When Bridget Coll was admitted into a long-term care home a few years ago, her partner Chris Morrissey was determined to make sure she wouldn’t be mistreated because she was a lesbian.
“I had no idea what was going to happen, how the staff and residents were going to be,” Morrissey explains.
Morrissey knew she’d need to advocate for Coll, whose dementia had progressed past the point where it was possible to care for her at home.
Morrissey is no stranger to advocating for herself and her loved ones. In the 1970s, as a Catholic nun working for the Franciscan Missionaries of St. Joseph, she met Coll while they were both stationed in the U.S. By 1989, the pair had moved to Vancouver to live together openly as a lesbian couple.
Coll was an Irish citizen, and Morrissey could not sponsor her immigration to Canada because they weren’t legally recognized as a couple. As a result, Morrissey launched — and won — a constitutional challenge requiring Canada’s immigration law to be amended to include same-sex partnerships.
In the decades since, she has advocated for LGBTQ2S+ refugees, immigrants and, now, fellow seniors.
Morrissey is part of a rapidly expanding population of seniors in Canada contending with the strained long-term care system. In 2021, Statistics Canada reported that one in five Canadians — seven million people — were aged 65 and older. That number will only grow in the coming years.
Courtney Dieckbrader, a specialist in senior programming for Qmunity, a LGBTQ2S+ resource centre based in Vancouver, says she’s heard troubling details about her clients’ experiences in long-term care. Dieckbrader co-ordinates events like yoga, writing workshops and gatherings, as well as resources like food security assistance and elder abuse support.
“I hear stories about people who say their care worker didn’t know what a trans person was or didn’t have the capacity to even use the right pronouns,” she says. “It can be extremely difficult for someone in that situation when that person has power over them.”
Although Qmunity does not offer housing support as part of its slate of services, Dieckbrader says she’s often approached by clients asking for housing advice because there are no formal resources or guides for LGBTQ2S+ seniors seeking care.
“I have a very limited toolkit because our province and our housing sector doesn't prioritize our community members going through that transition,” she says. “There are not specific resources that have been created.”
Not only are there no resources for LGBTQ2S+ seniors seeking accepting housing, Dieckbrader says, but those who do live in publicly funded housing also have no recourse to report homophobia and transphobia from caregivers.
While governments across Canada have been preparing for the “silver tsunami” for some time, little work has been done for seniors aging into care who belong to communities with specific needs.
Queer seniors make up one of those communities. In fact, 7.3 per cent of those identifying as LGBTQ2S+ in Canada are aged 65 and older.
And despite plenty of research showing LGBTQ2S+ seniors are often unsupported, abused and afraid in long-term care homes in Canada, B.C. has no specific policies or procedures in place to help this population thrive in care.
Nor does it offer any dedicated LGBTQ2S+ options for long-term care, something advocates say can force queer seniors into unsafe or unsupportive housing situations.
“It's long overdue that B.C. finds ways to prioritize safer housing for 2SLGBTQ+ seniors, whether it's through co-ops or special [long-term care facilities],” Dieckbrader says. “Seniors have been asking for it for a long time. This is not a new conversation.”
LGBTQ2S+ seniors’ housing elsewhere in Canada
As a new resident entered a long-term care facility in Toronto recently, his eyes lit up as he noticed a drag show was being put on near the main foyer.
“He turned around and he said, ‘I’m not going anywhere. I’m sitting right here,’” recalls Barbara Michalik, the executive director of academic, community partnerships and programming for the Rekai Centres, which runs the facility. “His family was trying to get him upstairs and he said, ‘No, I’m going to wait until this is done. This is the perfect place for me.’”
This kind of reaction isn’t unusual at the Rekai Centres, Michalik says. Ever since the June 2022 opening of Rekai’s “Rainbow Wing” — a 25-bed space in its Wellesley Central Place location dedicated to LGBTQ2S+ seniors — Michalik has seen lots of smiling faces from new residents.
“The new admissions and their chosen family members feel so safe,” she says. “They feel like they’re viewed as a whole person.”
In 2019, the Rekai Centres conducted a community study through Ipsos to evaluate the needs of LGBTQ2S+ seniors living in the area. The results, in addition to internal conversations, informed the development of what would soon become the Rainbow Wing.
“The community was overwhelmingly supportive of having a [LGBTQ2S+] unit,” she says, explaining the Rainbow Wing houses beds for LGBTQ2S+ residents who then access supports and services in the same communal space as residents of other wings in the building.
Wellesley Central Place, the Rekai Centres residence that houses the Rainbow Wing, is located a block from the Church-Wellesley neighbourhood, also known as “The Village,” Toronto’s LGBTQ2S+ community hub. Michalik tells The Tyee it was key to replicate the feeling of belonging residents get when they walk through The Village within the framework of the Rainbow Wing.
