LGBT Elders Research Articles

Queer kinship, queer ageing – perspectives from Poland

Although there is a substantial increase of literature on LGBT elders in Anglo-American academia, studies from Central and Eastern Europe are in paucity. This article draws on the narratives of older gay and lesbian people living in same-sex relationships gathered during focus groups interviews in Poland. Their narratives on defining and negotiating kinship reveal and reflect complex shifts and processes in post-socialist countries in the last few decades. The identities and experiences of this group are embedded both in the past regime denying the existence of homosexuality and current social context, still characterised by state-supported homophobia, yet bringing the development of LGBT organisations.

“Caring for Our Own”

AbstractThis article traces the founding of Senior Action in a Gay Environment (SAGE), the nation’s oldest and largest social service organization for LGBT elders. Drawing on archival documentation as well as interviews with SAGE founders and early members, the article shows how SAGE was born of two largely disconnected social transformations: the gay and lesbian movement and the national expansion of services and programs for the elderly that was enabled by the Older Americans Act of 1965. SAGE’s institutionalization and its relationship with the state allowed it to grow in an increasingly conservative political context while ensuring that the organization would not take a broadly intersectional approach to the challenges gay and lesbian elders faced. Despite its political limitations, however, SAGE provided a setting in which some white gay and lesbian elders began to see themselves as agents of social change.

Evaluating the Impact of State Policy Interventions for LGBT Aging: Comparative Case Study of New York and California

The majority of aging network service providers are unprepared to deliver targeted services to lesbian, gay, bisexual, or transgender (LGBT) older adults. In 2017, California legislature mandated ongoing LGBT sensitivity training for congregate living providers. Services and Advocacy for GLBT Elders (SAGE) developed a specialized training, Creating Inclusive Communities, for congregate living staff to learn the unique needs of LGBT elders. This secondary data analysis compared pre-test knowledge and attitudes of training participants in two states, one mandating LGBT aging sensitivity training (California, N=328) and one without the mandate (New York, N=622). Preliminary results show that prior to receiving training, California participants demonstrate significantly less knowledge of LGBT aging issues compared to New York participants; t(948)=-3.808, p<.001. Attitudinal differences were also demonstrated. These results suggest that laws mandating LGBT sensitivity training may help reach providers with greater training needs. Policy and practice implications will be discussed. Part of a symposium sponsored by Rainbow Research Group Interest Group.

Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility

ABSTRACT Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 hours, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff’s cultural competency regarding the needs of LGBT elders. Findings from this study found a significant increase in LGBT content knowledge between pre- and post-intervention assessments and a significant decrease in perceived preparedness when working with LGBT elders. These effects remained significant after controlling for staff designation, religion, educational attainment, and training session. Findings suggest that staff’s cultural competence affected their perceived readiness to address LGBT elders’ needs. Implications are related to the concept of cultural humility or the lifelong process of understanding others’ experiences based on the recognition of lack of un(der)preparedness to create a culturally supportive residential environment.

The LGBT Elder Americans Act

The social positioning of lesbian, gay, bisexual, and transgender (LGBT) older adults is influenced by a constellation of historic and contemporary policies that shape the way they interact with the world around them. Although the past few decades have witnessed several legislative decisions that reflect a more open stance toward LGBT individuals, there remains a lack of federal policies that protect them. This paper provides a critical analysis of the LGBT Elder Americans Act of 2019, a bill amending the Older Americans Act of 1965 to include LGBT older adults in the definition of those with “greatest social needs” for the purpose of service planning and implementation. As a theoretical framework, we apply a life course perspective and an equity lens to examine the promise and limitations of the LGBT Elder Americans Act in meeting the needs of LGBT older adults. It is critically important for social work practitioners, policy makers, and scholars to understand the principles that drive policy debates so that they can advocate on behalf of the most vulnerable members of the population. We offer three recommendations for future policy making: i) Apply a life course perspective to understand the lived experiences of LGBT elders; ii) Apply an equity lens to public policy; and iii) Expand research to guide and advance policy development.

