Openhouse is doing a remarkable job addressing the barriers to connect LGBT seniors to aging support services. But there are still too many LGBT elders, in particular those over 80 years of age, who do not utilize health and social services. This generation lived most of their adult lives in an era where they experienced trauma within the legal, health, and social service systems: They had to guard the disclosure of their sexual orientation or gender identity in light of real experiences of discrimination, criminalization and/or institutiona-lization. Many still do not disclose this information with their medical service providers, and this can have adverse health consequences.
As the Executive Director for SteppingStone Adult Day Health, with a staff culturally competent in LGBT issues, I have been perplexed as an aging service provider at not seeing more LGBT seniors in our Adult Day Health Care centers. SteppingStone Adult Day Health Care provides health and social services that assist frail, low-income seniors and adults with disabilities to live independently in their homes. We provide a range of health and social services—from art and music classes to physical and mental health therapy. The center provides assistance with care coordination, medication manage-ment and transportation assistance to and from the center. These programs are particularly helpful to people living alone. Since almost 60% of LGBT seniors live alone, and without children or family to support them, these programs can be of great assistance in keeping frail LGBT seniors healthy and more able to live on their own.
SteppingStone and Openhouse began a new collaborative project this year, funded by Kaiser, to look at a new strategy to break these barriers to accessing aging services and health care for LGBT seniors, in addition to LGBT veterans and those aging with HIV. This Health & Wellness program inserts a SteppingStone nurse into Openhouse’s weekly programming by making available a medical advice line to call SteppingStone Nurse Susan directly at 415-917-7302, or to make an appointment to talk to her directly about health concerns and referrals, including accompanying them to appointments, if needed. The program is open to seniors in the Openhouse community. It is our hope that we will begin to build trust with the SteppingStone nurse in the safety of Openhouse, and begin to transfer that trust to the broader healthcare system.
On the fourth Friday afternoon of the month, there is a Health & Wellness seminar on aging topics that is provided by the SteppingStone nurse. Such topics include brain health, healthy heart, pain management, and maintaining mobility. The upcoming seminar is focused on “Hearing Loss as We Age,” with a guest speaker from the SF Hearing & Speech Center. It will take place this Friday, July 24, from 3–4:30 pm at Openhouse. There is also a regular feature in the Openhouse monthly newsletter on health concerns through the “Ask the Nurse” column, and topical articles on healthy aging. http://openhouse-sf.org/wp-content/uploads/2015/07 July-2015-Newsletter.pdf
The monthly fourth Friday Health & Wellness seminars have been well received. The attendees are eager to speak directly with a nurse, and share their stories and concerns with each other about specific diseases and conditions they are managing. We’ve also discussed what is the difference between normal memory loss and dementia, and when we should be concerned about seeking help for ourselves or someone we are caring for who is showing possible symptoms. Practical questions come up, as to what to expect in a good doctor, and how to communicate with a provider such that they will be responsive to an individual’s concerns. It also helps to have questions written out before a visit, and have the support of someone to accompany you on appointments.
There comes a point where we must all be more engaged in understanding our bodies as we age to manage age-related diseases like diabetes, cancer, and heart disease, or just the normal deterioration of sight and hearing. The SteppingStone nurse is able to offer guidance on understanding the aging body, and how we can practice optimal self-care to take control of our treatment strategies. In all respects, staying physically active, modifying our diets and not smoking will fortify us against the decline of an aging body.
The nurse is also able to explain the dynamics of acute and chronic pain and how some pain medications may interfere with our other medications. The nurse might additionally offer ideas on alternative methods for reducing pain and inflammation in the body. In one session, a physical therapist was able to explain different movements and exercises that allow greater range of motion and mobility, allowing us to move with less pain and with more strength and endurance.
Being more knowledgeable about the needs of an aging body and practicing self-care under the health care of a primary care provider will go a long way to helping us maximize our ability to live out our senior years with the greatest well-being.
Moli Steinert is the Executive Director of SteppingStone, the largest provider of Adult Day Health Care in San Francisco enabling seniors and disabled adults to maintain their health to remain independent and age in community. Previously, Moli was the Executive Director of Openhouse, 2005–2008.
LGBT Resources for Seniors
Alzheimer’s Association Programs and Services:
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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