“Because we’re adjacent to The Village, we have our own little village,” she says. “[Residents] wanted to walk the halls and feel the culture. This is what we brought to them.”
When asked what sparked the Rekai Centres’ leadership to explore adding more support for LGBTQ2S+ residents, Michalik recalls a conversation she had with a resident named Gordon in 2009 after staff joked they should start planning his wedding with a female resident he was very close with.
“Gordon came downstairs to me,” she says, “He said, ‘I don’t really want to marry [her].’” After that, Michalik remembers Gordon telling her he was gay.
“He said, ‘please don’t tell anyone.’ And that’s what hit me,” she explains. “Why should a resident feel like that during the last few years of their life? Why should they go back and hide from what they fought to be?”
After this 2009 conversation, Michalik says she started working to make sure residents would never have to fear being themselves in Rekai Centres facilities. But, she adds, it took over a decade to ensure her organization was properly equipped to provide supportive, sensitive resources. (Michalik shared the same anecdote with Xtra in their recent piece about queer elder care.)
Both locations operated by the Rekai Centres provide equity-focused programming and Michalik says staff are educated about LGBTQ2S+ resident needs. Michalik says that local legislation, including the Toronto Seniors Strategy 2.0, and a subsequent City of Toronto toolkit, has helped ensured city-operated long-term care homes also prioritize LGBTQ2S+ seniors.
One province over, the Rainbow Resource Centre in Manitoba is taking a different approach to LGBTQ2S+ housing for seniors. Unlike the Rekai Centres, Rainbow is not an existing housing provider. The centre, now in its 50th year, offers programming for queer youth and seniors and supports advocacy and education in the region.
But like Rekai Centres, Rainbow has found itself at the forefront of LGBTQ2S+ seniors’ housing in Canada. Noreen Mian, the executive director of Rainbow Resource Centre, says securing housing for her organization’s senior clients has been a decades-long undertaking.
Needs assessment surveys and community engagement projects over the past 25 years continually highlighted housing as a barrier for her clients, Mian says.
Three years ago, the organization finally found the appropriate land and housing partner to make the project, Place of Pride, a reality.
While details for the site are still being finalized, Mian says Rainbow Resource Centre plans to create a campus at the Place of Pride with space for services, advocacy and drop-in support in addition to housing. An on-site coffee shop, for example, will be a place for community connection as well as low-barrier resources.
“People can just come and hang out if they need to,” she says. “This is a high-needs catchment [area], so they’ll be able to access more… basic needs like harm reduction, bathrooms and food.”
While the Rainbow Resource Centre is spearheading the initiative to bring housing to local LGBTQ2S+ seniors and owns the land Place of Pride is being built on, the operation of the independent living facility will be carried out by an existing Winnipeg non-profit housing provider, the Westminster Housing Society Inc.
Mian explains this partnership, wherein Westminster sublets the land from the centre and owns the building on it but then leases it back to the centre, is complicated on paper but has legal precedent.
The agreement effectively means the Rainbow Resource Centre will maintain a waiting list of eligible residents and move its operations on-site but will not operate the building and its units.
“You don’t want to be the organization saying, ‘no, sorry, you can’t live here,’ because that strains relationships,” Mian says. “So that was really key, as we entered into this partnership, that we could provide the social supports, the emotional supports, the programming on site… but we’re not actually operating the housing.”
Mian says she’d like to see action from the country’s different levels of government to make similar housing more accessible.
“I would just like to see long-term investment in queer spaces and queer housing, as well as a really co-ordinated effort to ensure health care is accessible as possible for LGBTQ2S+ seniors,” Mian says. “And that’s a tall order because these systems are slow to change.”
The importance of culturally appropriate supports
According to the latest report from the B.C. Office of the Seniors Advocate, the province has 294 long-term care facilities housing 27,702 publicly funded beds — 109 operated directly by housing authorities and 185 operated by contractors.
The Lower Mainland alone has a variety of housing options dedicated to seniors from specific cultural groups. There are assisted living and long-term care facilities for Chinese, Italian and Francophone seniors, to name a few, where details like building design, programming and food are tailored to the specific cultural needs of residents.
These culturally appropriate supports are often established in neighbourhoods with high populations of seniors belonging to a specific subculture. Residents benefit from living in an environment that replicates their neighbourhoods, similar to the Rekai Centres’ Village-adjacent care home in Toronto.
According to a 2017 needs assessment from the Ontario Centres for Learning, Research and Innovation in Long-Term Care, residents entering long-term care who are not culturally supported or respected may experience social isolation, health consequences, malnourishment and alienation.