MOBILIZING COMMUNITY PARTNERSHIPS TO ENHANCE HEALTH AND REDUCE INEQUITIES IN MULTICULTURAL COMMUNITIES

Community-based gerontological research plays an indispensable role in identifying and addressing the strengths, intersectionalities, and socio-structural inequities that shape the lives of older adults in multicultural communities around the world. This symposium highlights the innovative, global scholarship of Silberman Aging: A Hartford Center of Excellence in Diverse Aging, as the Center begins its sixth year. Through community-based research and academic-community collaborations, Center researchers examine challenges affecting the health and wellbeing of diverse and often marginalized aging communities in North America, West Africa, and East Asia. The first paper describes and evaluates a CBPR project that trains community-based natural helping networks to identify and refer older adults with dementia in East Harlem, NY. The second study explores the perceptions and strategies of community-based primary care physicians in Ulaanbaatar, Mongolia in dealing with elder abuse and neglect. The third takes a population health approach to the relationship between social capital and health among older adults in Ghana. Fourth, preliminary results from an evaluation of a nation-wide training initiative that promotes cultural-competencies among aging services providers working with LGBT elders. Finally, we present findings from a CBPR study examining barriers to palliative care among racially and ethnically-diverse community-dwelling older adults with serious illness. Although substantively and methodologically varied, these studies all demonstrate the importance of social networks in health in later life, and underscore the value of community-based research that supports collaboration, empowers communities, and ultimately transforms practice and policy to better meet the diverse needs of older adults around the globe.

KNOWLEDGE OF LGBT CULTURAL SENSITIVITY AMONG AGING SERVICE PROVIDER NETWORKS

The population of lesbian, gay, bisexual, and transgender (LGBT) adults aged 50 or above is rapidly aging, posing distinct challenges to aging service providers who work to meet their complex health and social needs. In 2011, Services and Advocacy for GLBT Elders (SAGE), home of the National Resource Center on LGBT Aging (NRC), developed and implemented a suite of trainings designed to sensitize aging service providers to the needs and experiences of LGBT elders. This descriptive study examines baseline (pre-test) survey data from individuals trained between 2013 and 2018 (N=10,500). Training participants represent all states throughout the U.S. and vary widely in race/ethnicity, age, and job title. Preliminary results indicate that knowledge measured prior to trainings shows substantial variation across geographic regions, suggesting the need for more geographically targeted approaches to training delivery. Implications for practice, research, and policy with LGBT adults in later life will be discussed.

All Bad? Experiences of Aging Among LGBT Elders in South Africa.

There is an almost complete dearth of research on the lives of lesbian, gay, bisexual, and transgender (LGBT) elders in South Africa. This study was a qualitative exploration through focus group discussions of the lived experiences of 22 LGBT people over 50 years of age in the Western Cape and Gauteng provinces of South Africa. Given high levels of poverty and inequality in South Africa, findings from a thematic analysis of participants' narratives foregrounded surprisingly strong themes of inclusion and belonging despite the structural challenges faced by many in South Africa. While narratives of marginalization and exclusion were present, these were juxtaposed with reports of belonging and inclusion in families, communities, through friendship networks, and in health care. Findings indicate that, while experiences of homophobia and transphobia are real among LGBT elders in South Africa, participants experience agency, support, and relatively high reported levels of social belonging as they age.

Raising Awareness and Addressing Elder Abuse in the LGBT Community: An Intergenerational Arts Project

This paper reports on a collaborative digital arts project conducted with LGBT youth and seniors in Vancouver, British Columbia, Canada, funded by the B.C. Council to Reduce Elder Abuse and conducted by faculty members and a doctoral student from Simon Fraser University. In the project, youth and seniors worked together to produce the first Canadian materials on LGBT elder abuse—three digital videos and five informational posters. We report on the methods used to produce and disseminate the materials, and as we reflect on the project’s outcomes, we consider both the challenges and potential of digital literacies in this context.

