As Canada’s population ages, long-term care (LTC) homes must prepare to meet the diverse needs of older adults, including those who identify as lesbian, gay, bisexual, transgender, Two-Spirit, and queer (LGBT2SQ). Despite progressive legislative changes, LGBT2SQ older adults continue to experience systemic barriers to equitable care, particularly in institutional settings. This study investigates the presence and scope of LGBT2SQ inclusive policies in LTC facilities across northwestern Ontario through an environmental scan and survey of LTC administrators. Of the 19 facilities contacted, 8 responded. The findings reveal a widespread absence of formal policies specific to LGBT2SQ residents, with most homes relying on ad hoc or case-by-case responses. Only one home reported having staff with prior training on LGBT2SQ care, although all expressed willingness to pursue such training. No facility reported LGBT2SQ-specific programming or structured inclusion frameworks. These gaps reflect a broader institutional failure to account for the historical and ongoing marginalization of LGBT2SQ individuals in aging contexts. The study underscores the urgent need for policy interventions that move beyond generic equality statements to adopt proactive, affirming, and structurally embedded approaches to LGBT2SQ inclusion. Recommendations include the development of targeted anti-discrimination policies, standardized intake procedures inclusive of sexual orientation and gender identity, and mandatory staff education. As the first generation of openly LGBT2SQ seniors enters LTC, addressing these policy deficiencies—even at the regional level—will be critical to ensuring safety, dignity, and person-centred care. Future work should explore whether similar gaps exist in LTC homes across other regions of Ontario and Canada.
Peter Brink (Wed,) studied this question.