Long-term Care | FAQs
Q | What is long-term care?
Long-term care includes services that meet your health and personal care needs when you can no longer do everyday activities on your own. These services can include in-home care, assisted living, skilled nursing care, rehabilitation, and memory care for people with dementia. You might need long-term care after a medical event like a stroke or an injury like a broken hip. Or you might need long-term care as you age. Long-term care may be costly. Long-term care insurance and governmental programs, like Medicare and the US Department of Veterans Affairs, can help cover some of the costs. For more information on long-term care, check out this resource from the National Institute on Aging→.
Q | What should I think about when looking for long-term care?
The level of staff training and acceptance of gender diversity varies by long-term care facility. Expressing your gender identity as a resident of a nursing home or assisted living facility may carry some risk of discrimination and poor treatment from staff and residents. To reduce this risk, try the following:
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Look for a long-term care facility that has a nondiscrimination policy with protections for gender.
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Look for inclusive imagery like the Pride flag or pictures of LGBTQIA+ people on promotional materials.
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Arrange time to talk with staff and residents to get a sense of their attitudes toward trans people.
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Ask about rooming options and whether your rooming arrangement of choice would be possible.
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Talk to LGBTQIA+ residents and staff, if possible.
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Assess safe staffing by asking about staff-to-resident ratios.
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Observe the cleanliness and upkeep of the facility and residents’ grooming.
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Find out which social activities are offered for residents.
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Try the food that would be served to residents.
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Research the facility online and read reviews.
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Consider cost, insurance coverage, and payment options.
Start planning early for long-term care, even before you need it. This way you can get on a waitlist if there is one, and you will have a good idea of which long-term care homes will be right for you when you need that level of care.
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Q | How do I know the quality of a long-term care facility?
When looking for a long-term care facility, look for quality indicators like:
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Passing state inspections and maintaining certifications
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Having enough staff for the number of residents
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Having staff that stay longer than one year
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Keeping the facility clean and managing odors
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Having residents who are happy and cared for
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Providing adequate and good quality nutrition
Consider visiting the facility at different times, such as the second (3-11pm) and third (11pm-7pm) shift and especially weekends. Another good time to visit is during the meal hours to see how food trays are distributed and to check the quality and amount of food provided.
You can also check the quality of a long-term care facility by contacting the state or regional agency that oversees long-term care facilities. If available in your area, request to speak with officers of the long-term care residents’ council or request to see incident reports for the facility.
To learn more about long-term care facilities in your area, check out the Medicare.gov nursing home compare tool→.
Additional quality indicators of long-term care facilities for trans and gender-expansive people include:
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Having a nondiscrimination statement protecting diverse gender identities
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Having policies to support gender-affirming rooming assignments
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Training staff about caring for residents in the LGBTQIA+ community
For details about LGBTQ-friendly long-term care options, see the Long-Term Care Equality Index→.
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Q | How can I find a LGBTQIA+ friendly long-term care facility?
Finding a LGBTQIA+ friendly long-term care facility can be difficult. Here are some strategies to help:
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Start the process of searching for long-term care facilities early, even before you need one. You may have to wait months to years for an opening at your long-term care facility of choice, so it’s good to put plans in place in advance and even consider getting on a waitlist.
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Check out the Long-term Care Equality Index→, a database of long-term care facilities that are affirming to LBGTQIA+ people. Using this resource may help you find out what to look for in a LGBTQIA+ friendly long-term care facility, even if you don’t find one listed in your area.
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Reach out to your support networks to find a current long-term care resident who would be willing and able to talk to you about their experience.
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Team up with other trans people to get support as you look for long-term care options and to make the search more manageable.
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Q | What rooming options would I have as a trans or gender-expansive person in a long-term care setting?
Rooming options will depend on federal and state law, available beds, and cost. Single rooms are usually more costly than rooms for two occupants. Long-term care facilities may have waitlists, and your options would be determined by the first available bed. Prohibition of housing discrimination by gender identity varies by state. Policies in states with protections against gender-based housing discrimination should allow residents to be paired with a roommate in alignment with their gender identity or to live in a single room. However, it is possible for a long-term care facility in states without such protections to attempt to pair a trans resident with a roommate who has the same sex assigned at birth. The Movement Advancement Project→ tracks housing discrimination policy by state.
When looking for a long-term care facility, ask about rooming options and whether your rooming arrangement of choice would be possible.
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Information on Long-term Care→ from the National Institute on Aging
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Housing Discrimination Policy Tracking by State→ from the Movement Advancement Project