“Understanding & Caring for Lesbian and Gay Older Adults” is the name of a training system aimed at direct care providers for the elderly. It is an important tool for those who work both in the community and in institutions such as nursing homes and assisted living facilities.
What follows is the interview that “Let Life In” (www.LetLifeIn.com) conducted with Judy Mann, Director of Learning and Professional Development at The Center of Applied Gerontology(http://www.cje.net).
LetLifeIn.com – Thank you for taking the time to meet with me.
Educating care workers on how to care for Lesbian and Gay Older Adults is something that has been virtually ignored. Why should it be different than caring for heterosexual older adults?
Judy Mann: Well for one thing, older gays and lesbians haven’t been a very visible group. They lived during a time when they could easily lose their home, their job, their families and even their lives for even being suspected of being homosexual. For these reasons, many gay and lesbian seniors are still very private about their sexual orientation and fearful of revealing that part of their lives to others.
A care giver needs to understand this about the person they are caring for.
LetLifeIn.com: Times have changed a lot in the past 20 years. Do you think it is still an issue?
JM: Well thank God and the recent Supreme Court decision, they are not considered criminals anymore. But that hasn’t stopped discrimination.
Did you know that in 36 states it is legal to fire someone based on their sexual orientation? Employers can chose not to hire a person because they are homosexual and landlords can use homosexuality as a reason not to rent in most parts of the country.
LetLifeIn.com: I didn’t realize that. It’s unbelievable.
JM: Because of all that, it is difficult for most openly gay older people to feel comfortable at a senior center, retirement home or nursing home as the stigma attached to being gay among their older peers is often greater than those younger. Few gays and lesbians would risk disclosing their homosexuality in such environments.
LetLifeIn.com: But surely, those in care-giving positions are more open- minded and understanding.
JM: I wish it were so. In a recent survey of nursing home social workers, more than half said their co-workers were intolerant or condemning of homosexuality among residents, while most of the remaining respondents did not answer the question at all.
LetLifeIn.com: Sounds like they are in need of some training.
JM: That’s an understatement.
LetLifeIn.com: Judy, I know this seems like an obvious question, but would you outline briefly what exactly the purpose of the training is?
JM: Sure. First let me make one thing clear. The purpose of the training is not to change the health care worker’s attitudes or challenge their personal or religious beliefs about homosexuality. (That is an immense undertaking in itself.) Because the topic can evoke strong emotions it is important to focus on how workers can provide quality care to all clients and residents, regardless of their sexual orientation.
The main purpose of this training is to sensitize the frontline workers to the sexual diversity within the elderly population, make them aware of the unique needs and concerns of gay and lesbian older adults, and show them how to provide them the dignified and respectful care they deserve.
That should be a fundamental right.
LetLifeIn.com: Maybe I’m naïve — but what do you say to a care-giver who says that he or she cannot respect a person who is homosexual?
JM: We explain, when we talk about respect we are referring to the ability to be polite and considerate, and to respect other peoples’ individually and differences just as you would want your own individuality and differences to be respected and accepted by others. In other words, we don’t discriminate on race, religion or ethnicity and we don’t discriminate based on sexual orientation.
LetLifeIn.com: It’s amazing to me that you would have to “explain” something like that.
JM: Oh, you’d be surprised on some of the things we have to explain.
LetLifeIn.com: Like what?
JM: Things like: Homosexual men are referred to as “gay” and homosexual women are referred to as “lesbians.” Or: Gays and lesbians are all races and nationalities. Some care-givers don’t know that the phrase “in the closet” is used to describe people who make an effort to hide their homosexuality.
LetLifeIn.com: It sounds like “Homosexuality 101.”
JM: Besides the basics, we focus on five unique issues that care providers need to be aware of:
- Lack of acceptance by traditional service providers.— Many older gays and lesbian older people are afraid of getting the care they need because they fear they will not be accepted, or even shunned by traditional care providers. There is a report from the National Gay and Lesbian Task force that indicates that some people working in nursing homes are intolerant of gay and lesbian residents. They site examples of such as aides refusing to bathe someone who was a lesbian or threatening to tell people that a resident was gay if he reported her negligent care.
- History of discrimination .— Elderly gays and lesbians lived much of their lives during times when they could lose their jobs or have their physical safety threatened if they were even suspected of being homosexual. Because of past discrimination many older gays and lesbians live in constant fear of being discovered.
- Lack of visibility — Older gays and lesbians grew up in a time whenpeople kept their homosexuality a secret. We know that there are older gays and lesbians receiving our services but very often we don’t know that they are homosexual.
- They are more dependent on social service organizations — Gay and lesbian older adults are less likely to have children than heterosexual seniors. They also may be estranged from their families. As a result they have to be more dependent on social service organizations to remain independent as well as for care.
- Fear or discomfort caring for older gay and lesbian adults — Many direct service providers have fears and discomfort about caring for a gay or lesbian client. Most of these fears are unfounded.
LetLifeIn.com: Would you mind elaborating on that?
JM: The fears that care workers mentioned the most were:
Fear of getting AIDS.
Care providers are taught to exercise universal precautions when providing direct care for clients— whether or not you suspect your client of being gay or having HIV/AIDS. Not every person who is gay has HIV/AIDS and not every person has HIV/AIDS is gay.
Fear of someone making a pass.
Sexual advances and suggestive comments are inappropriate no matter the sexual orientation of the client. They should be dealt with in a gentle but firm manner. We go into that a little more in the training.
Fear of sexually arousing a gay or lesbian client.
Many care givers have experienced this with heterosexual clients and are taught how to deal with it. If a person of the same gender as the care giver becomes aroused, they must treat it as they would a heterosexual encounter.
Fear that working with a homosexual person can make you gay.
It sounds simple but we must explain that homosexuality is not a disease and can’t be transmitted from one person to another.
LetLifeIn.com: I understand you have a handout that discusses the “Do’s and Don’ts” of working with gay and lesbian older adults. Can you go over a few of them before we conclude?
JM: Sure.
Do give homosexuals in your care the same care and respect that you give anyone else.
Don’t assume that because a person is no longer having sexual relations that they do not have sexual feelings.
Do accept the client/resident’s life partner just as you would a married spouse.
Do always use universal precautions when providing care regardless of your client/resident’s sexual orientation.
Don’t have conversations or arguments with clients/residents about whether homosexuality is right or wrong.
Do discuss concerns with co-workers if you feel that a person’s feelings about homosexuality are resulting in inadequate care.
Do talk with your supervisor if you are uncomfortable providing care to a homosexual because of their sexual comments or behavior.
Don’t respond any differently if you find two residents of the same gender showing affection or engaging in a sexual act than you would with two residents of the opposite genders.
LetLifeIn.com: Thanks Judy. Is there anything you’d like to add before we conclude?
JG: Only to repeat that all people deserve to be cared for with dignity and respect regardless of age, race, religion, ethnicity or sexual orientation. <<
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