AGING AND DIVERSE LGBT COMMUNITIES: BUILDING AWARENESS FOR COGNITIVE DECLINE AND CAREGIVING NEEDS

Health disparities exist in LGBT older adult communities, a high risk population for chronic health conditions. Cognitive decline from Alzheimer’s disease and related disorders (ADRD) is an increasing concern in LGBT communities due to natural aging. A 2010 report estimated an increase from 3 million to 7 million LGBT elders by 2030. Access to care challenges for LGBT elders, caregivers and service providers include lack of knowledge, discriminatory services, stigma, socioeconomic barriers, etc. To build ADRD awareness, a partnership of seven community and academic organizations held a one-day, highly-interactive conference on priority topics from results of a pre-event community survey. Sessions included: diagnosis/treatment/side-effects; LGBT affirming assessment and resources; substance use/effects on LGBT elders; health equity; diverse communities’ needs; caregiving and mental health. About half of 227 attendees were service providers (nurses, social workers, public health workers, therapists, psychologists, etc.); the remainder were from the LGBT community (caregivers, care-recipients, care-partners, families). Half of attendees were white and the remainder reflected the diversity of greater San Francisco region (Asian, Black/African American, American Indian/Alaska Native/Native Hawaiian/Pacific Islander, Hispanic/Latino). Speakers’ knowledge/expertise and interactive sessions were highly rated; post-conference evaluation respondents (n=118) intend to use information to improve: communication with LGBT/straight care-recipients, LGBT caregivers and/or providers (61%); management of care-recipients (59%); and educate LGBT caregivers and LGBT elder care-recipients (48%). Examples of attendees’ information needs were: caregiver stress, coping with discrimination, end-of-life, cultural competency, transgender health, etc. This interactive community awareness model can be adapted for LGBT elders, care-providers and healthcare professionals in global communities.

Advancing LGBT Elder Policy and Support Services: The Massachusetts Model.

The Massachusetts-based LGBT Aging Project has trained elder service providers in affirming and culturally competent care for LGBT older adults, supported development of LGBT-friendly meal programs, and advanced LGBT equality under aging policy. Working across sectors, this innovative model launched the country's first statewide Legislative Commission on Lesbian, Gay, Bisexual, and Transgender Aging. Advocates are working with policymakers to implement key recommendations, including cultural competency training and data collection in statewide networks of elder services. The LGBT Aging Project's success provides a template for improving services and policy for LGBT older adults throughout the country.

Is old age always already heterosexual (and cisgender)? The LGBT Gerontology and the formation of the "LGBT elders"

Abstract This article seeks to present an anthropological and critical view of the development of a thriving field of knowledge production (especially present in North America) which for some decades has investigated the aging processes among lesbians, gay men and bisexual and transgender people. This field, still relatively unknown in Brazil and in South America as a whole, has been named "LGBT Gerontology ". Thus my interest lies in critically and systematically presenting and contextualizing the main trends, controversies and theoretical debates in this field, as well as their recent implications on the complex constitution, legitimation and creation of public policies concerning the new social actors, who rise concomitantly - the "LGBT seniors."

“Coming Out” of Prison: An Exploratory Study of LGBT Elders in the Criminal Justice System

ABSTRACTThis two-phase qualitative study explores the experiences of 10 formerly incarcerated LGBT elders’ experiences prior to, during, and after release from prison. A core theme of self and the social mirror emerged from the data that represented LGBT elders ongoing coming-out process of unearthing their “true selves” despite managing multiple stigmatized identities or social locations, such as being LGBT, elderly, HIV positive, formerly incarcerated, and a racial/ethnic minority. These findings further our awareness of an overlooked population of LGBT who are older and involved in the criminal justice system. Recommendations that incorporate suggestions from formerly incarcerated LGBT elders for services and policy reform are presented.

Understanding Care Disparities Among Older Lesbian, Gay, Bisexual, and Transgender (LGBT) Adults: Recommendations for Culturally Competent Care

LGBT adults represent a growing, aging population. LGBT elders face significant health care disparities, and are often fearful of disclosing their sexual orientation or gender identity to practitioners. As a result, many older LGBT adults fail to receive appropriate screening or treatment. Various recommendations can be offered to help health providers offer more culturally competent, LGBT and age-affirming care.

Teaching Note: Infusing Diversity Content Into the BSW Curriculum: An LGBT Elders Example

Diversity is a topic that is increasingly important in BSW curriculum content. Social work students are going into practice in a multicultural milieu, and there is not enough room in the core curriculum for BSW educators to add unlimited elective courses to cover every diverse population group. As one case example, Baby Boomers of all races and backgrounds are aging, contributing to an unprecedented growth in the aging population. Included in this group are lesbian, gay, bisexual, and transgender (LGBT) elders. Diversity issues, including LGBT elder issues, cross all practice areas; therefore, infusion of content embedded in courses can at least introduce students to the needs of these diverse populations and assist them in envisioning possible solutions to address these needs. This article presents a rationale for the infusion of diversity content into the BSW curriculum focusing on the example of LGBT elders. Suggestions for pedagogical infusion strategies are included.

