9 posts categorized "Cultural Competence"

January 17, 2017

What LGBT Seniors Stand to Lose in ACA Repeal

This post originally appeared on the Center for Consumer Engagement in Health Innovation website on January 13, 206. Read the original post here.

By Aaron Tax

This blog is part of a series to highlight the dangers of the repealing the Affordable Care Act. Multiple times a week, Community Catalyst will highlight a different constituency to draw attention to the benefits the ACA has afforded them and to outline what a loss of coverage would mean.

Lesbian, Gay, Bisexual and Transgender (LGBT) older adults face many of the same health and aging challenges other older adults face, but more pronounced. As a result, they are arguably more at risk if the incoming administration and Congress repeals the Affordable Care Act (ACA) without a replacement plan and/or makes significant and harmful changes to Medicaid and Medicare.

LGBT older adults face unique risks within the health care system due to the standard issues facing an aging population combined with their sexual orientation or gender identity, such as:

  • Aging Combined with Discrimination: Similar to the older population in general, LGBT older adults face challenges with aging: declining health, diminished income, and the loss of friends and family. LGBT older adults, however, also face the added burden of actual or feared discrimination on the basis of their sexual orientation and/or gender identity. Many choose to go back into the closet for fear that caregivers will discriminate against them. Transgender adults, however, do not even have that option. Despite federal prohibitions on discrimination based on sex stereotyping and gender identity and the prohibition of discriminatory practices toward LGBT individuals based on health status - such as being HIV positive - built into the ACA, the sex stereotyping and gender identity protections are currently under attack in the courts, and LGBT older adults remain one of the most invisible, underserved and at-risk elder populations.
  • Isolation from Society, Services and Supports: Studies show that LGBT older adults are twice as likely to live alone; half as likely to have close relatives to call for help; and more than four times less likely to have children to help them. Nearly one-in-four LGBT older adults has no one to call in case of an emergency. At the same time, studies document that LGBT older adults access essential services – including visiting nurses, food stamps, senior centers and meal programs – much less frequently than the general aging population.
  • Lack of Access to Culturally Competent Health Care: The U.S. Department of Health and Human Services has found that LGBT older adults face additional health barriers because of isolation combined with a lack of access to social services and culturally competent providers. These barriers result in increased rates of depression; higher rates of alcohol and tobacco use; and lower rates of preventive screenings. 
  • Higher Rates of Poverty: LGBT older adults reflect the diversity of our nation in terms of gender, race and ethnic identity. But there is one critical statistic where they do not reflect the norm: they have much higher poverty rates and lower average household income than their straight and cis-gender counterparts. In fact, 35 percent of SAGE clients in New York City have annual pre-tax incomes below $10,000 and rely on Medicaid – a program with looming threats of block grants or per capita caps - to provide their medical care. An additional 35 percent subsist on annual pre-tax incomes of $20,000 or less and qualify for coverage under Medicaid expansion or could utilize tax credits to purchase insurance on the Marketplace. The Medicare-eligible segment of this population benefits from the ACA having lowered Medicare Part B premiums, the closing of the “donut hole” for prescription drugs, and payment and delivery reforms aimed at improving quality and the coordination of care for individuals with complex care needs.
  • HIV: As of 2015, the CDC estimates that one in two people who are HIV positive in the United States are now over 50. Yet little attention and money is targeted towards prevention for this population. One of the free preventive services covered by the ACA is HIV screening, though recommended testing in the U.S. cuts off at age 64. As a result, older adults are much more likely to be dually diagnosed with HIV and AIDS if and when they are ultimately tested.

Because of higher rates of health disparities, un-insurance, poverty and a greater reliance on programs like Medicaid and Medicare - two programs that could be facing significant retooling and subsequent funding cuts in the coming years - the protections provided by these programs and enacted in the ACA are critical for improving the quality of life for older LGBT individuals.

As we enter an uncertain time, we believe that we must do more to honor and support the LGBT elders who fought the fight and paved the way for the recent advances we have seen on LGBT rights. The least we can do is ensure that this population still has access to the foundational supports provided by the ACA, Medicaid and Medicare.

