A welcoming environment for gay and lesbian residents is a part of the culture at Village Nursing Home in New York City.
Staff of the facility's parent, Village Care of New York Inc., screen prospective workers to ensure that they can care for lesbian, gay, bisexual, or transgender (LGBT) residents without bias. Staff at all of Village Care's services are instructed to ask elderly people about their significant others, to include partners in treatment discussions, and to offer gay-focused social events. It's more than just good care, said Arthur Y. Webb, president and CEO of Village Care. It's good business. The company's nursing homes and community programs for elders are able to attract a key demographic that keeps the nursing home and other programs thriving, said Webb.
While many long-term care facilities hardly acknowledge the existence of LGBT seniors, several facilities and programs around the country are embracing them. The people who run those programs and have become experts in LGBT issues caution others that the clock is ticking to when the unique social and medical issues faced by this community will be common in many long-term care facilities.
If those issues are not addressed, a growing population of vulnerable seniors will suffer in unfriendly situations, said Lisa Krinsky, director of the LGBT Aging Project in Boston. “There's tremendous concern and fear about having to be closeted,” said Krinsky.
The LGBT Aging Project contracts with nursing homes to train staff members about LGBT aging issues and conducts programs designed to integrate awareness of those issues into facilities' cultures through its Open Door Task Force. “The intent is to go beyond a one-time only training session,” said Krinsky.
LGBT training begins with Krinsky's faculty examining the messages and policies coming from a facility's leadership. Next, the faculty examines how the staff actually puts these policies into practice. Finally, the trainers and trainees work on communicating to the gay community and local health care providers that the facility welcomes LGBT seniors.
A frequent question is whether making a facility more openly accepting of LGBT resident will mean it will be known as a “gay” place, said Krinsky. She advises staff and leadership to make changes in the larger context of enhancing acceptance of all types of residents.
“It's a very new field,” said Karen Taylor, director of advocacy and training at the New York-based Services and Advocacy for GLBT Elders (SAGE), which has developed its own curriculum specific to LGBT aging issues in long-term care facilities.
SAGE training deals with nursing home staffs' frequent discomfort in dealing not only with homosexuality but also with heterosexuality in nursing home residents, said Ms. Taylor. The idea of intimacy between residents can be uncomfortable for staff, but it should be addressed as part of providing quality health care, she said.
One thing to keep in mind is that sexual identity and gender identity is about more than just sexual practices, Taylor said. It's about culture, friendship circles, and life experiences.
SAGE teaches ways to make residents feel that their culture is respected. Nursing homes tend not to use neutral language around sexual identity and orientation, she said. Just changing the words used on intake forms is important. These, for example, typically give residents only standard choices for designating their relationship status: married, single, divorced, and widowed.
Facilities can become more inclusive by allowing residents to indicate that they have partners or significant others. The answer can in turn open up the possibility of residents saying who is important in their lives, and staff's acknowledgment of those relationships can ease a new resident's sense of isolation.
Staff should follow up on other information given by residents, said Ms. Taylor. For example, if someone mentions that he or she has had a roommate for many years, the aide taking that information should acknowledge that this person must have been significant in the resident's life.
That doesn't mean the staff should be asking residents whether they're gay or trying to force anyone to live “out” in the facility. The older LGBT generation may not be comfortable with peers knowing their sexuality or gender identity, Ms. Taylor said. Residents should be allowed to be as out as they feel safe to be, she said.
On the other hand, some LGBT seniors have been open about their sexuality for most or all of their adult lives, and they are looking for long-term care facilities that not only accommodate their needs, but also seek out other residents like them.