Resident Move-In Procedures Overview

Moving into a new long-term care community is a pivotal moment for an LGBTQ older adult.  Many fear that they will need to “go back into the closet” in order to receive quality care and be treated with dignity and respect.  For individuals coming out of the hospital, this might be their first introduction to long-term care and may not have chosen the community, but were referred there by the hospital as the first (possibly only) option available.  

First experiences such as the move-in process (also called admission) can set the tone and result in a retreat to the closet or an open and honest conversation about identity and culturally responsive needs. It’s a critical time to gather needed information in order to ensure each resident’s needs are being met in affirming ways.

This section includes assessing critical issues such as how to ask about someone’s sexual orientation and gender identity and expression and how to record and use that information in the most respectful manner.

During intake or move-in/registration interviews, does your community have procedures for asking new residents for information about the following and capturing this information in their records? Sexual orientation, gender identify, names/pronouns?

It’s considered a best practice by many industry standards to provide opportunities to gather information about an individual’s sexual orientation and gender identity / expression in order to ensure affirming and culturally responsive services. The National Resource Center on LGBT Aging has produced some of the most well-known documentation that explores how long-term care communities can ask and track this information during move-in interviews with new residents:

Inclusive Questions for LGBT Older Adults: A Practical Guide to Collecting Data on Sexual Orientation and Gender Identity

It is imperative that long-term care communities establish standard protocols to ensure that a resident’s expressed name and pronoun are used in record-keeping and in interactions with staff, volunteers, residents and visitors.  

For transgender individuals, the name and gender that appears on a legal state identification card, social security card, financial accounts, health insurance and healthcare records may differ from the resident’s expressed name and gender.  Long-term care communities must develop procedures for maintaining any legal naming obligations while also ensuring that only a residents expressed name and gender pronoun are reflected in day-to-day internal operations and interactions.  This includes activity rosters, service requests, room name plates, and every place in which a resident’s name is used unless there is a legal requirement to do otherwise.

For example:

Screenshot of EHR that asks about sexual orientation and gender identity

Does your community's forms provide gender-neutral options for identifying spouse/partner, emergency contact, and durable power of attorney as applicable?

Forms are often the first indicator to LGBTQ people about the extent to which an organization or long-term care community is inclusive of LGBTQ people.  Including gender neutral options for identifying important family members, friends, and emergency contacts is not only a positive signal of inclusion, it also provides staff with important information about what names and pronouns to use in discussing the important people in a resident’s life.