Aaron Tax, Director of Federal Government Relations, Services and Advocacy for GLBT Elders (SAGE)

 

January 2, 2017

New Year, New SAGECare Train the Trainer


TJohnston1By Tim R. Johnston

This year I’m resolving to double my efforts to train service providers on LGBT cultural competency. From housing providers to nurses to service coordinators, it’s my job to make sure that more people know the "ins and outs" of providing services and care that are welcoming to our community. 

That’s why SAGE is growing its roster of SAGECare Certified Trainers. Beginning with in-person training and expanding to webinars and on-demand content, SAGE and SAGECare Certified Trainers have trained more than 13,000 providers in all 50 states. A series of rigorous evaluations reveals that SAGE trainings create positive changes in participants’ knowledge and attitudes about LGBT older adults and aging. SAGECare offers trained agencies the chance to earn a SAGECare-branded credential that demonstrates their commitment to LGBT older adults.

SAGECare Trainers are certified to conduct one- and four-hour in-person trainings. Trainings employ several different teaching methods to help participants develop empathy for LGBT older adults, learn about LGBT cultures, and gain the skills needed to provide culturally competent care to LGBT people. Trainings are challenging, fun, impactful and often emotional. SAGECare is a national program and SAGE invites applicants from all regions, with a special emphasis on New York City, Washington, D.C., Chicago and Los Angeles.

Our next Train the Trainer will be in Chicago from May 23-25, 2017 – do you want to apply? More information, including information on travel costs, how much trainers are paid, and more can be found on the application.

If you can’t make the next Train the Trainer event but still want to get involved, another great option is SAGE’s National Resource Center on LGBT Aging’s Volunteer Education Ambassador program. Once approved, Volunteer Education Ambassadors are given a presentation they can use to help raise awareness about LGBT older adults and LGBT aging. Ambassadors all across the country have presented to local community groups, churches, universities and conferences.

When I conduct a training people often say, "LGBT aging—I’ve never thought about that!" Join me and help SAGE make 2017 the year that makes LGBT aging and LGBT older adults a top priority. Say it with me: "LGBT aging, yes I care about that!"

Click here to apply for SAGECare's next Train the Trainer event.

Click to explore housing resources, news and LGBT age-friendly communities with SAGE’s housing portal and interactive map.

November 14, 2016

SAGEMatters Fall 2016: Lives of Boundless Opportunities

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SAGEMatters Fall 2016: Lives of Boundless Opportunities

As we share the latest SAGEMatters with you, we are living through a period of unprecedented change. Perhaps nothing reminds us of this more sharply than this year’s high-stakes elections, which have turned long-standing political and social assumptions on their heads.

This theme of change runs powerfully through the features in this issue of SAGEMatters. Inside, you’ll find George Takei’s take on personal evolution; learn how Jeffrey Erdman has taken the LA leather scene by storm in his 50s; and follow an inspiring conversation with Kate Kendell, Mara Keisling and Carmen Vazquez about the changing landscape of gender identity. You’ll also learn how the federal government (after a lot of pushing by SAGE) is moving to transform publicly-funded aging services to make them more LGBT-friendly. Join us in celebrating the realization of a decades-long dream for our communities in New York City, as SAGE announces the construction of the first two LGBTfriendly elder housing communities in the Big Apple. And so much more.

This time of great change and evolution sets the stage for the launch of SAGE’s new strategic plan. The overriding goal of the plan is to dramatically expand the impact of SAGE’s work so that LGBT people can grow older with boundless opportunities for growth and enrichment. We believe that we can achieve this transformative vision by tapping into our legacy of “taking care of our own,” by building ties across generations, by encouraging communities to become LGBT age-friendly and by convincing partners of all kinds to get involved. This issue of SAGEMatters includes a special feature on our new plan—we hope you’ll be as excited as we are.

For me, all of this has a special personal significance as I celebrate my 10th anniversary at the helm of this amazing organization. I’m so proud of the great progress that we have made together on behalf of our LGBT elder pioneers. And I’m tremendously passionate about the next chapter of SAGE’s work.