Alternately, the same assessment found that residents living in culturally supportive long-term care environments were more likely to thrive. Residents with dementia, for example, were more likely to eat and drink when provided with familiar meals.
Cultural support is most commonly understood in terms of nationality, race or religion, but LGBTQ2S+ residents of long-term care can feel the same negative impacts if not adequately accommodated.
Not only does B.C. have no publicly or privately funded housing for LGBTQ2S+ seniors, it also does not appear to require long-term housing providers to meet any standards of care specifically for LGBTQ2S+ residents.
All seniors’ residential care facilities, including those that are private pay, are licensed under the Community Care and Assisted Living Act and must follow the Residential Care Regulation as well as certain standards of practice.
The Community Care and Assisted Living Act does require licensees to operate in a way that will support the health, safety and dignity of people in care, and it states that each resident has the right to “have his or her lifestyle and choices respected and supported, and to pursue social, cultural, religious, spiritual and other interests.”
Sex, sexual orientation and gender identity or expression are protected classes under the B.C. Human Rights Code, meaning it is illegal for care facilities to practice discriminatory behaviours against LGBTQ2S+ residents.
However, none of the acts or regulations that residential care licensees are required to uphold mention these protected classes explicitly or provide further standards of care related to LGBTQ2S+ residents.
This means there are no standardized policies surrounding what constitutes discrimination on the basis of sex, sexual orientation and gender identity in the context of long-term care in B.C.
Interpreting what it means to discriminate and how staff are trained about discrimination is largely left up to the discretion of individual facilities. The level of culturally supportive care that each long-term care facility provides can vary widely as a result.
Residents may be left feeling unsure whether their care staff know what it means to be transgender or how best to affirm their gender and sexuality. They may not know whether their same-gender spouse will be welcomed warmly during visits. And they may have fears that health conditions like HIV will be met with stigma.
Ultimately, a lack of provincial clarity around what it means to accommodate LGBTQ2S+ residents in long-term care leaves residents with a lot of uncertainty.
Morrissey says this created a situation where she needed to advocate for her partner to receive quality care in a culturally supportive environment.
She ensured Coll landed in a familiar facility where her connections would mean Coll was treated in a way that respected and supported her identity.
Coll spent a year and a half in long-term care until her death in 2016. During that time, Morrissey remembers one or two pointed comments from other residents, as well as a low-effort Pride celebration, but overall felt like she was in good hands.
In a statement emailed to The Tyee, a representative for Vancouver Coastal Health did not directly answer questions about the health authority’s long-term care regulations regarding LGBTQ2S+ residents.
The Tyee asked whether VCH long-term-care employees receive any training regarding serving equity-seeking elder clients, including LGBTQ2S+ seniors, or if the authority plans to incorporate training on these subjects in the future.
VCH was also asked whether there are any specific resources and activities made available to LGBTQ2S+ seniors living in VCH long-term care homes.
The health authority received these questions but did not answer them. Instead, it issued a statement reaffirming that Vancouver Coastal Health “continually looks for ways to improve our programs and services to ensure they are culturally safe, respectful and inclusive and advance health equity” and is “committed to supporting the 2SLGBTQIA+ community in all VCH-funded care homes.”
In BC and across Canada, LGBTQ2S+ seniors feel unsafe in care
Vancouver-based resource centre Qmunity has seen firsthand the impact of inequitable care on its senior clients. The centre, which serves queer, trans and Two-Spirit clients in-person in Vancouver and digitally across B.C., offers a variety of programming specifically for seniors and older adults.
“We have a clinical counsellor who runs a group to help people process [elder abuse] trauma,” explains Courtney Dieckbrader. “People are having such a hard time reporting through the channels that exist now. The provincial government has to create a regulatory body that feels safe to community members.”
When asked why Qmunity hasn’t responded to senior clients’ needs with more dedicated housing programming, Dieckbrader explains the organization just doesn’t have the funding for it.
While there exist positive examples of LGBTQ2S+ housing in Toronto and Winnipeg, B.C.’s dearth of resources for queer seniors isn’t unique. Canada-wide research conducted in the past decade shows queer seniors consistently feel uncomfortable or even unsafe in most of the country’s long-term care settings.
Jacqueline Gahagan is the associate vice-president of research at Mount Saint Vincent University in Halifax. Since 2017, they’ve been researching the unique housing needs of LGBTQ2S+ seniors in Canada.
In a series of focus groups held across Canada, Gahagan heard from seniors who had fears about housing discrimination, social isolation and the lack of government policies and practices about LGBTQ2S+ housing.
