One Facility's Experience Using the Community Readiness Model to Guide Services for Gay, Lesbian, Bisexual, and Transgender Older Adults

Abstract

The Community Readiness Mode/(CRM) is a change mode/that measures the readiness of communities/institutions to meet the needs of diverse clientele and to guide strategy development. This article presents model implementation with one long-term care facility interested in enhancing their ability to serve gay, lesbian, bisexual, and transgender older adults. ********** Today, there is an estimated 1 to 3 million gay, lesbian, bisexual, and transgender (GLBT) individuals over the age of 65 in the United States (Grant, 2010). This number may reach 4 million by the year 2030, and it seems that our social institutions might be ill-prepared to provide the necessary services to this aging population (Grant, 2010). Historians generally regard the Stonewall Riot in Greenwich Village on June 29, 1969, as the start of the gay liberation movement when gay rights became an emergent social issue in the United States. Many modern day older adults spent their young adulthood before the Stonewall years and carry with them internalized shame and fear because, during their formative years, homosexuality was highly criminalized, pathologized, and stigmatized (Grossman, D'Augelli, & Connell, 2003; Hollibaugh, 2004). In addition, many GLBT older adults continue to report trepidation and fear about their treatment within societal institutions, particularly retirement facilities and long-term care facilities (Brotman, Ryan, & Cormier, 2003; Heaphy, Yip, & Thompson, 2004; McFarland & Sanders, 2003). Seventy three percent of GLBT adults in one recent study perceived that discrimination against GLBT older adults exists in retirement care facilities (Johnson, Jackson, Arnette, & Koffman, 2005). This means that perhaps up to 2,920,000 GLBT older adults in the year 2030 will be seeking services from facilities that they believe do not have their best interests in mind. Therefore, it is imperative that counselors and other service providers understand the culture of these institutions and their openness to serving GLBT older adults. Relatedness, or connection to others, has emerged in recent research as an important protective factor for older adults facing transitions into long-term care facilities (Jungers, 2010). GLBT older adults are less likely to have others available to assist in advocacy because of their diminished social networks (Brookdale Center on Aging and SAGE [Senior Action in a Gay Environment], 1999). GLBT older adults are twice as likely to face aging alone, 4.5 times more likely to have no children to call on in a time of need, and are 2.5 times more likely to live alone than are their heterosexual peers (Hollibaugh, 2004). This lack of formal and informal social support leads to a myriad of problems for these older adults, including depression, substance abuse, unnecessary institutionalization, and premature death (Hollibaugh, 2004). Disconnection from a social network introduces a conundrum in which GLBT older adults find themselves relying more heavily on historically heterosexual institutions, the institutions that they fear because of discrimination and bias (Brotman et al., 2003; Grant, 2010; McFarland & Sanders, 2003). Gay and lesbian older adults are 5 times less likely to access services than are their heterosexual peers, albeit this underuse of services is not likely to continue as the Stonewall GLBT baby boomer generation, who has acquired significant advocacy skills, emerges (Grant, 2010; Hollibaugh, 2004). OLDER ADULT DEVELOPMENT Even though the landscape of service access is changing, the needs of older adults, including GLBT individuals, remain rather constant. Several developmental aspects of aging are salient to successful transition to long-term care. It is essential that those who care for older adults recognize the importance of both the physical and the emotional well-being of these individuals as they progress through continued stages of human development. …