13 posts categorized "Cultural Competence"

March 12, 2018

Long-Term Care Administrators and LGBT Aging Training

Older womrnBy Tim Johnson, Director of National Projects

This week is Long-Term Care Administrators Week. In my capacity leading the day-to-day activities of SAGECare—which provides training and consulting on LGBT aging issues to service providers—and as a trainer myself, I have had the pleasure of working with administrators across the country.

After years spent leading our training efforts, I am certain that creating an inclusive environment for LGBT older adults requires instruction, partnership, and—importantly—support from administrators.

SAGECare's goal is to make sure that LGBT older adults and their loved ones are treated with respect no matter where they live. One way we accomplish this is by training every staff person working in a long-term care community. This training is essential, but it's also just the first step. It is the leadership of ally administrators (and their teams) that takes the training and bakes it into the culture of a community and of its staff.

That is why I am thankful for administrators who go above and beyond to put in the time, energy, and effort it takes to make sure that their staffs have the skills and knowledge to affirm LGBT elders.

As a division of SAGE, SAGECare is part of the country’s largest and oldest organization dedicated to improving the lives of LGBT older adults. Visit sageusa.care for more information on SAGECare's LGBT aging training. 

March 8, 2018

Op-Ed: Standing Up for America’s LGBT Elders

By U.S. Senator Bob Casey (PA), Ranking Member of the Special Committee on Aging

Senator Casey - Close Up

Older LGBT Americans continue to pave the way for equality. They display perseverance and courage, and regardless of the obstacles, they fight against discrimination and stand up to bigotry—and they have done so for their entire lives. Unfortunately, the Trump administration is attempting to roll back many of the hard-fought gains made by the LGBT community over the years.

It is for that reason that I have been using the resources available to me as Ranking Member of the U.S. Senate Special Committee on Aging to fight on behalf of the millions of LGBT Americans age 65 and older.

Faced with prejudicial social stigma, this population experiences unique challenges that are often overlooked, including higher poverty rates, difficulty accessing health care, and social isolation. Older LGBT Americans may be less willing than younger generations to discuss their sexual orientation or gender identify, either out of generational norms or a life experience of discrimination. This can be particularly prevalent for older LGBT Americans entering senior living facilities.

When the Trump administration attempted to undermine the rights of LGBT elders by removing them from key survey questions concerning the LGBT community, I took action, alongside SAGE and Human Rights Campaign, among others. In June, the administration heeded my calls and announced it would continue surveying the needs of older lesbian, gay, and bisexual Americans who receive services through key programs at the U.S. Department of Health and Human Services.

Recently, I hosted a briefing on Capitol Hill with SAGE to educate congressional staff about the unique issues facing older LGBT adults. During the briefing, representatives from SAGE, Movement Advancement Project, Human Rights Campaign and Mary’s House for Older Adults highlighted issues that included visitation rights for unmarried partners in medical facilities, health care for older Americans with HIV/AIDS, and a lack of resources and cultural understanding of the needs of rural LGBT seniors. 

Our work to secure equality for LGBT Americans is not done. The gains achieved by the LGBT community through years of hard work and perseverance are not set in stone. And with the number of LGBT Americans age 65+ expected to double by 2030, new challenges will continue to emerge. That’s why I will continue fighting to ensure that this administration recognizes and supports the rights of LGBT Americans of all ages.

December 19, 2017

Pat Baldwin: Advocating for LGBTQ Elders in Michigan

Pat_BaldwinFive years ago, Pat Baldwin walked into the office of the executive director at the Hannan Foundation, an organization dedicated to preserving the dignity of elders in the state of Michigan, and took a seat. Pat, who is the director of the Hannan Center for Lifelong Learning, wanted to speak with the foundation’s director about an issue close to her heart—an issue for which she knew Hannan was uniquely suited to make a difference.

Having worked with older adults and the aging population at Hannan for the past 17 years, Pat recalls that she had seen an increase in troubling situations where LGBTQ people faced rampant discrimination or, more often, experienced almost complete invisibility.

"In the Detroit area, I knew that in senior centers and places where seniors go for programming, there wasn't really any mention at all of LGBTQ elders," Pat says. "I wanted to change that. I wanted to concentrate on being inclusive to the elders in the LGBTQ community.”

The Hannan Foundation, which has a long history as an innovative, trailblazing leader committed to the needs of LGBTQ older adults, saw the gap in the Detroit area and set to work on filling it.

