Affirming to All: Culturally Appropriate Services for LGBT Older Adults in Our Communities
Presenters • Moderator: Michelle Alcedo, Director of Programs, Openhouse • Cathy Koger, MA, LMFT, LGBT Program Coordinator, Peninsula Family Service • Rick Kaplowitz,Ph.D., Board Member, Billy De Frank LGBT Community Center, Vintage Senior Program • Wanda Hale, MPH, Program Manager, LTC Ombudsman program, Catholic Charities, Santa Clara County • Amy Andonian, Vice President, Home Care & Support Services, Institute on Aging
The Billy DeFrank LGBT Community Center Vintage Program provides nutritional lunches, emotional support groups, recreation and social activities, and educational programs for LGBT seniors aged 50 and above. The program consists of several different components. The premiere program is the Vintage Lunch program, which has provided a free or low cost nutritious lunch since October 2002. Participants meet on Wednesdays and Saturdays at 11:30 AM for lunch followed by activities that focus on promoting wellness, supplying relevant and culturally appropriate information, and reducing isolation.
The Role of the Ombudsman Long Term Care Ombudsman Program
Ombudsman • The mission of the Long Term Care Ombudsman Program is to advocate for the dignity, quality of life, and quality of care for all residents in long term care facilities • Specially defined functions of Ombudsman include receiving, investigating, identifying and resolving complaints made by or on behalf of residents who live in long term care
Santa Clara County Long Term Care Ombudsman Program • 51 Skilled Nursing Facilities • 350+ Residential Care Facilities for the Elderly also know as Board and Care or Assisted Living • 12,760 Long Term Care Residents
Program StatisticsFY 12/13 • Face to Face contact/interviews with 12,760 residents • Conducted 3,222 facility site visits • Investigated 1,714 formal complaints • Witnessed 128 Advance Health Care Directives • Benefited from 7,372 hours of service by volunteers
LGBT Older Adults and Long Term Care • Current estimates state that 9 million American’s identify as lesbian, gay, bi-sexual or transgender (LGBT).1 • 27% of LGBT baby boomers have concerns about discrimination as they age– and often experience violations of their rights while seeking long term care services and support.2
LGBT Older Adults and Long Term Care • A majority of respondents to a recent survey felt staff would discriminate against a LGBT senior who was out of the closet.3 • Negative treatment, including verbal and physical harassment by other residents and their families, was the most common reported problem.4
Santa Clara County LTC Ombudsman • Make complaints on behalf of a resident in long term care • Receive information about other supportive services for LGBT residents • Information or clarification on regulations (what should I report, etc?) 408-944-0567
Contact a LTC Ombudsman • Santa Clara County 1-408-944-0567 • San Francisco County 1-415-751-9788 • San Mateo County 1-650-780-5707 • Santa Cruz + San Benito 1-831-429-1913 • Monterey County 1-831-655-1334
References 1 Gates, G. (2011) How many people are lesbian, gay, bisexual, and transgender? Williams Institute: UCLA School of Law.http://williamsinstitute.law.ucla.edu/wp- content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf 2 MetLife Mature Market Institute, Lesbian and Gay Aging Issues Network (ASA), & Zogby International. (2006). Out and Aging: The MetLife Study of Lesbian and Gay Baby Boomers. Metlife. http://www.metlife.com/assets/cao/mmi/publications/studies/mmi-out-aging-lesbian-gayretirement.pdf 3 National Senior Citizens Law Center in collaboration with Lambda Legal, National Center for Lesbian Rights, National Center for Transgender Equality, National Gay and Lesbian Task Force and Services & Advocacy for GLBT Elders (SAGE). LGBT Older Adults in Long-Term Care Facilities: Stories From the Field. April 2011. http://www.lgbtagingcenter.org/resources/resource.cfm?r=54 4 LGBT Older Adults in Long-Term Care Facilities: Stories From the Field, loc. cit.
Founded in San Francisco in 1998, Openhouse enables San Francisco Bay Area lesbian, gay, bisexual and transgender (LGBT) seniors to overcome the unique challenges they face as they age by providing housing, direct services, and community programs.
Cultural Humility Trainings Openhouse’s training curriculum and program is nationally recognized. We are a training and community partner of:
To further our mission, Openhouse: • Is building housing welcoming to LGBT older adults. • Organizes housing workshops to provide LGBT seniors with resources and support to find affordable, stable housing. • Provides social services , information and referrals to safe • and welcoming health and social services. 55 Laguna The Hub for LGBT Older Adults 55+
Offers hundreds of LGBT-affirming programs including health and wellness workshops, women’s, transgender women’s, men’s and HIV support groups, yoga, meditation, monthly discussion groups, game days, arts and writing programs, cultural events, outings, and much more. • Provides ongoing, weekly emotional support and companionship to LGBT seniors through a volunteer Friendly Visitors program.
