National Resource Center on LGBT Aging
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November 26, 2012 — By Dawn Wolfe — Xpress LGBT newsmagazine

Hard to believe the fun and games might soon be over. But whether gay or straight, getting older often leads to doubts and anxiety. Among the LGBT community, there's a question that is coming up among more and more gay boomers, which is whether Michigan is a safe place for LGBT people to retire. Given an anti-marriage constitutional amendment and a seemingly-hostile state government, Michigan's pleasant peninsula may not seem such a pleasant prospect for sexual minorities facing their golden years.

Yet, despite the reality that Michigan is still behind many other states in terms of treating LGBT citizens equally under the law, a surprising partnership of activists, state and federal officials are working to make retirement a less threatening experience for Michigan's sexual minorities. While many advocates for LGBT seniors show that aging can be a frightening prospect for sexual minorities, the facts also show that things are changing –if slowly.

At first glance, Michigan would probably not seem like the most welcoming place for LGBT singles – and particularly LGBT couples – to retire. It's still legal under state law to discriminate against sexual minorities in employment and housing. The partnerships and marriages of same-sex couples have no legal recognition; anti-equality legislators, backed by socially conservative activists, have used 2004's anti-marriage amendment to successfully bar the spouses of state and local employees from the same benefits afforded opposite-sex spouses. These restrictions are in addition to those in the Defense of Marriage Act, which bars same-sex spouses or partners (regardless of where they were married) from receiving their loved one's federal pensions or Social Security benefits.

While discriminatory laws can make living in the state a more expensive proposition for same-sex couples while they're working, a whole new set of questions confront sexual minorities on retirement: whether retirement facilities allow them to live together – or allow visitation without harassment. In other words, many LGBT seniors, and those approaching retirement, wonder how safe it is for them to stay out of the closet as they become increasingly dependent on others to see to their needs.

According to the 2010 US Census, there are almost two million people over the age of sixty living in Michigan out of a population that is just under ten million— in other words, twenty percent of the population is near, at or beyond retirement age.

The question is how many of these elders are sexual minorities. According to LGBT Older Adults – A Population at Risk, a fact sheet published by the LGBT Older Adult Coalition, “There are currently 68,077 LGBT people aged 65 and up living in Michigan. Another 62,600 are 55-64 years old and will join the retirement age by 2020.”

While there's ample evidence that agencies across the board are preparing for what's being called a “Silver Tsunami” of elders as the Baby Boom generation retires, until as recently as two years ago little was being done, at least in Michigan, to prepare for the particular needs of the Rainbow Tsunami.

The stakes are high. While few specific cases of hate crimes or discrimination against Michigan's LGBT elders have been documented, “We know the problem is worse because people have a tendency to under-report,” said Equality Michigan Director of Policy Emily Dievendorf.

“I don't know if we have the tools to accurately measure this problem,” said Jay Kaplan, staff attorney for the ACLU of Michigan's LGBT Project and a co-founder of the LGBT Older Adult Coalition. “We're just starting to focus on this issue.”

While there has been little reporting done at the state level, a 2010 national report on the issue funded by the Arcus Foundation paints what could be a more accurate picture of the specific issues that elder LGBT persons are facing. LGBT Older Adults in Long-Term Care Facilities: Stories From the Field, is the result of a survey of 769 individuals nationwide, including, “284 [who] identified themselves as LGBT older adults,.. (and) 485 (people who) identified themselves as family members or friends, social service providers, legal services providers, or simply 'other.'” The survey was conducted by national organizations, including the National Senior Citizens Law Center, the National Gay and Lesbian Task Force, Services & Advocacy for GLBT Elders (SAGE), and the National Center for Transgender Equality.

