Saturday, November 17, 2018
Health

Retirement communities turn their sights on a once-invisible group: LGBT seniors

In 2016, as Kenneth MacLean was about to turn 90 and was looking to move to a retirement community, he had a question for Asbury Methodist Village in Gaithersburg, Maryland.

"I asked, ‘Would there be many gays here? Would gays be welcomed?’ " MacLean, a retired Unitarian minister, wanted to be sure his partner of 22 years, a man who lives in England and spends several months a year visiting him, would be welcomed by staff and other residents.

The staff member he talked to was generally positive about the community being welcoming, MacLean said, but "not quite ready" to answer his questions about gay residents. MacLean subsequently moved in and felt comfortable introducing his partner. But even after almost two years there, he has little sense of how many of his 1,400 fellow residents on the sprawling, leafy campus are also lesbian, gay, bisexual or transgender.

That could soon change. Last month, Asbury became the first facility in the Washington, D.C., region to receive LGBT-friendly certification from SAGECare, a program run by SAGE, a national advocacy organization for older LGBT people.

The certification program began two years ago to address the needs of the aging Stonewall generation - LGBT people who were at the forefront of the national battles for equality and acceptance in the 20th century. An estimated 2.7 million Americans 50 or older identify as LGBT, and that number is projected to exceed 5 million by 2060, according to a study by the University of Washington.

As they age, it is not always easy to find facilities where they are comfortable being out. While a few cater primarily to an LGBT clientele, the vast majority of older LGBT people will live in facilities that serve the general population, according to SAGE. Many worry that their peers, raised in an era when homosexuality was seen as criminal or deviant behavior, will not be welcoming or that they will face hostility from staff.

A 2015 report from the advocacy group Justice in Aging found that over three quarters of older LGBT people thought they or their peers could not be open with the staff of a nursing home or assisted living facility about their sexual orientation or gender identity.

The SAGECare certification aims to address this, and so far, close to 300 providers in 45 states have received it.

Facilities in historically progressive places like California, Washington state and New York have been more proactive about indicating they are LGBT-friendly, said Rob Liebreich, Asbury’s executive director, who previously worked in Seattle.

But the Washington, D.C., metro area has been slower to adapt, and local LGBT people have worried they would have to go back into the closet or risk being mistreated. Looking into facilities, they are not always comfortable inquiring about policies regarding LGBT residents, relying instead on word of mouth or discreet conversations with current members.

Arriving a year and a half ago, Liebreich decided the 92-year-old Asbury should make a more concerted effort to reach out. "We hadn’t been serving them as intentionally as we could," he said.

So far, Asbury has trained 25 percent of its staff on cultural competency; by August, it plans to have 80 percent trained, including executives who will receive four hours of intensive education, qualifying it for SAGECare’s highest level of certification.

Along with the SAGECare training, the facility started an LGBT task force in March charged with coming up with ways to engage residents on the subject. These have included showing the documentary "Gen Silent" (about challenges faced by older LGBT people) to residents and associates and advertising in a local guide focused on LGBT people.

Signaling that a facility is LGBT-friendly is not always a simple process. Unlike MacLean, many potential residents don’t inquire about it directly, and intake forms at Asbury don’t ask about a person’s sexual identity. This month, the facility announced its SAGECare certification on its website, but other than that, there are few overt indicators that it welcomes LGBT residents.

But staff members are implementing the lessons learned from their training, such as employing subtle language cues to help LGBT people feel welcome. For example, instead of describing an event as "Family Day," the phrase "All Families Welcome" is more all-encompassing, said Susan Grotenhuis, Asbury’s family and outreach coordinator. Similarly, she said, "instead of asking someone, ‘Tell me about your family,’ you could say, ‘Tell me about the important people in your life.’ "

The training also teaches staff not to gloss over people’s concerns about discrimination. For example, if a potential resident says she wasn’t sure whether she should bring her partner to the facility, "The initial response might be, ‘Oh, why would you think that? Of course, you would be welcome,’ " Grotenhuis said. "But it’s better to be more sensitive, to say, ‘Oh, I understand why you might have been concerned, but we’re very welcoming toward LGBT people, and we would welcome you to our community.’"

Staff are also trained in how to navigate terminology. " ‘Queer’ may be OK for some, but for older people, it might come with some stigma and negativity," Grotenhuis said, adding that it’s best to take cues from the residents’ own language during a conversation.

Since Asbury received SAGECare training, several other local facilities have begun working toward certification.

"What we often see in states and regions is that once the first retirement community steps forward, then many others will follow suit," said Michael Adams, SAGE’s chief executive. "This is an important first step to bringing the region up to par."

Facilities that have received the training say it has made a difference. The New Jewish Home, a facility on New York City’s Upper West Side with over 500 residents, began working with SAGE before it started offering the credential. While there were always LGBT residents, it is now taking a more active approach to making them feel comfortable, said Rabbi Jonathan Malamy, its director of spiritual care and religious life and a co-chair of its LGBT welcoming initiative. There are now rainbow flag decals on the front door and on the doors of key administrative offices, and some staff members wear rainbow pins on their ID badges.

"The onus is on the institution to anticipate and allay the anxiety and fear, to say, ‘You’re welcome; if you want to share this, we’re ready for you,’ " Malamy said. Since receiving the training, "I think we are freer about the conversations, and they are less fraught. . . . I think the difference now is, this is part of our mandate and our responsibility, and we shouldn’t rely on other people . . . to step up and start the conversation."

Green Hill, a 175-resident continuing-care facility in West Orange, New Jersey, that received SAGECare certification two years ago, has a section on its website devoted to LGBT issues and a nondiscrimination notice in the lobby. Last month, it raised a rainbow flag for the first time.

While many residents applauded such moves, some did not. "There have been, with some older residents, one or two mentions of discomfort that their whole home environment is going to be changed," said Amy Simon, a spokeswoman and LGBT senior housing and care program director there. "We talk with them about making a place for everyone and about not being concerned about it unless something should pass that gives them concern."

At places such as Asbury, where very few residents are openly gay, it may take longer for them to feel comfortable talking about it.

"If someone has a need to know, I’d be happy to tell them," said Bill Mullinix, a retired teacher who moved there in December. "I haven’t announced it to anyone. But when you’ve never been married and you’re 77 years old, I think most people can figure it out."

Alice Wong, 75, a retired federal civil servant, is an active member of PFLAG, an organization for parents of LGBT people. When she moved to Asbury four years ago, she wondered whether her daughter Ellen, a lesbian, would be accepted there.

"I didn’t ask about it, but I did worry about it. I assumed that coming from New York, I was moving into a much more conservative area," she said. "It wasn’t part of my looking, whether it was gay-friendly. I sort of assumed it wouldn’t be."

Wong said she has never encountered any negative feedback about her daughter. Still, it is hard for her and others to know who else at Asbury might be LGBT or how their neighbors feel about it.

"We don’t really know what the opinions are because there hasn’t been that much discussion," MacLean said. "The subject hasn’t come up."

That is likely to change soon, too. A group that runs a resident lecture series is planning a panel discussion on LGBT issues in October that will include Wong. And during Pride Month in June, more rainbow flags than ever before popped up on balconies and apartment doors around the campus.

Sitting with MacLean, Mullinix and Liebreich last week to talk about the topic, Wong mused about the idea of a meeting group for LGBT residents, similar to the Norwegian group that gets together.

"Well, it’d be kind of small," Mullinix said.

"I think it would be bigger than you think," Liebreich said.

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