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"I've spent most of my life 'out of the closet,'" said Kay Lahusen, a 79-year-old who's considered to have helped start this country's gay civil rights movement and is regarded as the first openly gay photojournalist in U.S. history. "A lot of people are more comfortable staying in the closet or passing as heterosexual because of prejudice, discrimination or fear of adverse consequences," she said.
This is particularly true with older adults who live in long-term care (LTC) communities - even among those who've been openly gay prior to requiring skilled care, explained Lisa Krinsky, LICSW, director of the LGBT Aging Project, a Boston-based organization that advocates for the rights of lesbian, gay, bisexual and transgender elders.
"An older adult who's lesbian, gay, bisexual or transgender and brings historical life experiences of discrimination and mistreatment, sometimes decides to go back in the closet when he or she enters a nursing home," Krinsky said.
These individuals are also five times less likely to access needed health and social services because of their fears of discrimination from care providers, according to SAGE (Services and Advocacy for LGBT Elders), a nonprofit agency based in New York.
"A lot of [organizations] brag about the diversity they have among staff and residents in their facilities, but they don't have polices that reflect interesting or exciting initiatives they're doing there to support this environment," she said.
As the LTC arena becomes more competitive, Krinsky believes administrators need to recognize the diverse needs of the LGBT population, which is estimated to represent 5-10 percent of American adults ages 65 and older (or 1.75 million-3.5 million people).
Acceptance Growing
However, some facilities along the East Coast heeded this call years ago.
Lahusen lives at Kendal at Longwood, an assisted living/skilled-nursing community located in Kennett Square, PA. Here, resident sexuality often is discussed prior to admission. Kendal is a not-for-profit facility governed by the principles of the Religious Society of Friends (Quakers).
"When someone's interested in living here, they're asked about their philosophies and preferences to make sure they'll be comfortable here," said Rene Fries, LPN, care coordinator at the facility. "Our boundary for what is considered normal is so generous - we really encompass everyone. People don't 'stick out' here."
Lahusen can attest to the facility's dedication to diversity awareness. She serves on Kendal's monthly diversity committee and is involved in various projects.
"It's one thing to be told 'we don't discriminate here,' and another to feel like you're really wanted somewhere because they appreciate diversity," she said. "It was also very reassuring to learn there were gay couples on the waiting list when I visited."
Early Obstacles
However, Fries admits it took some effort to get to where Kendal is today. Fries remembers the initial reaction of staff and residents when they encountered the first openly gay male to live there in the early 1980s. He was also the first-known resident to have AIDS.
"He had to come out of the closet almost by default because of his condition," Fries related. "Back then, AIDS was really new, and it was a growing experience for everyone to adapt medically and socially because everyone was just so scared of the disease. We weren't used to having an openly gay male as a resident."
Kendal has since underlined the respect for sexual orientation as part of its residents' rights and consent forms signed by staff upon hire and residents upon admission. "When you sign on to live or work here, you're acknowledging you'll embrace this philosophy," Fries said.
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