Many 2SLGBTQIA+ seniors entering long-term care hide their identities. The ‘Diversity Tapestry’ aims to change that.

31 May 2023

A person gets help applying makeup to perform at a Pride event.

Bruce, resident at Little Mountain Place, prepares for the care home’s Pride celebration.

As British Columbia’s population ages, more people are moving to long-term care homes for 24-hour health, medical and personal care. However, studies show that people from racialized and gender diverse communities may experience discrimination in care homes.

Creating safe and inclusive spaces

Researcher Erin Michalak is a champion for equity, diversity and inclusion. When she began looking at long-term care, she learned that there is a lack of best practices for facilities. That’s why Erin partnered with residents, care homes and health authorities to co-develop a learning resource that supports care homes to become more inclusive.

“We still have much to learn about how to create welcoming, safe and inclusive spaces for diverse residents in long-term care settings,” says Erin Michalak, professor in psychiatry at the University of British Columbia and researcher with the Vancouver Coastal Health Research Institute. “We co-developed this resource to help guide long-term care staff, care providers and others on their journey to build spaces that embrace and foster diversity.”

The resource is one of the first to summarize resources on inclusion for care homes in BC. The project team compiled best practices, testimonials and case studies to support diversity and inclusion in long-term care. They used a unique platform, the Tapestry Tool, to curate these materials. The platform allows anyone – patients, researchers, health authorities and advocates – to add their own content and resources.

Honouring people’s experiences

Including care home residents was a vital part of the project. The research team engaged with staff at long-term care homes to identify residents interested in participating. This included Little Mountain Place, operated by Vancouver Coastal Health, which is leading the way on inclusion in long-term care. Little Mountain Place began this journey after a resident expressed their needs around diversity and inclusion.

“When one of our residents shared that they were part of the 2SLGBTQIA+ community, we knew this was an opportunity to learn more about inclusion,” says Sandra Lee, the senior manager at Little Mountain Place. “One of our core values is that we care for everyone. It’s essential to us that people feel welcome and safe being who they are.”

Studies show many 2SLGBTQIA+ seniors hide their sexual orientation or gender expression in long-term care to avoid mistreatment.

“When I first came to long-term care, I worried I’d have to go back into the closet. Would it be safe to be who I am?” says Bruce, resident at Little Mountain Place. “It took a lot for me to accept this place. But over time, I began to trust certain people to share my story. The staff really made an effort to learn and celebrate 2SLGBTQIA+ expression and identity. Their support means the world to me.”

Over the course of a year, staff and residents at Little Mountain Place collaborated with the research team on a video that shared the story of their work to build a more inclusive home.

Little Mountain Place continues to work to become a safer and more welcoming space for all. Supported by the project team, the staff at Little Mountain Place participated in a training event on equity, diversity and inclusion. Through our team educator, staff receive ongoing learning opportunities to understand differences between gender identity, expression and sexual orientation. Efforts continue and initial results indicate residents and staff are reporting more positive interactions.

Engaging people for better outcomes

People deserve to be involved in their own care. That’s why research done in partnership with patients​ can improve health care and outcomes​. The BC SUPPORT Unit, part of Health Research BC, champions the participation of people with lived and living experience and communities in research and helps put this research evidence into practice to support health equity. Funding for the ‘Diversity Tapestry’ was provided by the BC SUPPORT Unit and developed using the Tapestry Tool in partnership with the University of British Columbia.

At Vancouver Coastal Health, equity, diversity and inclusion are essential to delivering exceptional care and building a great place to work. Vancouver Coastal Health values and accommodates unique differences to ensure that residents, patients, clients as well as staff and medical staff can thrive.

The project team continues to share the resource and encourages additions to the Diversity Tapestry. Future work includes expanding content to support racialized members of long-term care homes.

Visit the Diversity Tapestry


Quick facts

  • In 2021, BC had 308 long-term care homes: 37% for-profit, 28% not-for-profit and 35% publicly owned (CIHI, 2021).
  • About 4% of people in Canada identify as 2SLGBTQIA+ (Stats Canada, 2021).
  • Vancouver Coastal Health operates 56 care homes in the Vancouver, North Shore and Coastal regions (VCH, 2022).



Canadian Institutes for Health Information (2021). Long-term care homes in Canada: How many and who owns them? Retrieved March 7, 2023 from

Statistics Canada. (2021). A statistical portrait of Canada’s diverse LGBTQ2+ communities. Retrieved March 7, 2023 from

Sussman, T., Brotman, S., MacIntosh, H., Chamberland, L., MacDonnell, J., Daley, A., Churchill, M. (2018). Supporting Lesbian, Gay, Bisexual, & Transgender Inclusivity in Long-Term Care Homes: A Canadian Perspective. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 37(2), 121-132. doi:10.1017/S0714980818000077

Wellesley Institute. (2021). Leaving No One Behind. Retrieved March 7, 2023 from

Vancouver Coastal Health. (2021). About VCH. Retrieved March 22, 2023 from

Vancouver Coastal Health. (2022). Long-term care matrix. Retrieved March 22, 2023 from