The LGBTQ+ Inclusivity Training & Education Initiative (LITE) was developed out of a growing need for LGBTQ+ training and education for health care workers to benefit patients and their families who are using skilled nursing facilities (SNFs) or long-term care (LTC) facilities within the Duke Health HOPE SNF Collaborative. The training and education topics that you find below were carefully selected by LGBTQ+ members of the community, SNF administrators and health care workers, North Carolina ombudsmans, and associates of AARP of North Carolina and Carolina Aging Alliance. While these resources are for the SNF/LTC environment, we feel confident that there is helpful and supportive information for everyone.

This project was supported by Duke’s Bass Connections Health Policy and Innovation theme and Duke’s Clinical & Translational Science Institute. For more information or to suggest a resource topic, please email inquiries to the team at

Click HERE for the Duke Health LITE 6 Best Practices for LGBTQ+ Care flyer.

Below is a list of LGBTQ+ resources broken down into several categories. The materials are subdivided by the average length of time to read. If you find yourself with just 5-10 minutes, there are resources under each tile. If you have more time and would like more detailed information (15-30 minutes or more), please check out the links under the additional resources category.


HOPE SNF LGBTQ Link Icon - Aging


LGBTQ Dignity: Caregiving, Health and Housing Experiences of Adults 45+ from - Quick facts about percentage of LGBTQ older adults with health conditions, risk of social isolation, caregiver concerns, home insecurity and discrimination

How To Use Gender Pronouns from SAGE

Common LGBTQ+ Terms and Definitions from SAGE

Facts about Rural Aging for LGBTQ+ Older Adults from SAGE

Not Another Second - stories of LGBTQ+ older adults

DIGNITY 2022: the experience of LGBTQ older adults from - This report provides information about LGBT older adult experiences in the areas of relationships, caregiving, home and community, health care, and financial security.

More LGBTQ+ Aging Resources

Basic Knowledge

HOPE SNF LGBTQ Link Icon - Basic Knowledge


An Ally's Guide to Terminology: Talking About LGBT People & Equality from GLAAD MAP - This pdf provides simple examples of terms that can be used and terms that should be avoided.

An Ally's Guide to Talking About: Marriage for Same-Sex Couples from GLAAD MAP - Marriage is about love and commiment to one another, and the reasons we all marry are the same. This documents provides some guidance when talking about marriage and individuals who identify as LGBTQ.


Best Practices

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Tips for Working with LGBT Older Adults from - suggestions for working with LGBT older adults, including use of pronouns, staying open minded, and welcoming conversations

Inclusive Services For LGBT Older Adults: A Practical Guide To Creating Welcoming Agencies from SAGE - terminology, gender affirmation, and inclusion are essential to providing a welcoming setting for LGBTQ+ older adults

Commission on Sexual Orientation and Gender Identity: Best Practices for Promoting LGBT Diversity from the American Bar Association - This PDF offers guidance on practices that nursing home facilities can take to support LGBTQ older adults.

Cultural Competence in the Care of LGBTQ Patients from the NIH: National Library of Medicine - The objectives of this paper includes describing acceptable terms for gender and sexual identity in the LGBTQ+ community, summarizing challenges in the LGBTQ+ community, underlying communication necessary to provide culturally correct evaluation and treatment of LGBTQ+ individuals, as well as explaining cultural competence when caring for LBGTQ+ patients.

More LGBTQ+ Best Practices Resources

Caregiver Resources

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Six Tips for Starting an LGBTQ+ Peer Support Group In Your Community from The Affirmative Couch

Lessons Learned: Forming a Peer Support Group from The Affirmative Couch - Support group benefits and ways to address group needs

LGBT Caregiver Concerns from the Alzheimer's Association - This document provide suggestions for planning for the future, accessing quality health care, and finding support.

Resources for LGBTQ Caregiving from

COVID-19 & LGBTQ Older People from the Human Rights Campaign and SAGE - This flyer goes over some information for older adults, caregivers, and community members about COVID-19 and living as an LGBTQ older adult, and it provides some best practices to support older people in the community.

More LGBTQ+ Caregiver Resources

Dementia Care

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Assessing the LGBT cultural competency of dementia care providers from the Alzheimer's Association - assessment of preparedness, attitudes, and knowlegde about LGBT cultural competency and dementia

Issues Brief: LGBT and Dementia from SAGE - LGBT older adults have distinct aging experiences and face specific health disparrities leading barriers to accessing help, including discrimination, heterosexist attitudes, and lack of cultural competence on the part of providers.

LGBTQ Community Caregiving Guide: A Planning Guide for Caregivers in the LGBTQ Community from

Trans-Inclusivity in Alzheimer's Care with the Human Rights Campaign from the Alzheimer's Association

LGBTQ Older Adults and Dementia: What You Need to Know from the Alzheimer's Association - study about prevalence of cognitive decline among gender minorities

More LGBTQ+ Dementia Care Resources

Diversity & Inclusion

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LGBTQ+ older adults fear discrimination in long-term care, need protections from SAGE - safety of LGTBQA+ older adults living in LTC has to include widespread training to staff members

How To Be an Ally: Program Toolkit from American Bar Association - dos and don't; creating awareness of bias

Learning to Address Implicit Bias Towards LGBTQ Patients: Case Scenarios from the National LGBT Health Education Center - helping healthcare providers get knowlegde about bias towards LGBTQ+ patients. This is not specific to older adults but it helps to get a broad understanding about bias.