I know that as you read through this latest SAGEMatters it will be even clearer to you why SAGE’s efforts matter more than ever. Let’s keep working together so that all LGBT elders have the support they need to live lives of boundless opportunity.

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Michael Adams
Chief Executive Officer

SAGEMatters is the biannual magazine of Services & Advocacy for GLBT Elders (SAGE). View and download the expanded Fall 2016 issue here.

September 23, 2016

SAGE and ASA Co-Host #LGBTGenerations Panel

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When the American Society on Aging (ASA) decided to focus the Summer 2016 issue of Generations on LGBT aging, it marked a milestone in the march toward visibility and respect for LGBT elders.

On September 21, SAGE CEO Michael Adams joined other authors in the issue for a special panel discussion co-hosted by SAGE and ASA in New York. Adams' article "An Intersectional Approach to Services and Care for LGBT Elders" considers the unique strengths and challenges of LGBT elders.

Connect with Michael Adams on Twitter and see the event recap on Storify to learn more about why he believes practitioners and policymakers must bring an intersectional analysis to their work. Do you have thoughts on the subject? Join the conversation on social media with #LGBTGenerations!

June 20, 2016

The Longest Day: An LGBT Older Adult and Caregiver Perspective for Living with Alzheimer ’s Disease

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Peggy Killian, VP Communications, Alzheimer’s Association, St. Louis Chapter and the author, Sherrill Wayland

Annually the Alzheimer’s Association hosts Longest Day events on the summer solstice to raise awareness and understanding of the challenging journey faced by people living with Alzheimer’s disease and their caregivers. The Alzheimer’s Association, St. Louis Chapter, marked this Longest Day with a sunrise to sunset ride on the MetroLink train, interviewing people living with the disease, their caregivers, advocates and other professionals to raise awareness and understanding.

I woke up at 4 a.m. to make my way to the train station for a 5:30 a.m. Longest Day Ride and Interview to discuss supporting LGBT older adults living with Alzheimer’s disease and their caregivers. As I walked through my still darkened house, I was met with silence as my wife and our dogs continued to sleep in the early morning hours. This quiet, darkness made me reflect on what can often be a lonely journey for LGBT older adults living with Alzheimer’s disease and their caregivers. Who is there to hear their stories and support their journey?

The reflections from my early morning stayed with me during the hour long ride as we discussed how to best support LGBT older adults living with this disease. Following is a recap of the topics discussed and some steps that aging network providers can take to improve the supports for LGBT older adults living with Alzheimer’s disease and their caregivers:

The Importance of Advance Planning – We often discuss the need for financial and legal planning. Planning becomes even more critical when someone receives a diagnosis of Alzheimer’s disease that will most likely progress to a point where the person is reliant on others to make decisions and provide care. Regardless of a person’s marital status, documents such as durable powers of attorney for finances and health, living wills, and wills assist the aging network in knowing what their wishes are and who should be the person making decisions on their behalf. As advocates and aging network providers, we can help ensure that the planning documents are in place early in the support process.

Telling Our Life Stories – As Alzheimer’s disease progresses, it is often the long term memories that stay intact and shared by the person living with the disease. Creating a welcoming space for LGBT older adults to share their life experiences, loves, losses, fears, and significant relationships, including families of choice (close friends not related by blood or marriage), partner or spouse is critical in providing the best possible care and support. All too often, LGBT older adults do not seek supportive care from health and social services due to fear of and experiences with stigma and discrimination. By working to create welcoming spaces that honor a person’s life history, we can help people to share what is most important to them and may become an integral part of their future support and journey with this disease.

This life history can also be important during times of disaster and trauma, such as the recent mass shooting and deaths of 49 LGBT and allied community members in Orlando, FL. LGBT older adults have experienced a lifetime of stigma, discrimination, and many may have experienced violence such as that experienced during the Stonewall Riots and other events in their lives. Knowing their life story as an LGBT person will help aging network provide the support and understanding during a time of grief, crisis, or trauma.

