Research & Links

We’ll post interesting articles about aging services.


The website, Senior Advice, finds Austin the #1 city in the U.S. for Gay Retirement in an article titled: America’s Best Cities for Gay-Friendly Retirement by Lori Thomas. Click on the title to read the whole article.

Here’s the text about Austin:

Retirees from all walks of life want to settle down in a place that is fun and inviting, but also affordable and accommodating to the needs of older people. Members of the LGBT community have to be even more selective. Even in 2016 not all cities in America are particularly welcoming to those living “non-traditional” lifestyles and only a few select places have thriving social environments for LGBT residents.

Using SeniorScore™, an unbiased, data-driven algorithm that determines the most accommodating places in America for seniors, we have determined the best cities in the country for retirees who identify with the LGBT community. The SeniorScore™ evaluates over 100 variables across multiple categories that are pertinent to an area’s older residents, including access to healthcare, social and recreational activities, general affordability, safety, quality of environment, and more. Additionally, we analyzed the overall LGBT populations per capita for each city, the presence of gay-friendly social environments, support for gay-owned businesses, and the overall level of tolerance and legal protection of the communities.

Here are the best cities in America for gay-friendly retirement:

1) Austin, TX

Everyone and their pet poodle are moving to the Texas Capital but it’s not just young urban hipsters who find life here very inviting. Austin is a very progressive city where tolerance is the norm. Over 5% of the population identify as gay and there is a thriving social scene to go along with this large community. There is also a general acceptance of the LGBT community by the population at large and strong support for gay-owned businesses – there is even an Austin Gay & Lesbian Chamber of Commerce. But beyond the abundance of gay bars and a Pride Week that rivals those in many large coastal cities, Austin is also a political hub for LGBT advocacy.

For outdoor recreation, it’s hard to top this charming metropolis. With tons of sunshine and warm weather, outdoor walking trails galore, urban swimming holes like Deep Eddy Pool and Barton Springs, and an overall focus on wellness, Austin is an outdoor lover’s dream. The city also boasts one of the best restaurant and bar scenes in the country, so there is never a shortage of interesting places to explore with friends after hours.

The cost of living has been heading upward for years, but it is still quite affordable relative to other major urban destinations like Los Angeles, San Francisco, and New York. And while property taxes tend to be pretty high, Texas has no state income tax and average incomes are much higher in Austin than in other parts of the US.

For full details on the Austin score, click Austin SeniorScore™.


Here’s an article from The Gerontologist Journal (2015, Vol. 55, No. 1, 154–168), titled:

Special Issue: Successful Aging Among LGBT Older Adults.

Purpose: Lesbian, gay, bisexual, and transgender (LGBT) people are a health disparate
population as identified in Healthy People 2020. Yet, there has been limited attention
to how LGBT older adults maintain successful aging despite the adversity they face.
Utilizing a Resilience Framework, this study investigates the relationship between physical
and mental health-related quality of life (QOL) and covariates by age group.
Design and Methods: A cross-sectional survey of LGBT adults aged 50 and older
(N = 2,560) was conducted by Caring and Aging with Pride: The National Health, Aging,
and Sexuality Study via collaborations with 11 sites across the U.S. Linear regression
analyses tested specified relationships and moderating effects of age groups (aged
50–64; 65–79; 80 and older).
Results: Physical and mental health QOL were negatively associated with discrimination
and chronic conditions and positively with social support, social network size, physical
and leisure activities, substance nonuse, employment, income, and being male when
controlling for age and other covariates. Mental health QOL was also positively associated
with positive sense of sexual identity and negatively with sexual identity disclosure.
Important differences by age group emerged and for the old–old age group the influence
of discrimination was particularly salient.
Implications: This is the first study to examine physical and mental health QOL, as an
indicator of successful aging, among LGBT older adults. An understanding of the configuration
of resources and risks by age group is important for the development of aging
and health initiatives tailored for this growing population.

Click on the link below to download the PDF file.

LGBT Aging Successfully Study


August 16, 2017

Contact: CMS Media Relations
(202) 690-6145 CMS Media Inquiries

CMS Releases Hospice Compare Website to Improve Consumer Experiences, Empower Patients

Today, as part of our continuing commitment to greater data transparency, Centers for Medicare & Medicaid Services (CMS) unveiled the Hospice Compare website. The site displays information in a ready-to¬¬-use format and provides a snapshot of the quality of care each hospice facility offers to its patients. CMS is working diligently to make healthcare quality information more transparent and understandable for consumers to empower them to take ownership of their health. By ensuring patients have the information they need to understand their options, CMS is helping individuals make informed healthcare decisions for themselves and their families based on objective measures of quality.

“The Hospice Compare website is an important tool for the American people and will help empower them in a time of vulnerability as they look for information necessary to make important decisions about hospice care for loved ones,” said CMS Administrator Seema Verma. “The CMS Hospice Compare website is a reliable resource for family members and care givers who are looking for facilities that will provide quality care.”