Local Community Advocacy: Advocating for the Needs of LGBT Older Adults Receiving Aging Services from SAGE

Our Internal Commitment to Diversity, Equity, and Inclusion from Justice in Aging - This resource explains why diversity, inclusion, and equity are important for the aging process.

Protecting the Rights of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) People from US Dept of Health & Human Services - gender Affirming Care and other LGBTQ+ peoples' rights

More LGBTQ+ Diversity & Inclusion Resources

Elder Abuse

HOPE SNF LGBTQ Link Icon - Edler Abuse


Responding to Transgender Victims of Sexual Asault from the US Justice Department Office from Victims of Crime - Some transgender individuals segregate their healthcare (in which only certain professionals are aware of their transgender status while other professionals are not) due to fears of rejection, denial of services, and/or violence.

Mistreatment of Lesbian, Gay, Bisexual, and Transgender (LGBT) Elders from - Occurence of abuse and neglect of LGBTQ older adults is prevalent. Types of violence include verbal harassement, threat of violence and physical violence.

VIDEO: Elder Abuse Among LGBT Community - Quick video on issues affecting LGBTQ older adults help seeking such as threat of being outed, fear that authorities won't believe in the accusations, fear losing financial support, and fear of living alone.

VIDEO: Building Support for LGBT Elder Justice from SAGE - This is a comprehensive video on elder abuse among LGBTQ+ older adults. It shows the types of abuse and suggests ways to support LGBTQ+ older adults against abuse.

End-of-Life Care

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VIDEO: End-of-life care considerations for LGBTQ older adults with Carey Candrian, PhD | Moving Medicine from the American Medical Association - End-of-life care disparities are influenced by financial insecurity, lack of social support, lifetime effects of stigma, and discrimination.

Simple Tips in Supporting Older LGBTQ Friends and Loved Ones at End of Life from SAGE

Perspective: Advancing Health Care for Lesbian, Gay, Bisexual, and Transgender Patients in Missouri from the National Institutes of Health - history of marginalization and effective strategies for healthcare providers based on suggestions from SGM patients and communities


HOPE SNF LGBTQ Link Icon - History


History of Gay Rights from - view a timeline of the American Gay Rights Movement

LGBTQ Rights Timeline in American History from - a timeline of major LBGT events in the United States

History of Lesbian, Gay, Bisexual and Transgender Social Movements from - a timeline of major LBGT events in the United States

Love Story Behind America’s First Gay Marriage from - This article covers the history behind the book The Wedding Heard ’Round the World: America’s First Gay Marriage and includes a snippet of the book for interested readers.

More LGBTQ+ History Resources

Inclusive Environment

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LGBT Older People Built the LGBT Community from - This document brings simple suggestions for how to create a supportive organization and community that engages everyone in helping LGBTQ+ older adults to feel included and protected.

Older Adults Equality Collaborative: Equality Assessment Checklist from - Social Security pays survivors benefits to the surviving spouse and some dependents of a deceased worker. A surviving spouse could be entitled to benefits or a higher benefit amount based on a marital relationship, and marital status is important to determining entitlement to benefits.

Why the Long-Term Care Equality Index? from the Human Rights Campaign and SAGE

SAGECare Resources Page - SAGE certification details to support LGBTQ+ inclusive practices in your SNF

Dos and Donts for Straight Allies from the University of Illinois - helpful, short "dos and donts" for allies when someone comes out

More LGBTQ+ Inclusive Environment Resources

Legal Information

North Carolina Resources

HOPE SNF LGBTQ Link Icon -NC Resources


LGBT Center of Raleigh - The LGBT Center of Raleigh provides various services to the surrounding area, including support groups, HIV/STI testing, mental health resources, social events, and more.

LGBTQ Center of Durham Resources List - This list compiled by the LGBTQ Center of Durham provides LGBT supportive businesses, individuals, and organizations in the Durham area and its surroundings.

Equality North Carolina - building LGBTQ+ power through advocacy, education, and uplifting the stories of queer and trans North Carolinians in pursuit of racial and social justice

Carolina Aging Alliance - a safe, supportive, and empowering home for the local LGBTQ+ community

Trans in the South: A Directory of Trans-Affirming Health & Legal Service Providers from the Campaign for Southern Equality

More LGBTQ+ Resources in North Carolina

Religion & Moral Grounds

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Faith Positions from the Human Rights Campaign - website that highlights various relious views on LGBTQ+ individuals

Religious Exemption Laws from the Movement Advancement Project - a map showing states that allow coorporation to seek exemption from providing services that burden their religious beliefs. NC does not have such exemptions when it comes to health care services needed among LGBTQ+ older adults.

Conscience and Religious Nondiscrimination from US Dept of Health & Human Services - This document explans the rights of healhcare providers when it comes to refuse to perform, accomodate, or assist with healthcare services on religious or moral grounds. Federal Health Care Provider Conscience Protection Statutes protect health workers in two topics: abortion and assisted suicide practices.