
            the educational arm of the nation’s largest civil rights
            organization working to achieve equality for LGBTQ         An exploratory study by the Human Rights Campaign            The Commitment to Caring Pledge is
            people, are joining forces to address these issues by      Foundation and SAGE revealed that there is great             the first step in the Long-Term Care
            launching the Long-Term Care Equality Index (LEI) to       interest by aging services providers to participate in the   Equality Index.
            promote equitable and inclusive care for LGBTQ older       Long-Term Care Equality Index initiative. Participating
            people in residential long-term care communities.          aging services providers will benefit by:                    Senior living communities are
                                                                                                                                    invited to sign the pledge, indicating
            SAGE and HRCF believe that most long-term care                                                                          an intention to adopt the LGBTQ
            communities do not want LGBTQ older adults to face         • Learning best practices for LGBTQ equity and
                                                                                                                                    inclusive policies and practices
            discrimination or have to worry about the care they will       inclusion
                                                                                                                                    necessary to provide culturally
            receive. But these communities may be unsure how           • Having access to quality training and education           competent and responsive care to
            to protect their LGBTQ residents from discrimination,                                                                   LGBTQ older adults.
                                                                       • Gaining assistance with meeting state and federal
            provide them with optimal care and extend a warm
                                                                           regulatory requirements, including the new CMS
            welcome to allay their concerns.                                                                                        In doing so, organizations will
                                                                           Phase III Requirements of Participation
                                                                                                                                    then have access to both an online
            The LEI will encourage and help long-term care             • Seeing an improved ability to develop culturally         assessment tool and resources that
            communities to adopt policies and best practices that          appropriate marketing for future staff, clients and      will help create a more informed and
            provide culturally competent and responsive care to            funders                                                  LGBTQ-welcoming community.
            LGBTQ older adults. More than just an assessment, the                                                                   Visit theLEI.org to learn more.
                                                                       • Earning public recognition as a leading provider of
            LEI will provide resources and technical assistance to
                                                                           LGBTQ-welcoming services
            bring these policies and practices to life.

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“Supporting the needs of our aging LGBTQ
 population is the responsibility of all of us.
                                                  LGBTQ
 From the need for well-trained, culturally
 competent staff in facilities to the need for
                                                  TERMINOLOGY
 more culturally competent systems and            • C
                                                     ISGENDER: A term used to describe a person                  • Q
                                                                                                                     UEER: A term people often use to express
 policies, change is something we must all          whose gender identity aligns with those typically               fluid identities and orientations. Often used
                                                    associated with the sex assigned to them at birth.              interchangeably with LGBTQ.
 work on together.”
 — CHRIS GARGIULO                                 • G
                                                     ENDER EXPRESSION: External appearance of                    • S
                                                                                                                     EXUAL ORIENTATION: An inherent or
   DISTRICT MANAGER, ON-SITE SERVICE SOLUTIONS      one’s gender identity, usually expressed through                immutable enduring emotional, romantic or
   SODEXO                                           behavior, clothing, haircut or voice, and which may             sexual attraction to other people.
                                                    or may not conform to socially defined behaviors
                                                    and characteristics typically associated with being           • T
                                                                                                                     RANSGENDER: An umbrella term for people
                                                    either masculine or feminine.                                   whose gender identity and/or expression is
                                                                                                                    different from cultural expectations based
                                                  • G
                                                     ENDER IDENTITY: One’s innermost concept of                    on the sex they were assigned at birth. Being
                                                    self as male, female, a blend of both or neither—               transgender does not imply any specific sexual
                                                    how individuals perceive themselves and what they               orientation. Therefore, transgender people may
                                                    call themselves. One’s gender identity can be the               identify as straight, gay, lesbian, bisexual, etc.
                                                    same or different from their sex assigned at birth.
                                                                                                                  Source: HRC Glossary of Terms

                                                  • L
                                                     GBTQ: An acronym for “lesbian, gay, bisexual,
                                                    transgender and queer.”

