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 Aging Gay Population Worries That Move To Homes Means Move Back Into Closet

The revolution in the rights of Americans who are lesbian, gay, bisexual, or transgender (LGBT) appears to have reached the tipping point, but events have pressed so quickly that some advocates worry that a move into a nursing home will mean a move back into the closet.
Thirty-two states and the District of Columbia have now legalized gay marriage. President Obama, once a foe of same-sex marriage, now says he has “evolved” to believe that the Constitution’s equal protection clause should protect all marriages, gay or straight. Many activists now believe that it’s no longer a matter of “if,” but “when,” gay Americans achieve full equality before the law.
Things have moved so quickly, though, that it’s sometimes easy to forget that, when the 21st century began, 14 states still had laws outlawing sodomy on their books. (In Idaho, those convicted could face a lifetime behind bars.)
So those who advocate for seniors and for sexual independence find themselves caught between two competing timelines: one that sees the spreading acceptance of what used to be called “alternative lifestyles,” and another that sees the aging of generations for whom it’s all too much, too soon.
“I think that the conversation has to take place from the leadership,” says Dayne DuVall, chief operating officer of the National Certification Board for Alzheimer’s Care. “The younger generation isn’t as affected. The millennials on down are not so close-minded, regardless of their upbringing. It’s the boomers that we have to worry about.”
‘There’s A Dread’
There’s a dread of nursing homes, I’ll tell you that,” Margaret Cruikshank, author of Learning to be Old: Gender, Culture and Aging, told Provider in an interview last spring. “In my gay community, there’s a fear that the aides will be insensitive.”
DuVall, the Alzheimer’s specialist, says he worries those fears are justified. This week, he attended a conference of nonprofit providers where one of the case studies at a workshop involved dealing with employees who refused to help LGBTresidents because of their sexual identity.
DuVall says he was one of only three in a filled-to-capacity room who spoke up for the rights of the residents.
“It threw me against the wall,” he says. “The thing is, there is a huge disconnect here. And I don’t know the answer here, except education. I want people to realize that this has to be part of the conversation.”
It’s not simply a matter of vague inclusion; nonprofit homes, in particular, could lose their status if the government sees them discriminate against people for their sexuality. DuVall is gay, but he says he’s not just advocating for his brothers and sisters: He says he worries also about heterosexual couples in homes, or anyone else whose sexuality warms to what might once have been called “deviant.” In the days of the ubiquitous Internet, for instance, how will leaders help their conservative staff remain tolerant of, say, avid pornography fans?
“It’s not just for sexuality, it’s for culture,” he says. This month’s cover of Provider deals with questions of cultural competency.
‘We Have Work To Do’
Pat Giorgio is the chair of the board for the National Center for Assisted Living (NCAL) and helped develop a specialized curriculum for training staff about the rights and dignity of all residents, regardless of their sexual identity.
“Many seniors go back into the closet when needing long term care because of fears of discrimination—and this is a travesty,” Giorgio tells Provider. “We have work to do in getting the information out there, but the foundation for assisting staff about the very real issues facing LGBT people is in place.”
Lindsay Schwartz, PhD, senior director of NCAL’s workforce and quality improvement programs, has traveled the country with a special in-service training that helps staff understand the needs, fears—and rights—of residents who are gay, lesbian, bisexual, or transgender.
“Providing person-centered care means respecting and honoring each unique individual,” Schwartz says. “Sexual orientation and gender identity do not define long term care residents, but their preferences should be treated with the same sensitivity as race, religion, or any other characteristic that a resident holds dear.”
Earlier this year, the Mature Market Resource Center handed NCAL its National Mature Media Award for a staff training program on sensitivity to LGBT individuals.

“I have presented this training in all of my communities,” Giorgio says. “The feedback I received in Iowa last month was we need to be having this discussion/training in every community, and I agree.”
Clocks Ticking
DuVall says he’s glad to see so many advocates take on the problem of anti-gay discrimination head on. But the clocks are ticking, he adds.
“If you do not have a sensitivity training, you’re behind the curve,” he says. “You cannot impose your personal views on long term care. You need to check that at the door. Do that, or leave the business.”
Bill Myers is Provider’s senior editor. Email him at Follow him on Twitter, @ProviderMyers.
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