by Sadiya Abjani, Director of Training and Instructional Design, SAGE
When we talk about creating welcoming, person-centered spaces for older adults, two words frequently pop up: equality and equity. People often use them interchangeably, but they actually mean very different things. Understanding the difference between the two is a crucial first step in providing truly affirming care for LGBTQ+ older adults in residential and long-term care settings.
Let’s start with some simple definitions.
Equality means treating everyone exactly the same, regardless of their individual differences. Imagine handing out pairs of shoes to a group of people. If you give everyone a size 8 shoe, that is equality. You are treating everyone equally, but the shoe is only going to fit a small handful of people.
Equity, on the other hand, means recognizing that we all start from different places and have different needs. Equity is giving everyone a pair of shoes that actually fits their specific feet.
In senior housing or residential care settings, equality might look like a provider saying, “We treat all our residents exactly the same.” While this sounds fair in theory, it ignores the unique histories, backgrounds, and systemic barriers that different people bring with them. Equity means acknowledging those differences and actively working to ensure everyone has the specific tools they need to thrive.
When it comes to caring for LGBTQ+ elders, an “equality” approach simply falls short. Many LGBTQ+ older adults have lived through decades of stigma, criminalization, and discrimination. Because of this history, treating them “just like everyone else” often means assuming they are straight and cisgender, which can inadvertently erase their identities, make them feel unsafe, and lead to substandard care.
The statistics paint a clear picture of why a tailored, equitable approach is necessary. According to an AARP study, 85% of LGBTQ+ older adults are concerned about facing discrimination based on their sexual orientation or gender identity when seeking long-term care. Furthermore, data from SAGE highlights that LGBTQ+ older people are twice as likely to be single and three to four times less likely to have children than their heterosexual peers. This means they often lack traditional family support systems and rely heavily on “chosen family.” If a care community only views support through a traditional lens, LGBTQ+ residents are left at a severe disadvantage.
How do we move from equality to equity in senior living communities? It starts with intentional, inclusive practices, just like those championed by our SAGECare training programs and the Long-Term Care Equality Index (LEI). Here are two real-world examples:
1. Inclusive Intake Questions An “equal” approach uses a standard, one-size-fits-all intake form, typically asking for a person’s “marital status” or the name of a “husband/wife.” An equitable approach updates these forms to include open-ended questions about sexual orientation, gender identity, chosen names, and pronouns. It also leaves room to define “chosen family” as emergency contacts. Asking inclusive intake questions signals right away that your community sees the resident for who they are. It builds immediate trust and prevents older adults from having to hide their identity or awkwardly correct staff members.
2. LGBTQ+ Focused Programming Because LGBTQ+ elders are more likely to age alone and face social isolation, equitable care means creating programming designed specifically to combat those unique challenges. Instead of just offering general recreation activities, an equitable community might host an LGBTQ+ social hour, celebrate Pride Month, or bring in local LGBTQ+ guest speakers. This isn’t about giving one group “special treatment.” Rather, it provides a safe, affirming space for marginalized residents to connect, share their life experiences, and build a supportive community without fear of judgment.
No one should have to go back into the closet just to receive quality care and housing. Shifting our mindset from equality to equity ensures that we are not just treating everyone the same, but treating everyone with the specific dignity, respect, and understanding they deserve. By embracing inclusive policies and programming, we can make sure every LGBTQ+ older adult feels truly at home.
Compassion with Pride Resource
