By Dr. Karen Skultety–
Ask anyone you know about how they envision aging and you are likely to hear, “I never want to end up in a nursing home.” People of all ages and backgrounds share a common goal: to age in the place they call home, surrounded by people they love, in a community where they feel they belong. The desire to age and thrive at home is no different for LGBTQ seniors, but the risks of living in an institutionalized setting are.
Research tells us that LGBTQ seniors face discrimination and mistreatment in long-term care facilities. According to “Stories from the Field: LGBT Older Adults in Long-Term Care Facilities,” published in 2011 by the National Senior Citizens Law Center, 78% of those interviewed felt it would be unsafe for an LGBT senior to be “out” in a care facility. Over 80% believed that staff and other residents would discriminate against an LGBT elder who was out of the closet, and 43% reported personally witnessing or knowing individuals who experienced instances of mistreatment. In addition, for transgender seniors, these risks are even higher. Denial of care is common for transgender seniors and many report thoughts of ending their lives rather than moving into long-term care (Witten, 2014).
Openhouse has listened to community members who have shared their fears about what it would be like for them to leave their homes and to move into a nursing home. We believe LGBTQ seniors who have lifetimes of fighting for the rights of our community should not endure going back in the closet as they age. The ideal solution is one that aims to support LGBTQ seniors to age in their homes.
We are thrilled to announce that Openhouse is partnering with On Lok to design a solution that ensures our community can age as who they are, with dignity and support. On Lok is a family of nonprofit organizations founded in the early 1970s by a group of citizens concerned about the plight of seniors and the lack of long-term care options in the community. With 46 years of history and experience both in creating innovative models of care and serving diverse senior communities through integrated health and social services, On Lok has a wide-reaching experience base and is a trusted partner in its communities. In fact, On Lok is the creator of the Program for All-Inclusive Care for the Elderly (PACE), a nationwide model created specifically to support seniors who desire to age in their communities, rather than in a nursing home.
On Lok’s expertise combined with Openhouse’s leadership in delivering programs and advocating for LGBTQ seniors can create a much-needed solution—a program that is designed with the LGBTQ community, for the LGBTQ community. This new program will be one of the many Openhouse offerings at our new community center at 75 Laguna Street scheduled to open in April 2019. It will add to the continuum of services Openhouse currently offers to LGBTQ seniors, both for those living in the on-site housing and to the larger community.
Dr. Marcy Adelman, founder of Openhouse, believes that addressing this unmet need is critical to achieving the founding vision of Openhouse. “From the beginning, we wanted to make comprehensive and LGBTQ affirming long-term care services available to our community. Access to these services means that San Francisco LGBTQ seniors across the city, especially those living with dementia or other chronic conditions, will be able to stay in their homes as they age. Many years in the making, this partnership is a dream come true; it brings together On Lok’s expertise in long term care with Openhouse’s commitment and proven track record. ”
Reports show that current long-term care and aging services are not being utilized by LGBTQ seniors. Data from the recent Dignity Fund Needs Assessment suggests that LGBTQ seniors are 4 to 10 times less likely than their heterosexual peers to access available services in San Francisco. In addition, LGBTQ seniors are estimated to make up less than 2% of the population in programs designed for seniors at risk of nursing home placement—such as Adult Day Health Care, Community-Based Adult Services and social day programs. That’s less than 2%, despite the fact that LGBTQ seniors make up 11–12% of the city’s senior population and are more likely to be at risk for nursing home placement due to lack of family support, health disparities and other risk factors.
The reality is that either LGBTQ seniors are not enrolled in these programs or that they are using the programs but are hiding who they are. This double-bind of being forced to choose between being “out” or receiving services is untenable and unacceptable. Certainly, an important first step in addressing this challenge is the LGBTQ Bill of Rights, passed in 2016 to support the rights and protections for LGBTQ seniors living in long-term care facilities. Openhouse is proud to be part of leading efforts to implement this historic legislation. We believe the next crucial step is addressing the desire for LGBTQ seniors to avoid nursing home care altogether. So, after years of thinking about this unmet need, Openhouse has found the right partner to help us design a solution.
Over the coming months, Openhouse and On Lok will look to LGBTQ community members to help share their experiences and ideas about service delivery and to shape this program to ensure it meets the needs of our community. We look forward to working in partnership with On Lok and the LGBTQ community. Together, we can transform aging services in San Francisco and ensure that every senior can age in the place they call home.
Karyn Skultety, PhD, is the Executive Director of Openhouse. Openhouse enables San Francisco Bay Area LGBTQ seniors to overcome the unique challenges they face as they age by providing housing, direct services and community programs. Openhouse programs include: resource, housing and referral navigation; community engagement programs; support and wellness services. In addition, Openhouse provides training, advocacy and support to aging services providers caring for LGBTQ seniors across the Bay Area.
Dr. Marcy Adelman oversees the Aging in Community column. For her summary of current LGBT senior challenges and opportunities, please go to: sfbaytimes.com/challenges-and-opportunties
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