It is also important to recognize that LGBT older adults and caregivers may first need to develop trust with your organization. LGBT older adults and caregivers may then feel comfortable and safe to share their stories. If at first a person doesn’t feel comfortable sharing, give them space, time and reassurance that your organization is a welcoming space.

Respecting Relationships – LGBT older adults often express feeling that their significant relationships and families of choice are not recognized or respected in the same way as a non-LGBT person’s significant other, family or spouse. Giving the same recognition and honor to LGBT older adult’s relationships and caregivers is important to help ensure that the support systems are in place to best meet the needs of an LGBT person living with Alzheimer’s disease and their caregivers.

For organizations offering caregiving and grief support, it is essential that facilitators and volunteers can assist in creating the welcoming space where all relationships are respected and honored within the group setting.

Offering LGBT Cultural Competency Training – The Alzheimer’s Association has been a strong partner with SAGE over the years.  Several Alzheimer's Association Chapters have participated in SAGE's LGBT Cultural Competency training. They are among some of the first SAGECare Credentialed Organizations. Providing LGBT Older Adult Cultural Competency training is an essential step to supporting staff and volunteers in working with LGBT older adults and their caregivers. It also sends a large signal to the LGBT community that your organization is welcoming to LGBT older adults and caregivers.

As my interview ended and I walked from the platform back to my car, it struck me, “While I can get off this Longest Day Ride, the ride for LGBT older adults living with Alzheimer’s disease and their caregivers, is one that repeats itself day after day.”  Through continued education and awareness, we can create an aging network that values and supports the journey of LGBT older adults living with Alzheimer’s disease and their caregivers. Take time today, to visit the National Resource Center on LGBT Aging and the vast array of resources available on Alzheimer's/Dementia, caregiving, legal and financial planning, and best practices for serving LGBT older adults.

Sherrill Wayland is the Manager of National Projects at SAGE.

June 3, 2016

SAGE CEO Michael Adams Receives Burton Grebin Award for Innovation


Michael AdamsToday, SAGE CEO Michael Adams received The Burton Grebin, MD Award for Innovation from the Continuing Care Leadership Coalition (CCLC), for his personal commitment to the important issue of LGBT long term care.

The Burton Grebin, MD Award for Innovation was established in 2010 following the passing of Dr. Burton Grebin, a leader and innovator in pediatric long term care. In his honor, CCLC established this aware to be given to an individual who has been innovative in the field of long term care, and who embodies the dedication that Grebin brought to the long term care field.

SAGE is committed to innovative solutions to help LGBT elders age successfully. In May, SAGE launched SAGECare, its new cultural competence training program for care providers nationwide. Through SAGECare, providers across the country are trained to offer cutting-edge senior care to LGBT clients.

With its comprehensive set of educational offerings and credentials, SAGECare has established a new set of benchmarks in LGBT elder care, and has trained 11,477 providers to date. For more information, visit sageusa.care.

From the award ceremony:

"We are proud as members of CCLC to care for some of the most vulnerable and diverse populations in New York and the nation. We recognize Mr. Adams today as we continue to work to improve as skilled and culturally competent providers of care for all who see long term care from our organizations."

 

May 18, 2016

Annual Report: SAGE Seized Every Opportunity in 2015

SAGEAnnual20152015 was a remarkable year for SAGE and LGBT older people because it presented unique opportunities to advance our agenda—and we seized every last one of them. Indeed, over the past twelve months we have repeatedly demonstrated the remarkable difference we can make for older members of our community when we work together and energetically deploy the full range of tools at our disposal.

A few things made 2015 very special. In June, the Supreme Court decreed that marriage equality for LGBT people was a constitutional right. Then in July, there was the White House Conference on Aging, which takes place once a decade. Ten years ago at the 2005 White House Conference, SAGE made history by becoming the first and only official LGBT delegate to the Conference.

Last year, we took it to a whole new level by blanketing the Conference with the testimony of hundreds of LGBT elders from across the country and forging an overwhelming presence at the big event. Our efforts paid off big time, with the announcement by the U.S. Administration on Aging of an important new commitment to make its work more LGBT-inclusive.

