ABSTRACT
This chapter explores social work practice with lesbian, gay, bisexual, and transgender (LGBT) older adults by describing the unique perspectives they bring to practice settings. LGBT people who came out risked job loss, eviction, imprisonment, estrangement from their families, and involuntary psychiatric treatment and institutionalization. Culturally competent social work practice with LGBT older adults in health care settings may address health disparities related to concerns about facing discrimination and underutilization of services. Life-long economic inequalities grow more pronounced over the life course, and poverty and economic insecurity are significant problems for many LGBT older adults. Transgender older adults are particularly vulnerable in long-term care facilities, especially if they have a cognitive impairment like Alzheimer's disease. Advance care planning for long-term and end-of-life needs is essential for older adults to ensure that aging LGBT individuals receive the health care they need and want, and to maintain economic security.