Who are San Francisco’s LGBT seniors? About 20,000 LGBT seniors 60+ currently live in San Francisco. Source: Jensen, Diana. (2012). Lesbian, Gay, Bisexual, and Transgender (LGBT) Seniors in San Francisco: Current Estimates of Population Size, Service Needs, and Service Utilization; San Francisco Human Services Agency Planning Unit
San Francisco Demographics • Caring and Aging with Pride –one of the first LGBT aging projects to have a majority of LGBT adults 60+. • LGBT Older Adults in San Francisco: Health, Risks and Resilience • 295 participants in SF, 39% age 70+ Source: Fredriksen-Goldsen, K. I., Kim, H.-J., Emlet, C. A., Muraco, A., Erosheva, E. A., Hoy-Ellis, C. P., Goldsen, J., Petry, H. (2011). LGBT Older Adults in San Francisco: Health, Risks, and Resilience. Findings from Care and Aging with Pride.
San Francisco Demographics (Source: Adelman and Gurevitch, 2006.)
San Francisco Demographics (Source: California Health Interview Survey, 2009.)
San Francisco Demographics (Source: California Health Interview Survey, 2009.)
San Francisco Demographics (Source: Fredericksen-Goldsen, et al., 2013.)
HIV and AGING 50% of people living with HIV will be 50 and older in 2015 (Source: Administration on Aging, http://www.aoa.gov/AoARoot/AoA_Programs/HPW/HIV_AIDS)
Select Health Disparities Between LGBT Older Adults and Those Who Are Not LGBT • LGBT Older Adults of Color have the highest levels of health disparities: • LGB Latinos are least likely (of LGB population) to have health insurance, with 64% lacking any coverage. • LGBT AA women are least likely to have had a mammogram in past 2 years. • LGBT Asian and PI most likely to experience psychological distress. Smoking: 27% in LGBT population as compared to 15% in heterosexual pop. Higher rates of drug and alcohol use. LGBT older adults are less likely to have health insurance than their straight counterparts (Kreley, 2009). Gay men at higher risk of HIV, other STDs, especially among communities of color. Older lesbian and bisexual women suffer higher rates and earlier onset of common disorders such as diabetes and rheumatoid arthritis and cancer.
San Francisco Demographics 31% of LGBT older adult participants have served in the military (Source: Fredericksen-Goldsen, et al., 2013.)
Findings LGBT seniors are often childless, single and living alone. • LGBT seniors are extremely isolated and most do not have traditional, informal caregiver support available to them. • Must rely on formal, long-term care solutions and are at a higher risk for early institutionalization. • Isolation increases vulnerability and risk, impacts health, and substance-abuse issues, finances, housing, etc.
References • Adelman M, Gurevich L, de Vries B, Blando J., Openhouse: Community building and research in the LGBT aging population, Lesbian, gay, bisexual, and transgender aging: Research and clinical perspectives. Kimmel D, Rose T, David S, editors. New York: Columbia University Press. • Administration on Aging from: http://www.aoa.gov/AoARoot/AoA_Programs/HPW/HIV_AIDS • California Health Interview Survey (2009), UCLA Center for Health Policy Research. Accessed on September 26, 2012: Accessed on September 26, 2012: http://www.chis.ucla.eduCalifornia Health Interview Survey • Fredriksen-Goldsen, K. I., Kim, H.-J., Goldsen, J., Emlet, C. A., Muraco, A., Erosheva,E. A., Hoy-Ellis, C. P., Goldsen, J., Muraco, A. (2013). LGBT Older Adults in San Francisco: Health, Risks, and Resilience , Findings from Caring and Aging with Pride.
References • Jensen, Diana. (2012). Lesbian, Gay, Bisexual, and Transgender (LGBT) Seniors in San Francisco: Current Estimates of Population Size, Service Needs, and Service Utilization; San Francisco Human Services Agency Planning Unit • Krehely , Jeff (2009). How to Close the LGBT Health Disparities Gap, Center for American Progress. http://www.americanprogress.org/issues/2009/12/lgbt_health_disparities.html
Common Assumptions Made in Health and Social Services Service providers assume they can identify any LGBT adult who is accessing their services.
Common Assumptions Made in Health and Social Services Healthcare and social service providers believe that if they don’t ask about sexual orientation or gender identity, then their organization is not discriminating against LGBT people.
Common Assumptions Made in Health and Social Services Because our culture tends to desexualize all older adults, providers may think, why does it matter if an older adult is LGBT?
Common Assumptions Made in Health and Social Services When working with LGBT older adults, the best care is always tailored care.