                                                                                    WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   11
“Our founders, Wybe & Marietje
                     Kroontje, envisioned a senior living
                     community that welcomed seniors
                     from all walks of life. We reaffirmed
                     their vision during our strategic
                     planning process in May of 2019, some
                     45 years later, by deliberately crafting
                     our mission and vision to place great
                     emphasis on inclusivity.”
                     —F
                       ERNE MOSCHELLA
                      PRESIDENT AND CEO
                      WARM HEARTH VILLAGE

12   us.sodexo.com
CONCLUSIONS                                                                                                                                        4 THINGS YOU
While the effort may seem insurmountable in some           practices and governance structures that will ensure                                    CAN DO NOW
instances, the reality is that senior living communities   a welcoming and inclusive atmosphere for all of their
can achieve wide recognition and acceptance as             residents. Tools and resources provided by the HRC
welcoming to LGBTQ older adults, even in supposedly        Foundation and SAGE (see sidebar Setting the Standard
unwelcoming geographies.                                   with the LEI) will help do that and more.
                                                                                                                                                 1. Create key partnerships
For example, Pennsylvania is among the 27 states in        With 3 million LGBTQ older adults doubling in number                                  that help build an informed
the country that ranked in the lowest-rated category,      by 2030 in the U.S., it is incumbent on organizations
“High Priority to Achieve Basic Equality,” in HRC’s 2017   to continue driving strategies and policies that reflect                              strategy for LGBTQ inclusion.
annual State Equality Index (Human Rights Campaign,        the realities of changing demographic trends in the U.S.
2018). The state lacks non-discrimination and hate         seniors market. That means crafting a relatable and                                   2. Ensure diversity and
crime laws and maintains other laws that severely          relevant strategy that addresses the market dynamics
undermine LGBTQ equality and allow for religious-based     and unprecedented growth opportunities, while also                                    inclusion are on the agenda
discrimination.                                            building unique competencies through awareness at all                                 for talent and succession
                                                           levels of the organization. It is an important effort to
Yet in that environment many of the hospitals and          ensure that quality of life is improved for LGBTQ older
                                                                                                                                                 planning processes.
health care centers around the state have embraced         adults.
LGBTQ inclusion. In fact, Pennsylvania ranked fifth                                                                                              3. Provide training and
among states for having 19 facilities awarded
“Healthcare Equality Leaders” on the HRC’s Healthcare                                                                                            development opportunities
Equality Index (HEI) 2018. Included on that list was the                                                                                         that help staff and volunteers
Abramson Center for Jewish Life (now part of Abramson      “Understanding the needs of diverse                                                   use appropriate language
Senior Care), one of just a few senior care communities
                                                           populations is critical to our business and                                           when engaging the LGBTQ
to participate in the HEI. That accomplishment is the
perfect testament to making possible, the seemingly        to providing the best possible care we can
                                                                                                                                                 community and its allies.
impossible.                                                offer. As a market leader in providing
                                                           in-home care for seniors and other adults,
Still other senior living communities like Warm            we know that creating an environment                                                  4. Visibly market your
Hearth Village in Blacksburg, Virginia have long
                                                           where everyone feels a sense of inclusion                                             community in a way that
enjoyed informal recognition and word-of-mouth
endorsement for being LGBTQ-welcoming. At the same         and belonging is key to shaping quality                                               opens doors to potential
time, however, they are actively engaging credible         experiences.”                                                                         LGBTQ residents.
and qualified third-party guidance on strategy, best        — CARL MCMANUS
                                                             CHIEF EXECUTIVE OFFICER
                                                             COMFORT KEEPERS FRANCHISING, INC -
                                                             NORTH AMERICA

                                                                                                    WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   13
ABOUT SODEXO
                                                                      Backed by nearly 460,000 employees around the world,        Sodexo remains an established thought leader and
                                                                      Sodexo’s commitment to diversity and inclusion remains      innovator in the space of diversity and inclusion—
                                                                      a top priority. Currently in the 16th year of metrics-      conducting ongoing, original research on topics that
                                                                      driven efforts, Sodexo’s diversity journey has resulted     include gender balance and quality of life around the
            Sodexo is a global Fortune 500 company with a             in a systemic culture change for the company and its        world. For its achievements, the company has received
            presence in 72 countries. Delivering more than 100        employees, clients and customers. Diversity and inclusion   numerous accolades and recognition, from being
            services that enhance organizational performance,         are strategically woven into the very fabric of the         ranked in the Top 10 of DiversityInc magazine’s “Top 50
            contribute to local communities and improve quality       organization as key business drivers, increasing employee   Companies for Diversity” list for the 11th consecutive
            of life, Sodexo is a leading provider of sustainable      engagement and expanding business development               year, to landing on FORTUNE Magazine’s list of “World’s
            integrated facilities management and food service         opportunities.                                              Most Admired Companies.”
            operations.