SAGE also flexed our policy advocacy muscle in 2015, convincing the U.S. Department for Housing & Urban Development (HUD) to issue a bold new directive to federally supported senior housing providers across the country to eliminate discrimination against LGBT older people. Of course, putting the right rules in place is only half the battle—bringing those rules to life is where the rubber hits the road. That’s why the powerful advances SAGE engineered last year in its LGBT cultural competency training for aging service providers is so important.

Much of the important progress we made last year was thanks to SAGE’s relentless commitment to collaborate with key partners who can make an important difference for LGBT elders. Of the many partners we worked with in 2015, AARP stands out thanks to a successful pilot program joining SAGE affiliates and AARP local offices in key states across the country. The results far exceeded our expectations, including when we convinced AARP to issue a powerful public statement in support of Houston’s HERO ordinance and in opposition to transphobic fear-mongering. Expect more to come as we keep building on this exciting foundation.

And finally, 2015 was a breakthrough year in SAGE’s efforts to leverage our headquarters and long history in New York City to forge uniquely ambitious LGBT elder services that can inspire similar progress across the nation. SAGE took a huge step in that direction last year when we expanded out of the Chelsea neighborhood to establish full-fledged LGBT senior centers in four new locations, including three of the Big Apple’s most prominent people of color neighborhoods.

There is much more we could talk about, given all of the exciting progress we packed into 2015. Since we can’t cover everything, I hope this annual report shares enough of our highlights so it’s clear why your support for SAGE’s work is so important and why we should be so proud of what we are accomplishing—together—to ensure that every LGBT older person can age with dignity, support and boundless opportunity.

 

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Michael Adams
Chief Executive Officer

 

SAGE's 2015 Annual Report has more on how the organization expanded its programs, enlisted a wide array of new partners, and flexed its advocacy muscle to affect positive change for LGBT elders across the country. View and download SAGE's 2015 Annual Report today.

May 4, 2016

SAGECare: Creating a More Welcoming Space for LGBT Elders

By Vera Lukacs

SAGE is proud to announce the launch of SAGECare-- a new training initiative for service providers led by a passionate and experienced team from SAGE. It offers cultural competency training to service providers who wish to join a more inclusive community for LGBT elders, as well as learn to welcome LGBT older adults with open arms.  

Lrp1552SAGECare goes above and beyond the usual method of diversity training. The program creates a space for service providers to expand, transform and elevate their understanding of the needs of LGBT elders. The training provided by SAGECare help staff and administrators learn how to comfortably engage with LGBT elders; how to become open minded and non-judgmental, and how to create LGBT-inclusive programming. Once a person completes the training online or in-person, your agency will be awarded a SAGECare credential.  

A SAGECare credential indicates that a provider has completed a training especially geared toward LGBT elders by SAGECare Leadership or Certified Trainers, using SAGE-certified curricula. Agencies that have earned a credential are listed on the SAGECare website and are able to use the SAGECare logo on advertising, websites and other platforms as specified by a Licensing Agreement. By presenting a SAGECare credential badge, you will demonstrate to your community that you have the background, skills, and knowledge to work with a diverse population. Please review these badges to ensure that a service provider is SAGECare credentialed:  

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So, why invest in LGBT competency? “Because your mission is to serve people with the best care possible. SAGECare helps you serve your LGBT and other diverse clients even better. When your staff and agency become LGBT competent, you can communicate with your clients, residents and their families with even more compassion and depth — what’s great for all community members is great for business.” said Hilary Meyer, SAGECare Director.  

Have more questions? No problem. Contact SAGECare here or check out SAGECare’s FAQ page. SAGECare has already trained over 10,000 providers, join them or find one today!  

Vera Lukacs is a digital media assistant at SAGE.

April 21, 2016

2016 Leaders of Tomorrow: Bruce Williams

This post originally appeared on Long-Term Living on April 19, 2016. Read the original post here.