The generation of Canadians currently preparing to enter long-term care lived through a time where homophobic and transphobic legislation and beliefs meant it was impossible to be openly LGBTQ2S+ without repercussions, Gahagan explains.
“The same generation of people who were around trying to hide their identity and not get fired… are now just trying to find a safe, affirming, affordable place to live at the end of their lives,” they say. “It feels really incredible to me that that generation of individuals who were discriminated against still fear discrimination going into long-term care facilities.”
The study’s focus groups also highlighted potential solutions that would make LGBTQ2S+ seniors feel safe and supported.
Nearly 80 per cent of participants said being able to live with other LGBTQ2S+ people was important, while 57 per cent of respondents said they’d prefer to access housing with staff or landlords who identified as LGBTQ2S+.
Not all participants were interested in finding housing exclusively for queer folks. “Rather, the folks that work [and live] there actually need to know something about [LGBT] histories and treat them with respect,” Gahagan says.
“The care many LGBT older adults receive in those facilities is fear-inducing to the point that they will go back into the closet because they don’t want to confront a worker,” they add.
Gahagan added the current state of Canada’s housing market — especially high rental prices — has compounded LGBTQ2S+ seniors’ difficulties finding safe, accepting housing.
“Affordability is trumping the ability to get people into spaces that are safe,” they say.
Ultimately, Gahagan believes provincial and federal action is necessary to not only fund new housing initiatives for LGBTQ2S+ seniors but to ensure housing providers are required to meet certain standards of equity in caregiving.
“There’s a segment of the population that has never had a safe, affordable, affirming place to live,” they say. “Let’s do the right thing and get some money from the $72-billion-a-year housing strategy and actually do something for older LGBT folks.”
Progress will require government, community action
Dieckbrader and Gahagan both told The Tyee all levels of government could take very concrete steps to ensure publicly funded care facilities are meeting certain standards of care for queer seniors.
Dieckbrader believes the province should mandate anti-discrimination training, specifically around caring for LGBTQ2S+ residents.
“Staff, managers and health-care providers should be informed and there should be consequences when discrimination happens. Policy needs to be not just written, but enforced,” she says.
Although the federal government doesn’t directly oversee publicly funded seniors’ care, Gahagan says it has a role to play in not only enforcing standards across the provinces but showing that LGBTQ2S+ seniors’ care is a priority.
Until provincial and federal governments take action to directly support queer seniors, B.C. organizations do have the option to follow Rekai and Rainbow’s precedents and establish their own LGBTQ2S+ living facilities.
A non-profit could buy land and partner with a housing provider — as Rainbow Resource Centre did in Winnipeg — to create community-specific independent housing for its clients. An existing facility that already has a large LGBTQ2S+ senior population could mimic Rekai Centres’ model and reserve beds for community members.
Morrissey believes Vancouver Coastal Health should ensure there is space for LGBTQ2S+ seniors in new long-term care projects.
She raised the question of LGBTQ2S+ housing recently as part of her City of Vancouver's Seniors' Advisory Committee work on the VCH's Pearson Dogwood long-term care facility redevelopment. The new facility will see residents housed in different “neighbourhoods,” a layout seeking to move away from long hallways and clinical design. Morrissey recommended one of the neighbourhoods be reserved for queer residents and allies.
According to Morrissey, the current director of long-term care and assisted living initially seemed receptive to her idea, but communications fizzled out.
“We had a conversation about this as a potential solution, and then nothing happened,” Morrissey says.
The experts interviewed for this piece did mention smaller-scale initiatives they’ve seen individuals turn to in the absence of official support. A group of LGBTQ2S+ seniors could decide to rent multiple units in the same building or on the same street, or even buy a home together, for example.
Intergenerational support was another action nearly every source mentioned to The Tyee.
“I would encourage younger folks within the community who are doing [advocacy] to take a look at the seniors in their community as well,” Dieckbrader says.
For Morrissey, there’s an understanding that the entire long-term care industry is facing funding and staffing issues that could make it difficult to focus on specific communities.
“If there are some standards that the federal government is working on, [LGBTQ2S+ care] would be something that could be incorporated,” she said.
Although she’s comfortable living at home and only receives visits from a care worker once a week, Morrissey admits she’s thinking more and more about her own care options.
“I try to live in the present as much as possible,” she says. “I wonder, though, how long am I going to be able to continue living on my own? Then what’s going to happen to me? Where am I going to end up going? And will I have to continue to be an advocate for myself?”
“Sometimes I get tired and think, ‘What the hell? I’ve been doing this for years and years and years. It’s about time somebody else took over.’”
Read more: Rights + Justice, Housing
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