The quiet, peaceful faces of those who love you. Calm assurances whispered from the love of your life. No cares, judgments, snubs, or fears in the room with you as you slip away. Everyone wants to leave the world with dignity and in the company of love, but sadly, many in the LBGT population are robbed of this fundamental, final life event.

Growing up in an age of criminalization and stigmatization, LGBT seniors deal with depression and fear as they manage prejudice and obstacles to fair and compassionate health and aging services. According to a comprehensive 2011 survey, conducted by The Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults and the National Resource Center on LGBT Aging, a great number of the elderly never divulge their sexual orientation to their own primary physicians or caregivers.

There is an urgent need to provide LGBT seniors with the dignity in death that any person desires. This can be accomplished in the following ways:

• Life review without fear or condemnation. An LGBT senior should be allowed the opportunity to look back and reconcile their relationships, memories, and significant insights. The act of shaping the meaning of their life is a therapeutic, comforting, and satisfying necessity.
• Care goals and assurance of rights. The act of putting their ordered affairs in writing is vital. The social climate may not offer much legal protection or attempt to discriminate against them if they are unable to speak for themselves.
• A good death. Members of the LBGT community must have the comfort of knowing their final wishes will be completely fulfilled. Hospice care attempts to provide patients with full access to their social network and, a “good death” means nothing is left unresolved.
• Next steps. The key to safeguarding respectful and relevant healthcare for the LGBT community is education. Grief counseling and hospice care will entail specific services that should be modeled for clinicians nationally.  Health care workers and facilities should collaborate with prominent advocacy groups to impart and incorporate culturally pertinent end-of-life care.

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