Characterizing lesbian, gay, and bisexual patients' experiences with elder abuse: A chart review study

Older adults who identify as lesbian, gay, or bisexual (LGB) may be at increased risk of elder abuse (EA) due to unique risk factors; however, research in healthcare settings has been limited by the lack of data on sexual orientation. Since 2022, the Veterans Health Administration (VHA) has collected self-reported sexual orientation for all patients. The objective of this chart review study was to use newly available electronic health record (EHR) data to explore the documented experiences of older LGB adults identified with EA concerns.

We randomly sampled 100 of 201 Veterans aged ≥60 years with an outpatient visit between 10/2022-9/2023 who identified as LGB and had a social work visit for possible abuse/neglect. We conducted protocolized chart reviews of clinical notes within ±180 days of the social work visit for 23 LGB patients, with EHR documentation confirming EA, to describe key characteristics and documented EA experiences.

Among 23 EA cases in LGB Veterans, 8 (35%) had cognitive impairment, 8 (35%) reported a history of child maltreatment, and 7 (30%) reported military sexual trauma. Veterans' sexual orientation was sometimes noted to contribute to past abuse experiences; however, the relationship between sexual orientation and EA or EA care processes was rarely documented by clinicians.

Findings highlight important considerations for sexual orientation minority patients experiencing EA, including opportunities to examine both contributors to EA risk among older LGB patients and to address LGB-specific care needs for this population in future research.