"At the board level, we started with something as simple as changing the language in our publications to be as inclusive as possible to LGBTQ people," Pat explains. "We started including language that we were 'open and affirming,' and we took the time to tell our participants what this all means. We changed HR information, made sure we as an organization took a proactive stance for LGBTQ people in our non-discrimination policy, provided diversity and inclusion training, and worked to be sure LGBTQ elders were comfortable."

This attention can help a person recognize their own self-worth and feel a sense of belonging to a community, Pat explains. And while many LGBTQ young people have been embraced and supported by friends and family members, LGBTQ elders grew up in a different generation where they may have lacked a support system, experienced financial disparities, or feared reprisal if they came out as LGBTQ.

"I've had LGBTQ people tell me that they feel very comfortable here, and that makes me feel good," Pat says. "I want to be sure everyone is cared for."

Pushing for Non-Discrimination Protections at the Local Level 

Even though advocates like Pat have been stepping up for their communities across the nation, the reality is that in Michigan, just like in 31 other states, LGBTQ people are not fully and explicitly protected from discrimination.

"I was appalled to know that here in Michigan, the Elliott-Larsen Act did not cover the civil rights of people in the LGBTQ community," Pat says. As a lifelong resident of Detroit, Pat says it’s important to her that this situation change. She's proud of her city and her state, and she wants to ensure that no one fears discrimination in their local community.

Pat Baldwin Kara Sprague

Pat credits an attorney friend with introducing her to some of the challenges LGBTQ elders endure because of the scarcity of non-discrimination laws. "She was the spark that lit my fire," Pat says about her friend, recalling an anecdote about a transgender person whose guardianship was granted to someone who did not support their gender identity and subsequently saw their hormones withheld and gender-affirming medical care held hostage.

"Some of these stories made me think about how that would feel—how personnel and staff treat people sometimes, and how we could do better," she says. "Then I started being more cognizant, aware, and intentional about wanting to be a better advocate."

Pat has been an advocate for LGBTQ people in Michigan for many years, most prominently as a board member of SAGE Metro-Detroit. SAGE is the nation’s largest and oldest organization dedicated to improving the lives of LGBT elders, and Pat says she is thrilled to help it make a positive impact.

"I'm very proud and very humbled to be a part of SAGE," Pat says. "This is very important work, and I'm so happy to be a part of it."

Today, part of that work is focused on securing inclusive protections for the LGBTQ community in Michigan, whether it’s creating an equitable workplace, finding welcoming housing, or seeking business services.

"It would be monumental if the Elliott-Larsen Act were amended to prohibit discrimination based on LGBTQ identity," Pat says, although she adds that enforcing the law involves its own set of challenges. Increasing public support and educating more Michiganders about LGBTQ people and the discrimination they face is a central need. "But if we passed the law, it would show that we're a very forward-thinking state and that we have recognized that this is the right thing to do. It should have been done a long time ago."

Shaped by Family & Faith

Pat is an ally of the LGBTQ community who identifies as straight, is married to a man, and has four children and five grandchildren. What’s more, she recognizes the importance of non-LGBTQ people standing up and speaking out in favor of equal treatment.

She recalls one story that illustrates the importance of treating everyone equally. When Pat was younger, her cousin began transitioning from male to female, and at one point, they sat Pat and her mother down to announce the news.

"My mom was very nonchalant about it all, and after my cousin talked and said what she needed, my mom said, 'I love you. I want you to be happy, whatever that is.' I really appreciated that," Pat says. “For her to say that was good at the time, of course, but it was also important for me to hear that. It was nice to see that my mom was happy that my cousin was happy to be the person that they're meant to be. That set a good example for me." 

Pat also says she finds strength in her faith. "I know that the Jesus I serve is one who loves everyone for who they are," she says. Pat recognizes that the official policies of some religious officials contradict that view, but she sees a change in the future. "The bottom line is that people from the LGBTQ community should be able to be their authentic selves," she says. "You have to just stay true to what you know." —Adam Polaski, Freedom for All Americans

October 31, 2017

What Students Need to Know About LGBT History

LGBTQ History is made every day, not just to be celebrated over the course of one month. We recently asked SAGE Facebook fans about what they view as the most important stories for the next generation to learn. Check out some of the answers below:

Sidenote: Our Instagram story poll returned almost unanimous results—where's the LGBT History in our schools? We have several Facebook followers who would make A+ teachers, if you're in need!


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Join the conversation on Facebook and Like SAGE USA to add your voice to a nation of LGBT elders, allies, and advocates.
—Lucy Doyle

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


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.


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


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

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."