Even in Massachusetts, which is considered a beacon of tolerance and diversity for many gay, lesbian, bisexual, and transgender Americans, the older members of this group remain in the shadows, as in the rest of the country.
Many fear going into assisted-living or skilled nursing facilities, or getting home health care, say those who work in agencies serving gay and lesbian elders. They retreat into the closet rather than face scornful remarks of fellow residents or possible discrimination from caregivers.
But a growing number, led by aging gay and lesbian baby boomers, are starting to assert themselves. They are familiar with anti-discrimination laws and are not afraid to make sure those laws are enforced. They are looking for retirement complexes, assisted-living facilities, and skilled nursing facilities that not only tolerate them, but welcome them.
“I think people are gradually coming out more,” says Linda S. George, RN, MA, CAN, executive director of Boston Senior Care, a home health agency that serves about 3,000 people in the city. “And young gay people are very much out. I think things will be equal in 50 years, maybe 40.”
Agencies Join Efforts
In the meantime, some agencies and companies that serve the elderly including Boston Senior Home Care are actively working with staff and clients to become more welcoming to lesbian, gay, bisexual, and transgender elders, including offering training for nurses and other healthcare workers. A skilled nursing facility in the Boston area, the Chelsea Jewish Nursing Home, plans to break ground next year for a unit specifically for elderly gay and lesbian residents.
About 2.4 million Americans older than 55 are gay, lesbian, or bisexual, according to researchers at the University of California in Los Angeles. But many hide behind a wall of fear and isolation, says Lisa Krinsky, director of the LGBT Aging Project in Massachusetts. The project’s services include cultural competency training sessions for agencies and facilities that work with aging adults.
Gay and lesbian elders are more likely to live alone, without children or other family members to care for them. They may limit visits from friends for fear their neighbors may guess they are not heterosexual. “I know how older people have a secret life,” says Michael Ridolfi, RN, BSN, MEd, director of health services at BSHC. “They weren’t raised to be out in the open the way people are today.”
Studies of gay, lesbian, bisexual, and transgender elders show their greatest fear in going into retirement communities, assisted-living, or skilled nursing facilities is for their safety. The next greatest fear is they won’t be cared for properly. If gay and lesbian elders know a facility will be friendly and welcoming to them, many of them are more likely to self-identify rather than return to the closet, say those who work with lesbian, gay, bisexual, and transgender elders.
Krinsky says a lot of nurses want to know why they should care whether someone is gay or lesbian, if all they are doing is managing a patient’s health.
“The fact is that folks may simply feel better about their treatment if they’re not holding a secret and if they know that their provider knows and respects them.”
If gay and lesbian elders know a facility will be friendly and welcoming to them, they are more likely to self-identify rather than to return to the closet, say those who work with lesbian, gay, bisexual, and transgender elders. They are more likely to have friends visit and less likely to become isolated, lonely, or depressed.
On home-care visits, Ridolfi looks for certain clues someone living alone with no children or photos featuring a specific person. They may never openly tell him they are gay, he says, but they often relax and start talking. “They are always glad to have somebody to talk to,” Ridolfi says. “And they always look forward to my visits.