Downloaded from http://journals.lww.com/homehealthcarenurseonline by BhDMf5ePHKbH4TTImqenVICwrFV2GrwdUTtQfcraCENQhW8KKXYXrcgpBkmgG4f2Tx9svQvWEWI= on 10/18/2020 July/August 2020 Home Healthcare Now 209 Joselito Briones / Stocksy Leslie A. Alvarado, LMSW, Caroline Dorsen, PhD, FNP-BC, Char Jere, Louise Woerner, MBA, FAAN, Emily Jones, and Sarah M. Miner, PhD, RN When compared with their heterosexual cisgender (nontransgender) counterparts, LGBTQ+ older adults are more likely to delay or not seek medical care, often due to fear of real or perceived discrimination from healthcare providers. HCR Home care is a home healthcare agency in Upstate New York that has been delivering high-quality in-home healthcare services for over 40 years. We recognized that we had a unique opportunity to address the vulnerabilities of older adults in the LGBTQ+ community and to better meet their health needs as they age in place. We developed a five-step process to implement a program to better serve the home healthcare needs of the LGBTQ+ population in our community. The goal of this initiative is to provide ongo- ing community education on home healthcare, awareness of the social and health issues surrounding LGBTQ+ older adults, and ultimately to improve care and decrease health disparities. This article describes the five-step process, the challenges, successes, and implications for the future. Ensuring there are healthcare solutions available for vulnerable and marginalized individuals is key to changing the way home healthcare is structured and improving quality of life and health outcomes for all. Designing a Program to Serve Older Adult LGBTQ+ Populations in Home Healthcare B y 2030, there will be an estimated 7 mil- lion lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) adults 65 or older in the United States (National Resource Cen- ter on LGBT Aging, 2013). The plus (+) in LGBTQ+ is added to be inclusive of other identities along the LGBTQ+ spectrum that do not identify with lesbian, gay, bisexual, or queer/questioning. When compared with their heterosexual cisgender (non- transgender) counterparts, LGBTQ+ older adults are more likely to be single, live alone, and not have children (Choi & Meyer, 2016). They are also more likely to delay or not seek medical care as compared with their heterosexual, cisgender counterparts, often due to fear of real or perceived discrimination from healthcare providers based on past negative experiences or those expressed by friends or family members (Movement Advancement Project, 2019). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.