Services and Advocacy for GLBT Elders (SAGE). SAGE is the country’s largest and oldest organization dedicated to improving the lives of LGBT elders. With its headquarters located in New York City, its mission is to address issues related to LGBT aging. SAGE offers services and programs to LGBT older people throughout New York City and via its national affiliate program, SAGENet, which includes 27 affiliates located in 20 states across every region of the country. Affiliates provide services and programs to LGBT elders living in the community. Affiliates serve as advocates for the support of LBGT elders on the city and state policies that affect them (http://​www.​sageusa.​org/​advocacy/​sagenet.​cfm). SAGE offers a variety of services and programs (e.g., the arts and culture and health and wellness). Another service offered by SAGE, AGEWorks, is an employment program for LGBT elders that, like SAGENet, has sites around the country. SAGE conducts advocacy for public policies affecting LGBT elders at federal, state, and local levels in order to improve LGBT elders’ economic security, community support, and health and wellness. SAGE also trains aging providers and LGBT organizations on concerning how to support LGBT older elders in LTC settings. The organization offers cultural competence training as part of its National Resource Center on LGBT Aging and retains a training corps of nearly 40 cultural competence experts throughout the USA (http://​sageusa.​org/​about/​what.​cfm).

National Resource Center on LGBT Aging. Established in 2010 through a federal grant from the US Department of Health and Human Services, the National Resource Center on LGBT Aging is the only technical assistance resource center and clearinghouse in the country devoted exclusively to improving the quality of services and supports offered to LGBT elders . The Center provides training, technical assistance, and educational resources to aging providers, LGBT organizations, and LGBT elders. SAGE, discussed above, leads the Center and collaborates with 18 leading organizations throughout the USA (http://​www.​lgbtagingcenter.​org/​).

Other Organizations and Resources. As of this writing, the number of resources that address LGBT elders is proliferating rapidly. There are now assisted living facilities and nursing homes that openly cater to elders who are LGBT. Innovative programs targeted at LGBT elders and designed to provide a continuum of health, wellness, and social services to community dwelling LGBT elders are emerging in various communities across the USA. An example is the Chicago Elder Project at Howard Brown Center. This program is offered in conjunction with community partners (including Rush University Medical Center, CJE-Senior Life, Heartland Alliance, and Midwest Palliative and Hospice Care) to serve LGBT elders by providing culturally competent and sensitive care (Howard Brown Health Center, http://​www.​howardbrown.​org). Advocates for the rights of elders, such as the Long-Term Care Ombudsman (see Chap. 16), The NSCLC, Lambda Legal, the National Center for Lesbian Rights, the National Center for Transgender Equality, and he National Gay and Lesbian Task Force, are helping raise to the visibility and ensure the rights of elders who are LGBT.

Readily apparent from this chapter on mistreatment of LGBT elders is that few studies on elder mistreatment collect information on LGBT elder abuse. Also readily apparent is that the time has come for inclusion of this variable or variables in these datasets. LGBT elders who are mistreated are victims (polyvictims) in a multiplicity of ways—for their sexual orientation, gender identify, historic trauma either felt or experienced and the abuse or abuses (e.g., physical abuse, neglect, or exploitation) that they experience when they are abused. Seeking redress for elder mistreatment is also fraught with peril. Should an elder disclose what was previously undisclosed, the old issues of being ostracized or mistreated solely because of one’s sexual preference could be less tolerable than enduring the abuse. Even if an elder discloses what was previously disclosed, many service systems and providers are, as yet, untrained and unsympathetic for the elder’s plight and thus the intervention offered may do more harm than good. These authors stress that it is high time to include LGBT issues in research on elder abuse in order to understand incidence and prevalence of the problem in this community, to characterize victims and perpetrators, to delineate and bolster available remedies, to conduct meaningful research and advocacy, and, most importantly, to improve the quality of life of present and future LGBT elders.

The mistreatment and victimization of older LGBT adults are slowly coming to light in both practice and research. However, at this point, few studies examine this phenomenon. What is certain is that being LGBT may place elders at increased risk for mistreatment due to factors such as isolation, previous exposure to a traumatic event, and reticence to seek assistance from informal and formal networks. Penalties for elder mistreatment must be utilized by law enforcement more frequently, and statues that explore elder mistreatment as a hate crime also explored. It is critical that advocates, practitioners, researchers, and policy makers understand, intervene in, and prevent the mistreatment of LGBT elders .