Research summary: Helping 2SLGBTQI+ older adults to age in place
Official title: Helping 2SLGBTQI+ older adults to age in place: What we heard report
Authors of the report: Anna-Maria Occhiuto, Sarah Morningstar, Nathalie Padros Ross, Ivana Previsic and Stéphanie Tourillon-Gingras
Alternate formats
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Why this study
This study was a part of the Government of Canada's first Federal 2SLGBTQI+ Action Plan. The purpose was to increase understanding of the experiences of 2SLGBTQI+ older adults aging in place. This study will strengthen 2SLGBTQI+ data and contribute to evidence-based policy.
What we did
ESDC consulted with older adults aged 55 and over, who are Two-Spirit, lesbian, gay, bisexual, transgender, queer, and/or intersex, or who use other terms related to gender and sexual diversity (2SLGBTQI+). Participants lived at home in communities across Canada. Data was collected through:
- an online survey (536 respondents)
- individual interviews (67 participants)
- a Photovoice activity (41 participants)
- walking interviews (5 participants), and
- five focus groups with organizations serving 2SLGBTQI+ groups and older adults
What we found
This study found themes shared with the general population. These included:
- wanting to age in their own homes and communities
- worrying about rising living costs, and
- having enough retirement income
Most survey respondents (81%) plan to age in their current home. Only one third (33%) had a financial plan to cover the costs and half (50%) were not confident they could afford the services needed to age in place. Less than 2% plan to age in a retirement home or in long-term care.
Most interview participants receive health and care services outside their homes. Participants said that telehealth and in-home services should be more available. They also said that social supports are central for helping them age in place. For example, friends and family can help with running errands, home maintenance, and social activities to prevent isolation.
The 4Ss: Safety, Stability, Social Support and Society
The study also found four common themes (the 4Ss) that help 2SLGBTQI+ older adults to age in place.
Safety
Physical, emotional, and psychological safety affect older adults' ability to age in place. For 2SLGBTQI+ older adults, safety was hard-earned, but fragile.
Most (80%) survey respondents faced some form of discrimination. Most often it was based on:
- sexual orientation (58%)
- age (44%), and
- gender identity or gender expression (26%)
Interview participants indicated that awareness and a sense of vigilance help determine the people and places that are safe. For them, aging in place means:
- enjoying the comfort and safety of home
- living authentically
- being independent
- being with loved ones, and
- pursuing hobbies and passions
Stability
Stability means having dependable resources, relationships and sources of support to help older adults age in place. For 2SLGBTQI+ older adults, this takes extra time and energy. For example, moving to a new neighbourhood means making sure it is safe to be themselves and changing services may mean educating providers on how to meet their needs.
Many interview participants had good careers and were financially secure. This gave them stability and resilience in the face of challenges. To stay financially stable, some participants did not share their sexual orientation at work. Survey respondents had diverse financial realities. In focus groups, organization representatives said that 2SLGBTQI+ people earn less over their lifetime, especially transgender people. This results in less financial security when they retire.
Social Support
Social support is important for physical and mental wellbeing. The journey to living authentically was often difficult for most participants. Over time, most participants found friends and communities who accepted, supported, and loved them. Chosen family and intentional community were very important. Many rely on these connections more than their biological families for support as they age.
Some survey respondents (41%) felt not very confident or not confident at all about having the social support they needed to age in place. Respondents with a disability were even less confident. Of these respondents, 30% had no one they could count on for help with daily tasks as they age.
Society
Wellbeing is connected to how safe people feel in society. The life experiences of 2SLGBTQI+ older adults shape their hopes and fears about aging. Interview participants said that Canada has made progress but some still face discrimination and stigma. Many worry that progress could slow or that hate could grow again. This could harm 2SLGBTQI+ rights. Due to these concerns, participants want to age in place. They want to avoid institutional or long-term care due to the fear of discrimination and increased vulnerability. Fears include:
- being mistreated or receiving poor care - especially for transgender participants
- having to hide their sexual orientation or gender identity again (going back into the closet)
- being separated from their spouse or partner(s), and
- facing attitudes and behaviours from residents that may have bullied them growing up
What it means
This study helped strengthen 2SLGBTQI+ data and could inform future policies and programs. Suggestions from survey respondents, interview participants, or organization representatives include:
- improve access, availability and affordability of health and care services
- set professional standards for health care and require 2SLGBTQI+ awareness training
- support and fund more 2SLGBTQI+ inclusive services and organizations
- support alternative aging and housing models
- improve data, awareness and visibility
- improve financial and housing security
Contact us
For the full report, consult the Helping 2SLGBTQI+ older adults to age in place: What we heard report.
Contact us using the email address below.
Strategic and Social Policy Branch, Social Policy Directorate, Social Research Division
Email: esdc.nc.sspb.research-recherche.dgpss.cn.edsc@esdc-edsc.gc.ca