Document Type


Date of Degree

Spring 2009

Degree Name

PhD (Doctor of Philosophy)

Degree In


First Advisor

Specht, Janet K Pringle

First Committee Member

Ayres, Lioness

Second Committee Member

Beck, Frank D

Third Committee Member

Buckwalter, Kathleen C

Fourth Committee Member

Campbell, Sara L

Fifth Committee Member

Mobily, Paula R


This qualitative study used narrative analysis of interviews with 10 older lesbians (aged 55 and over) who have made a financial commitment to live in a continuous care retirement center (CCRC) specializing in lesbian, gay, bisexual and transgender (LGBT) care. The specific aims were to:

1. Describe what has impacted older lesbians' decisions to live in an LGBT-specific CCRC.

2. Describe factors that both positively and negatively impact older lesbians' perceptions of elder care. The study combined two qualitative strategies (across-case, thematic analysis and narrative analysis) and used a convenience sample.

Themes identified in across-case analysis were interpreted in the context of patterns in the narrative analysis. Categories, topics and subtopics were organized temporally. This within and across case strategy facilitated the ability to view the whole as well as individual and identify salient themes and representative stories across cases.

Stories of past negative experiences with family (resulting from the participants' sexual orientation) as well as past positive experiences within the gay community were widespread across cases. Presently, the participants are caring for older heterosexual family members and realizing that in their lesbian friendship circles they have experienced this type of care and support and not in their biological family relationships. Additionally, they are increasingly aware of their own aging and realizing that at some point they might not be able to support themselves and each other in ways that preserve their dignity and prevent discrimination, as they generally can now.

The participants' past experiences (as well as expectations stemming from them) coupled with present experiences and realizations, have led to the decision to live in an LGBT CCRC. They have concluded that the only way to be assured of dignity and respect in elder care is to decide on the LGBT CCRC. Positive perceptions regarding the decision to live in this elder care option were straightforward and directly reflected the findings for Aim I. It is important to understand older lesbians' elder care decision making because continued lack of knowledge may potentially undermine optimal care delivery of elder lesbians across settings.


Continuous Care Retirement, Decision Making, Elder, Lesbian, Long Term Care, Older Adult


viii, 121 pages


Includes bibliographical references (pages 110-121).


Copyright 2009 Marcena Lynn Gabrielson

Included in

Nursing Commons