Hospice facilities offer specialized care and support to individuals with a terminal illness and a prognosis of six months or less if the illness runs its normal course. Once a patient elects hospice care, the focus shifts from curative treatment to palliative care for relief of pain and symptom management, and care is generally provided where the patient lives. Additionally, caregivers can get support through the hospice benefit, such as grief and loss counseling. Hospice Compare helps patients and caregivers find hospice providers in their area and compare them on quality of care metrics.

Section 3004(c) of the Affordable Care Act (The Act) amended section 1814(i)(5) of the Social Security Act to authorize a quality reporting program for hospices. The Act requires hospice providers to report data to CMS on a number of quality measures selected through notice and comment rulemaking. The Hospice Quality Reporting Program (HQRP) includes both quality data from the Hospice Item Set (HIS) and Hospice Consumer Assessment of Healthcare Providers and Systems (Hospice CAHPS®).

The Hospice Compare site allows patients, family members, caregivers, and healthcare providers to compare hospice providers based on important quality metrics, such as the percentage of patients that were screened for pain or difficult or uncomfortable breathing, or whether patients’ preferences are being met. Currently, the data on Hospice Compare is based on information submitted by approximately 3,876 hospices.

The Hospice Compare website will reflect current industry best practices for consumer-facing websites and will be optimized for mobile use. For more information, please visit to view the new Compare site.

For more information, visit the Hospice Quality Public Reporting webpage.

Other CMS Compare websites include: Inpatient Rehabilitation Facility Compare; Long-Term Care Hospital Compare; Hospital Compare; Physician Compare; Nursing Home Compare; Medicare Plan Finder; Dialysis Compare; and Home Health Compare.

For more information on today’s announcement, please visit:



John Banvard, 100, and Jerry Nadeau, 72, are military veterans, and served in World War II and Vietnam, respectively.  When they met in 1993, they were “sort of in the closet.” John’s wife of over 35 years had died nearly a decade prior and he had never been in a serious relationship with a man. Neither had Jerry.  At first, the two seemed worlds apart. John was a lover of art and theater, while Jerry was an outdoorsman. But they hit it off and soon became inseparable.

There’s a lovely interview with them on StoryCorps.
Click here to listen to the interview

Don Kilhefner, PhD is a Jungian Psychologist in Los Angeles. He has been an important figure in the field of gay psychology and psychological health since the beginnings of the Movement. He now champions the importance of Gay Elders serving as mentors for younger generations. He has a number of videos on YouTube under the name Gay Tribal Elder.

Click Here for “Gay Tribal Elder with Don Kilhefner” Archive of You Tube Talks and Appearance


AARP has produced a major study titled “Maintaining Dignity: Understanding and Responding to the Challenges Facing Older LGBT Americans.” It’s a VERY impressive study.

Here’s a link to the page at AARP for Maintaining Dignity.   This link will download a pdf.


Here is a summary of the Key findings:

More lesbians than gay men are living with a partner or are married. Gay men may be more isolated than lesbians.

Bisexuals age 45 and over are less likely to be ‘out’ and can be harder to reach with general LGBT outreach compared to lesbians, gay men, and transgender community members.

The gender expansive community faces unique challenges and increased fear of discrimination.

Black and Latino LGBT Americans are more concerned about multiple forms of discrimination and negative outcomes as they age.

The three biggest aging concerns of LGBT Americans age 45+

  • 76% are concerned about having adequate family and/or social supports to rely on as they age
  • 73% do not have access to LGBT-specific senior services (and 91% are at least somewhat interested in LGBT-welcoming housing development for older adults)
  • 60%+ are concerned about long-term care
    • 67% concerned about neglect
    • 62% concerned about abuse
    • 61% concerned about limited access to services
    • 60% concerned about verbal or physical abuse
  • LGBT participants are largely satisfied with their current healthcare relationships, but also fear discrimination and prejudice
  • Any action to intentionally affirm LGBT adults by long term care providers and facilities can improve patient comfort and quality of care
    • 88% would be more comfortable if providers were specifically trained for LGBT patient needs
    • 86% would be more comfortable to see explicit advertising promoting LGBT-friendly services
    • 85% would be more comfortable to know if providers are staff are LGBT themselves
    • 82% would be more comfortable to see LGBT-welcoming signs or symbols displayed on site/in offices, online or in communications
  • With all the concerns facing LGBT people, those age 45 and over are still “mostly” optimistic if they are living in an LGBT-friendly community
  • LGBT community members often have a broad social support network, but can be surprisingly weak in having support from their family
  • LGBT older Americans live in all sizes of cities, towns, suburbs and rural areas, but they seek out LGBT-friendly local communities, even within more conservative regions of the country
  • Though small communities are far less likely to provide access to LGBT-specific health or senior services, community size is less important than a community’s perceived LGBT-friendliness in determining if a person feels supported
  • Older LGBT community members are also parents and grandparents
  • There is some fear of housing discrimination among older LGBT adults

Texas Health & Human Services has released a brief report on its
Aging Well Texas Initiative.

Here’s a link to the report. Click here or on the image below.