By Sharon Schnall

Bruce Williams was discriminated against because of his sexual orientation as recently as 2012, but he's working to make sure that becomes a thing of the past.

Williams, 69, is the first senior services coordinator with The Pride Center at Equality Park, a nonprofit center that serves the LGBT community of South Florida. He began volunteering at the center eight years ago and eventually became president of the senior advisory committee. 

Williams
Image via southfloridagaynews.com

The senior programming arm of The Pride Center creates critical connections among providers and recipients. Coffee and Conversation, a weekly two-hour program, attracts 200 attendees, up from 30 to 50 attendees just four years ago. The event is one of the nation's largest weekly gatherings of LGBT adults according to the national organization Services & Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE).

There's been significant growth of program availability and participant attendance with other center senior classes, including enhanced fitness, driver safety, income tax preparation and mastering personal technology. A Boomer/Senior Health Exposition, now in its seventh year, attracts 60 area vendors and 600 attendees.

Last year, senior activity included an estimated 27,000 visits, Williams says. The senior events meet members' needs for socialization and camaraderie, but they also educate seniors about community resources.

"I like to use new and different approaches," Williams says. "I like to maintain a flexibility. What worked yesterday does not work today; what works today may not work tomorrow."

Williams should know—he spent nearly 25 years running a Houston, Texas, continuing care retirement community. From 1981 to 2006, he served at different times as assistant director and acting director of Treemont Retirement Community, where he oversaw residential life and 200 employees associated with 330 independent living apartments and a 114-bed healthcare facility.

"His experience in the long-term care community gives him the knowledge, insight, hands-on practical applications, purpose and compassion that he brings to the center. A senior himself, he is the perfect example to those he serves," says nominator Betty Rosse, a professional educator, public speaker and group facilitator, who has presented at the center.

To provide quality care to LGBT persons, as with any other population, Williams says, "You have to be accurate reading what people need and require."

Easier said than done.

Older adults in the LGBT community grew up in a world of homophobia. They remember the Stonewall riots and the McCarthy hearings. "There's tremendous intolerance and bigotry that exists," Williams says, adding he did not live an openly gay life until 2009.

Discrimination because of one's sexual orientation can cause isolation, distrust and fear, which impacts how willingly long-term care services are pursued. For anyone who "has grown up their whole life with stigma," the reluctance to discuss sexual orientation and openly engage with senior service representatives, healthcare providers and community agencies is warranted, he adds.

Non-LGBT professionals, Williams says, are not necessarily aware of how LGBT life experiences impact one's economic resources, family support and employment prospects.

"With my background in long-term care and acute care, I came here with a mission. I know the value of advance planning," he says. "I spent 25 years in the field of long-term care. I am well aware of how using the services of long-term care will tremendously enhance the final third of one's life."

This year, The Pride Center began serving as SAGE-authorized trainers under the Protect our Elders initiative subsidized by Our Fund, a Florida philanthropic organization. SAGE's curriculum teaches best practices when serving LGBT seniors. South Florida healthcare and service professionals will complete the first phase of training through The Pride Center and other local trainer agencies. The training carries continuing education credits for degreed workers in the field of LTC services.

A hallmark of the Protect Our Elders curriculum is promoting cultural competency. The concept, with roots dating back to the 1980s, promotes awareness and respect about others' differences and cultivates a willingness and ability to be responsive through appropriate attitude and policy.

Williams wants people to proactively address matters of aging and be vocal about what they value in service delivery. His message: don't postpone making the "appropriate moves, the appropriate changes, at the right time." 

"It's as simple as posting a picture of a same-sex couple, for example, among an array of portraits featured in continuing care retirement community's main lobby," he says. "It shows acceptance." It's as straightforward and respectful, he adds, as using the word "partner" on a doctor's intake questionnaire or on a housing application.

"We age with so many commonalities, and we age with so many differences," Williams says. "We age with so many preferences. It's a work-in-process trying to understand what someone's individual wants and needs are.

"I am making people aware of the possibilities—they have the choices."

Sharon Schnall is a writer based in Ohio.