                                                   For more information, visit us.sodexo.com or e-mail SodexoOfficeOfDiversity@sodexo.com

14   us.sodexo.com
ACKNOWLEDGMENT                                     WORKS CITED
                                                   Abrahms, S. (2019, January 3). Retirement Housing Options             Marcum LLP. (2019, February 25). Five Year Nursing Home
This white paper was researched and                    for LGBTQ Seniors. Retrieved from Kiplinger: https://www.             Statistical Analysis. Retrieved from Marcum: http://
written by Samuel Wells of S.E.Wells                   kiplinger.com/article/retirement/T036-C000-S004-                      marcumllp.com/lp/nursing
Communications, LLC and edited by                      retirement-housing-options-for-LGBTQ-seniors.html                 Mullaney, T. (2019, January 1). Senior Living Executive
David Boyd Williams of Sodexo.                     Adams, M. (2011, April 20). LGBTQ Advocate Sees Hurdles                    Forecast: 2019 Business Trends, Challenges,
                                                       Ahead. Retrieved from AARP: https://www.aarp.org/                      Opportunities. Retrieved from Senior Housing News:
Special thanks to AARP Research, the                   relationships/family/info-04-2011/biggest-issues-                      https://seniorhousingnews.com/2019/01/01/senior-
Human Rights Campaign Foundation                       facing-older-LGBTQ-americans.html                                      living-executive-forecast-2019-business-trends-
                                                                                                                              challenges-opportunities/
and SAGE for the many valuable                     Burling, Stacey. (2018, October, 3). Gay and Gray: The
                                                        retirement housing industry learns how to help LGBT              PGIM. (2016). The Business of Aging. Retrieved from Wall Street
contributions.                                          seniors. Retrieved from The Philadelphia Inquirer: https://          Journal: https://partners.wsj.com/pgim/the-business-of-
                                                        www.inquirer.com/philly/health/senior-living-retirement-             aging/
                                                        home-lgbt-friendly-20181003.html                                 Presbyterian Senior Living. (2016, February 4). Non-Profit vs.
                                                   Family Caregiver Alliance. (2016). Caregiver Statistics:                   For-Profit Senior Living Organizations: What You Need to
                                                       Demographics. Retrieved from National Center on                        Know. Retrieved from Presbyterian Senior Living: https://
                                                       Caregiving: https://www.caregiver.org/caregiver-                       www.presbyterianseniorliving.org/blog/non-profit-vs-
                                                       statistics-demographics                                                for-profit-senior-living-organizations-what-you-need-to-
                                                                                                                              know
                                                   Health Dimensions Group. (2018, December 3). Top Trends
                                                        in Aging Services 2019. Retrieved from HDG: https://             SeniorLiving.org. (2017). Best Gay Retirement Communities
                                                        healthdimensionsgroup.com/top-trends-aging-                           and Cities in the US. Retrieved from SeniorLiving.org:
                                                        services-2019/                                                        https://www.seniorliving.org/retirement/LGBTQ/
                                                   Houghton, A. (2018, March). Maintaining Dignity: A                    The Equal Rights Center. (2014). Opening Doors: An
                                                       Understanding and Responding to the Challenges Facing                  Investigation of Barriers to Senior Housing for Same-
                                                       Older LGBT Americans. Washington, DC: AARP Research,                   Sex Couples. Washington, DC: The Equal Rights Center.
                                                       March 2018. Retrieved from AARP Research: https://doi.                 Retrieved from https://equalrightscenter.org/wp-
                                                       org/10.26419/res.00217.001                                             content/uploads/senior_housing_report.pdf
                                                                                                                         Tobijah. (2017, May 23). Best Gay Retirement Communities
                                                   Human Rights Campaign. (2018). Health Equity Index 2018.
                                                                                                                              and Cities in the US. Retrieved from SeniorLiving.org:
                                                      Washington: HRC.
                                                                                                                              https://www.seniorliving.org/retirement/LGBTQ/
                                                   Knochel, K. A., Croghan, C. F., Moone, R. P., & Quam, J. K.           Wheeler, D. R. (2016, August 25). LGBTQ Seniors Are Being
                                                       (2010). Ready to Serve? The Aging Network and LGB and                 Pushed Back Into the Closet. Retrieved from The Atlantic:
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                                                       Aging.                                                                lgbt-seniors/497324/
                                                   Kozuch, E. (2018, October 8). HRC Releases 2018 Municipal
                                                       Equality Index Rating Cities on LGBTQ Inclusion. Retrieved
                                                       from Human Right Campaign: https://www.hrc.org/blog/
                                                       hrc-releases-2018-MEI-rating-cities-on-lgbtq-inclusion
* THE USE OF “LGBTQ” IS FOR UNIFORMITY ONLY, THE
ACTUAL STUDY USED “LGBT”.
                                                                                                 WHY “LGBTQ-WELCOMING” WILL SOON BE A HALLMARK OF THE MOST SUCCESSFUL SENIOR LIVING COMMUNITIES   15
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