Investigating the Needs and Concerns of Lesbian, Gay, Bisexual, and Transgender Older Adults: The Use of Qualitative and Quantitative Methodology

Extensive research on the specific needs and concerns of lesbian, gay, bisexual, and transgender (LGBT) older adults is lacking. This article describes the results of both quantitative studies (i.e., LGBT Elders Needs Assessment Scale) and qualitative studies (i.e., focus groups and in-depth interviews with lesbian, gay, or bisexual [LGB] older adults and LGB grandparents) that specifically sought to investigate the unique needs and concerns of LGBT elders. The results identified 7 areas (medical/health care, legal, institutional/housing, spiritual, family, mental health, and social) of concern and the recognition that the needs and concerns of LGBT older adults be addressed across multiple domains, rather than in isolation.

Aging Out in the Desert: Disclosure, Acceptance, and Service Use Among Midlife and Older Lesbians and Gay Men

Lesbian, gay, bisexual, and transgender (LGBT) persons in the county of Riverside, CA and in the Palm Springs/Coachella Valley area, in particular, responded to a questionnaire addressing concerns about identity disclosure and comfort accessing social services. Distributed at a Pride festival, as well as through religious, social, and service agencies, the final sample for analysis of 502 comprised 401 (80%) gay men and 101 (20%) lesbians in 4 groups: < 50 years of age (18%), 50 to 59 (26%), 60 to 69 (36%), and over 70 (20%). Results reveal that almost one-third of midlife and older gay men and lesbians maintain some fear of openly disclosing their sexual orientation. Along comparable lines with similar proportions, older gay men and lesbians maintain some discomfort in their use of older adult social services, even as the majority reports that they would feel more comfortable accessing LGBT-friendly identified services and programs. In both cases, lesbians reported greater fear and discomfort than did gay men; older gay men and lesbians reported that they would be less comfortable accessing LGBT-identified services and programs than did younger gay men and lesbians. These data support prior research on the apprehension of LGBT elders in accessing care, the crucial role of acceptance, with some suggestions of how social services might better prepare to address these needs.

Lesbian, Gay, Bisexual, and Transgender Aging Concerns

Lesbian, gay, bisexual, and transgender (LGBT) elders and long-term couples have become more visible and their special concerns about aging are being recognized by gerontologists. LGBT elders are a diverse group with regard to all characteristics. This article focuses on the characteristics, research needs and barriers, service needs and barriers, clinical implications, and suggestions for appropriate treatment to increase awareness of clinical gerontologists who may not be familiar with LGBT seniors or who wish to improve their services to this population. Gerontologists working in long-term care facilities and those working in social and home care services may be especially interested in the special concerns of transgender elders and the recent changes in public policy regarding all LGBT elders.

Specifying Long-Term Care Provider Responsiveness to LGBT Older Adults

In-depth interviews and focus groups with lesbian, gay, and transgender older adults addressed the question “What does it mean for long-term care providers to be responsive to lesbian, gay, bisexual, and transgender (LGBT) older adults?” Sixteen domains of long-term care provider responsiveness to LGBT older adults were identified, including awareness of centrality of partners, knowledge of importance of preferred gender expression, openness to welcoming LGBT older adults, and ability to create LGBT-safe environments. Future research should include LGBT elders who belong to ethnic minority groups, bisexual elders, and LGBT older adults who do not identify with LGBT labels.

PROMOTING AWARENESSofLGBT IssuesinAgingina Baccalaureate Nursing Program

It is estimated that up to 10 percent of the American population is lesbian, gay, bisexual, or transgender (LGBT) and that up to 7 million members of this population are elderly. Both the Institute of Medicine and Healthy People 2020 have addressed the health disparities that affect elderly members of the LGBT community. Nurses are well positioned to bridge health disparities and provide culturally sensitive care across the lifespan, but compared with that of other disciplines, the nursing literature is lacking in content addressing LGBT health. Eliminating health disparities in the care of LGBT elders should be a priority in nursing education.The authors review the issues LGBT elders face and recommend how content related to LGBT aging can be integrated into nursing curricula.