In 2015 there were an estimated 3.9% or 9 million Americans who identified as lesbian, gay, bi-sexual, transgender (LGBT). During the past few years we have seen an increase in the number of long-term care residents who are openly part of the lesbian, gay, bi-sexual, transgender (LGBT) community. The federal 1987 Nursing Home Reform Law requires nursing homes to “protect and promote the rights of each resident”, emphasizing individual dignity and self-determination in the provision of long-term care. Every nursing home accepting Medicare and/or Medicaid reimbursement must meet federal requirements, including those regarding residents’ rights. Individuals living in nursing homes have the same rights to be free from discrimination and harassment as individuals living in the larger community. Specifically, they have rights and protections provided by federal nursing home regulations and state and federal anti-discrimination provisions. The rights of all residents should be honored and respected, regardless of sexual orientation, gender identity, or expression.
The Rights of All Residents Are as Follows:
Right to be free from abuse:
All residents have the right to be free from abuse. Facilities must develop and implement policies and procedures that prohibit mistreatment of residents, and investigate and report allegations of abuse. Resident mistreatment includes all types of abuse such as verbal, sexual, mental and physical abuse, neglect, and financial exploitation. This includes abuse from an employee, another resident, and visitors.
Right to be treated with respect:
All residents have the right to be treated with dignity, respect and consideration, and have the right to exercise their choice and self-determination. Residents have the right of the resident to be addressed in the manner in which they choose, including is the use of the residents preferred pronoun. Residents must have the right to groom and choose clothing befitting their gender identity.
Right to privacy:
Residents have the right to private and unrestricted communication with anyone they choose, and privacy regarding their medical, personal and financial affairs. Residents also have the right to privacy regarding their bodies. Care is to be provided in a way that allows for maximum privacy, whether it is in their room or in a community bathroom.
Right to participate in your care:
Residents have the right to be informed about care and treatment, participate in their own assessment, be involved in care planning, and make decisions regarding their treatment. This includes making healthcare choices related to gender transition. Residents also have the right to designate a legal surrogate to act on their behalf. Care planning in the facility needs to include input from the resident and/or family, and should address personal preferences for all aspects of their care. The facility must acknowledge any person that has been named power of attorney for the resident.
Right to receive visitors:
Residents have the right to receive visitors of their choosing. According to the federal government, “residents must be notified of their rights to have visitors on a 24-hour basis, which could include, but is not limited to, spouses (including same-sex spouses), domestic partners (including same-sex domestic partners), other family members, or friends.”
Right to be fully informed:
Facilities must inform residents of any changes in services, changes in care or treatment, changes in what is covered by Medicare and Medicaid or other health care insurance, and change in roommate or room. Facilities must provide notice before making a change in roommate and be as “accommodating as possible” by considering each resident’s preferences.
Right to participate in activities:
Residents have the right to participate in (or choose not to participate in) social, religious, and community activities both inside and outside of the facility.
Right to choice:
Residents have the right to make their own choices, including what to wear, how to express themselves, and their daily routine. Residents have the right to retain and use personal items. Residents also have the right to room with a person of their choice, including same-sex spouses or partners if they live in the same facility and both consent to the arrangement.
Right to remain in the home:
A nursing home cannot transfer or discharge a resident unless one (or more) of the permissible reasons for transfer or discharge apply. Residents cannot be transferred or discharged due to their sexual orientation or gender identity.
As long-term care caregivers we have a responsibility to uphold the rights of all of our residents and foster a community free from bullying, harassment, and abuse.