According to the report, “Altogether, 328 people reported 853 instances of mistreatment,” including 200 instances of verbal or physical harassment from other residents, 116 instances of verbal or physical harassment from staff, and 97 instances of staff refusing to accept the medical power of attorney from a resident's same-sex spouse or partner. Other incidents included restriction of visitors (93), refused admission or re-admission, attempted or abrupt discharge” (169), and refusal to provide basic services or care (51), or medical treatment (47). In 80 reported incidents, staff refused to refer to a transgender resident by that person's preferred name or with the appropriate pronoun.

Given the other findings, it's perhaps not surprising that the vast majority of the survey's respondents said “No or not sure” to the question: “Do you feel that an LGBT older adult can be open with the staff of a nursing home, assisted living facility, or other long-term care facility about his/her sexual orientation and/or gender identity?”

Among those who work closely with Michigan's LGBT seniors, there exists a fear of social isolation at best and abuse or neglect at worse. During Michigan's first LGBT Elder Summit in 2010, “...there was a woman who had relocated to a private pay continuum of care facility where you start out with independent living, then assisted living, etc., and she said that she had to shed all of her previous life as a lesbian in order to fit in,” remembered Michael Bartus, a member of both the LGBT Older Adult Coalition and of the State Commission On Services to the Aging.

While Bartus, a retired aging services professional, said he has both the experience and means to make sure that he and his partner of thirty-six years will receive culturally-appropriate, respectful care if or when the time comes, the same is not true of many other LGBT elders.

“In any kind of congregant living situation there are these things that people don't think of. For example, having pictures of your partner in your living space, running the risk of people making comments on your LGBT visitors, being ostracized or bullied as a result of your history, or having to fabricate a history in order to fit in,” Bartus said. “When you move the situation into a long term care facility it becomes more troublesome because then you are more dependent on staff—aides—and older adults in general figure out pretty quickly that you don't want to get on the 'wrong side' of someone. If you add in that there's a bias of a negative type because of your sexual identity, it's scary.”

“(There are) nursing homes (which) say that the sexual orientation of their residents is irrelevant – that's nonsense,” declared Kaplan. “To deny it is to deny part of who that person is. (Institutions) should acknowledge (seniors') sexual orientation, their partners—you can't be one size fits all. It's been that way for many years and it just doesn't work.”

Why are LGBT elders so vulnerable? According to the LGBT Older Adult Coalition's Population at Risk fact sheet, “Nine out of 10 LGBT older adults have no children to care for them as compared to two out of 10 heterosexual older adults. Furthermore, LGBT older adults have often been ostracized from an extended network of family members based on their sexual orientation or gender identity.”

According to the report, the majority of LGBT elders, seven out of ten, live alone, and they are three times as likely to live in poverty as their heterosexual peers. Also, while LGBT adults tend to form networks of “chosen families” that look out for each other, these networks tend to be closely-related in age. This means that, unlike the multi-generational biological families of many heterosexuals, many members of the same LGBT chosen family may be facing similar aging-related issues at the same time. In addition, LGBT older adults are at a higher risk for health issues including AIDS, mental health issues, and substance abuse.

Couple that with the fact that even married same-sex partners are legal strangers in the eyes of Michigan and federal law, and it multiplies the stress and anxiety to a situation that can have a negative impact on everything from their finances to their ability to visit and make important decisions for each other as they age.

Yet, there is good news looming despite the dire prognosis. In the past two years, things have begun to change thanks to the work of activists, federal officials and even some of Michigan's public servants.

About two and a half years ago, according to long-time LGBT activist and co-chair of the LGBT Older Adult Coalition Kat LaTosch, a number of LGBT leaders were called together by Jay Kaplan to start discussing the needs of the community's seniors. “Here we are, all people who have been providing services and doing work for the LGBT community for a decade or more, and we wondered what happens when an LGBT person goes into retirement. I was just appalled that not one of us could come up with a single LGBT culturally competent provider,” LaTosch exclaimed.

She added that there has definitely been a perceived need. “We (Affirmations, LaTosch's former employer and Ferndale's LGBT community center) kept getting calls (for referrals to elder care facilities), and I knew people who had gone into adult living communities, and where they have gone completely back into the closet for fear of how they'd be treated.”

