This study adds to the existing literature about the worries of older LGBT adults as they anticipate long-term care. The results suggest that older LGBT adults seek LGBT-inclusive residential care settings that encompass two distinct yet related aspects of LGBT-affirmative care: the procedural (e.g. culturally competent skills and knowledge of practitioners) and the implicit (e.g. the values and mission of the organization). This paper identifies implications for practice, policy, and training.

This study aims to provide empirical evidence regarding whether attitudes, beliefs, and intentions of elder-service providers can be positively affected as a result of attending cultural competency training on the unique challenges of sexual and gender minorities. Stigmatization throughout the lifespan may have a causal influence on barriers to care, social isolation, and concomitant health disparities. Data were collected for this study at 4 Massachusetts training events to pilot a cultural competency workshop on lesbian, gay, bisexual, and transgender (LGBT) aging for mainstream elder service providers. This quasi-experimental study included the analysis of pre- and posttest surveys completed by the service-provider attendees (N = 76). The analytic strategy included descriptive statistics, paired t tests, chi-square analyses, and repeated measures analyses of variance. Findings revealed statistically significant improvement in numerous aspects of providers' knowledge, attitudes, and behavioral intentions subsequent to the training sessions. These included (p = .000) awareness of LGBT resources, policy disparities, spousal benefits for same-sex couples, and the intention to challenge homophobic remarks. This study concludes that mainstream elder-service provider training on LGBT aging issues results in positive change. Recommendations include long-term follow up of participants, the inception of agency-level surveys to appraise institutional culture change, and increased curriculum on transgender older adults.

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This paper reports formative qualitative findings from the Open Door Project (ODP), a unique program created by the Lesbian, Gay, Bisexual and Transgender (LGBT) Aging Project. Data were collected from Open Door Task Force members (N = 34). This includes 4 focus groups that were held with a total of 22 participants;and key informant interviews that were conducted with 12 participants from 10 different agencies. Findings revealed that agencies took significant steps to make important and long-lasting structural changes, including changing their diversity and personnel policies, and intake forms to be LGBT inclusive; implementing ongoing staff training initiatives on LGBT issues; and actively involving leadership, including senior managers, executive directors, vendors, and Councils on Aging, in helping to create and sustain organizational change. The ODP is an effective model to increase cultural competence in working with aging LGBT communities.

Lesbian, gay, bisexual, and transgender (LGBT) older adults face an increased risk of adverse behavioral health outcomes compared with the general population of older adults, yet little attention has been given to factors contributing to these disparities or to the ways in which clinicians can address these challenges. We present the case of a 75‐year‐old widowed lesbian woman with depression to illustrate how a lifetime of exposure to discrimination and stigma can produce high levels of stress and isolation while also fostering resilience. We then offer recommendations and resources for promoting psychological health among LGBT older adults by attending to the historical and cultural forces that affect LGBT health, and by implementing inclusive policies and programming. The article concludes with suggestions for advancing research and policy to help achieve greater health equity for LGBT older adults. J Am Geriatr Soc 67:1565–1570, 2019