Table 1:

Themes, categories, and representative quotations from focus groups with LGBT Older Adults’ regarding the themes of definitions and etiologies of abuse.

Categories	Representative Quotations
Definitions of Abuse
Typical definition of elder abuse	“elder abuse is an… intentional act, which may be medical, physical, mental or social, … a failure to act by a caregiver or a person or people in a relationship… which causes harm to a person who is 60 plus years old “
Ostracism due to LGBT status	“he move away… and then when [his mother] died the sister of all of his relatives, only they inform him that she passed away but he doesn’t go to the funeral, …because the family … doesn’t like to mingle with him. So I think it is abusive mentally”
	“And I find that a lot of us are isolated and ostracized by our families”
Service providers	“… if you have to call the police for a situation and they come and it’s SGL, same gender loving people, they think it’s a joke.”
	“I mean it’s not the physical abuse I suffered at the hands of New York’s finest “
	“When I go to my doctor, I’m afraid to talk about who I am and ask for help, and that to me is a hindrance for me getting the care that I need. And for me, that’s a form of abuse…I’m not going to get the right kind of medical care that I deserve. “
Etiologies of Abuse
Desire for Power and Control	“I think it’s a power trip that people in terms of if they feel inferior it helps their self-definition to hurt someone lower than themselves.”
Cycles of Family Violence	“But besides that, we’ve got to, we’ve really got to go back into our family and our history and people in general because abuse just doesn’t start … as a child, some of us are abused by our parents … They could be hating for whatever reason, but when they grow, as a child they’re abused, and they bring that up through the ages with the kids beating up their kids, the kids beating up their kids, and it goes up on the line. It’s just not one, bad thing, it’s ongoing. “
Abuse due to increased dependency and changing roles	“The grown children might not have the patience. It’s like when… the children were small you had so much patience to teach them this…but when you get up in age they don’t have that patience.”
	“I think a lot of times through the years, I mean, it was loving and everything, but after while when one gets kind of ill.. they become like co-habitating… it’s like you’re in a prison without bars. You want to leave, but there’s no place to go; you’re up in age now. So you have to deal with whatever happens…. And you resent that… and the loving that you had before, it’s kind of like fades away.”
Increased victimization due to LGBT status & aging	“And the answer is there are still people today who think that they can get away with… abuse towards homosexuals via the senior.”
	“But I bet if you took a survey, you’d find there’s a lot of still harbored resentment against this community and because of the resentment… the LGBT community is much more susceptible to abuse and then when you become elderly and frail and defenseless, even more.”
	“We have more than one thing to fight against. The discrimination of being LGBT and… then you have the double whammy of being elderly.”
Isolation of family & lack of advocates	“And I find that a lot of us are isolated and ostracized by our families, so when we have to depend on nursing homes and medical facilities and we don’t have anybody to advocate and come and visit us to make sure that we’re alright and that things are going fine for us, those are the times when we are abused. You see it happening all the time, you know… riddled with bed sores because nobody cares. Nobody’s visiting, nobody’s taking heed to what’s happening to the older adult in the community.”
Providers’ communication	“When I go, “What’s your pain level?” It’s so and so. Okay, bah, bah, bah, into the computer. Alright, bah, bah, bah, you’re out.”
Medical P roviders Personal Bias	“My mother was in a nursing home, 95, terrible problem with her knee. I went out and I found a doctor in the hall…he said to my mother, ‘Alright, what’s the problem?’ She says, ‘My left knee is in terrible pain,’ so the doctor didn’t give her anything…’What do you want at your age? You’re 95.”
	“Also we need to be careful when other gay people go especially to the doctors…Try to let them know that you are gay and that way they… comfortable to take care of us because some of them no”
Under-resourced Long Term Care	“Because my impression is that a lot of people were hired because economically it was cheaper to get people who are less qualified.”