Actions speak louder than words.
That was one of the main takeaways from “Offering Culturally Appropriate Care and Services to LGBTQ+ Seniors,” a recent webinar that featured Hinshaw & Culbertson LLP partner David J. Alfini and Westmont of Carmel Valley Executive Director Chad Boeddeker CDP.
Although the legal aspects of the presentation were more California-focused (as Alfini splits his time between Chicago and Los Angeles, and Boeddeker helms his senior living community in San Diego), most of the talk applied to general aspects of LGBTQ+ elder care that can be applied anywhere throughout the country.
The program started with what could be called “LGBTQ+ 101,” with definitions of terms such as “sexual orientation,” “gender identity” and “gender expression,” as well as listings of pronouns (with Alfini advising people to use their own pronouns when introducing themselves to members of the LGBTQ+ community and to then ask them what pronouns they prefer). As for who composes the LGBTQ+ senior population, the age typically starts at 50, with 2.7% of the adults that age or older identifying as LGBTQ+—and it’s a demographic that is getting larger, although it’s new to senior living, Alfini noted.
And to put things in perspective, Alfini listed what would have been pivotal moments in the life of an LGBTQ+ individual who is 65 years old, such as being 10 years old when the Stonewall rebellions occurred in 1969. “Many LGBTQ seniors that I’ve spoken to have said that, until that point, they had never even heard the term ‘homosexual’ or ‘gay,’” Alfini said. “It was something that was new to them, and … they hadn’t even understood what they were feeling inside of [themselves]. That same person would have been 14 years old when the American Psychiatric Society removed homosexuality as a mental disorder or 34 years old when “Don’t Ask, Don’t Tell” was enacted or 56 years old when marriage equality was legalized throughout the country.
“What this means is that this is somebody who has had institutionalized discrimination with respect to healthcare; legal status; and, likely, employment and housing during most of their young life and, in certain areas, parts of their adult life,” Alfini said.
Boeddeker noted that the cornerstones to successful aging include economic security, social connections, health and well-being while key challenges include a lifetime of bias, a lack of competent healthcare and a reliance on one’s chosen family—meaning those latter aspects need to be addressed in order for elder LGBTQ+ individuals to be and feel included in a senior living facility. Alfini added, “That prideful spirit [from having to go around rules all their lives] can present a lot of issues with a resident or a community member within senior living. And, a lot of times, people who have been discriminated against are in ‘survival mode.’ When looking at choices for senior living, they are skeptical consumers. These are people who feel they have been lied to by institutions all of their lives—so when they’re looking at where they’d like to be, they’re going to be skeptical of marketing materials and what [people] are telling them.”
The needs of trans individuals were also addressed, as they have unique healthcare issues. Two pertinent points were that not all trans residents have medically transitioned; and not all people want to be publicly acknowledged as trans. So it is not just about addressing the LGBTQ+ community as a whole, but it is about evaluating each person separately.
As for what LGBTQ+ elders look for in a living community, Boeddeker said that seeing a peer group (individuals with similar values) is very important. He also stressed that potential residents want to feel that they do not have to return to the closet, that they do not want to feel alone, and that they want to be seen and heard. “You can fly a rainbow flag but that doesn’t mean you have a sense of what your potential resident needs,” he said.
An especially important part of the talk revolved around tips and pitfalls for meeting the needs of the LGBTQ senior. Employee training is one salient issue, with Boeddeker saying that it is required at his facility but that the community also has outsiders come in and that it reaches out to organizations such as SAGE, a pro-LGBTQ+ senior organization, for additional materials; there are also one-on-one meetings with employees about LGBTQ+-related issues.
Marketing materials and admissions were a couple other areas that were addressed—which is needed, “as the LGBTQ consumer is going to be very vigilant and skeptical,” Alfini reiterated, adding that advertisements and flyers need to really show that the facilities are very welcoming. “Also, as a lawyer, I must say, ‘Do not overpromise or offer things that are not possible in your marketing materials because the litigation [can come] back to bite you.’” Boeddeker added that forming a relationship with the potential resident is vital—and that could involve inviting that person to a facility-hosted event or some other inclusive action. He also advised that admissions officials should be prepared for questions, with Alfini saying that the admissions team should be very comfortable with those inquiries.
Alfini also stated that the Human Rights Campaign and SAGE have created the Long-Term Care Equality Index, which “provides an opportunity for senior living providers to participate by submitting information on their community and being designated as an affirming and welcoming community for LGBTQ elders.” (Typing in “Chicago” yielded five results, including Glenwood Apartments, Hartwell Place, Wesley Place, Winwood Apartments and Good Life Senior Residents-H.O.M.E.; Town Hall Apartments in Lake View are also LGBTQ+-friendly)
Note: Alfini emphasized that this webinar was not meant to provide legal advice. Those with inquiries can call him at 312-704-3193 or email him at dalfini@hinshawlaw.com.