Those first meetings were the genesis for the LGBT Older Adult Coalition, which was formed in 2010 and is comprised of representatives from the ACLU of Michigan, the Advisory Council to Michigan’s Commission on Aging, Adult Well-Being Services, Affirmations, Area Agency on Aging 1-B, KICK, Citizens for Better Care, The Jim Toy Community Center, Oakland Family Services and the Village of Redford.

In April of 2011, the Coalition hosted Michigan's first summit for LGBT elders, “to gather as many elders together as possible and hold an all-day brainstorming session to collect everyone's deepest fears, what they needed, and the solutions they wanted,” LaTosch explained. Since that time, the Coalition has hosted a 2012 summit, created a web site with several resources for LGBT elders and caregivers, and started providing both receptions for caregivers and trainings for elder care workers and LGBT service providers to help both groups serve the specific needs of LGBT elders.

According to Oakland Family Services Clinician Lezlee Eddy, “(The Coalition) decided that having these (provider) receptions would be a useful way to connect with other providers, to begin the process of disseminating information and eliciting recognition of the need for standards of competent care.”

“Some who attend are already aware of the issue. They acknowledge and recognize that they already work with older adults who are lesbian, gay, bisexual or transgender. Others are asking questions and indicating that this is a new area of consideration, and they are interested in displaying caring behaviors toward their clients,” Eddy said. So far, she said, the Coalition has hosted provider receptions in Oakland, Macomb and Washtenaw counties, “and had a mix of providers attending each.”

But not every provider of elder care in southeast Michigan has been eager to attend a reception. “Providers who are uninterested in learning about the specific needs of LGBT older adults or who have a bias against people who may identify as LGBT are not attending the receptions,” Eddy said. “These negatively-biased providers are, of course, encountering LGBT clients, and their clients are at risk of significant psycho-emotional, and possibly physical harm.”

The receptions are just the beginning of the services being offered to service providers who want to give culturally-competent care to LGBT elders. Natalie Pearce, LMSW works for Adult Well-Being Services in Livonia, has been offering full trainings in LGBT-elder issues since January of 2012. “The demand for the training is very high. As of (Oct. 16), I will have completed a total of 10 (12), four-hour training sessions since January of 2012, i.e. in less than one year’s time,” Pierce said.

While the Coalition itself is simultaneously becoming more focused on advocacy and broadening its reach across the state, a few individual Coalition members and others have come together to form a southeast Michigan affiliate of Services and Advocacy for Gay, Lesbian, & Bisexual Elders (SAGE). According to LaTosch, the new SAGE chapter will focus on direct services and support to reduce isolation among LGBT elders.

Laura Champagne is one of the main volunteers working to create the new affiliate, an effort that started out with a HOPE grant received by the ACLU's LGBT Project. In addition to helping with the two Coalition summits, the group—which is currently called Gay Elders of Southeast Michigan (GEM)— has been holding a Wednesday coffee klatch at Affirmations and a Sunday group at a local restaurant. “We hope to find other venues for similar activities in other areas of our seven county region. We have begun developing sustainable programming,” Champagne said. Plans include a December social event and a January meeting about health care reform.

In addition to working on the local and state level, the Coalition has also been active on the national front. Coalition members were among attendees at the first LGBT elder housing summit hosted by the Department of Housing and Urban Development in December 2011.

The Obama administration's support of the LGBT community hasn't ended with the refusal to defend the Defense of Marriage Act or the repeal of “Don't Ask, Don't Tell.” The Obama administration, through HUD, has also taken a stand on the issue of discrimination against LGBT elders.

That stand isn't limited to hosting summits. On February 3, 2012, the agency promulgated the LGBT Housing Rule in the Federal Register; the rule prohibits discrimination against LGBT residents in housing— including housing for seniors—that receives money from the agency. According to HUD Public Affairs Supervisor Brian Sullivan, “Section 202 of the Housing Act, for example, provides housing assistance to the elderly. If a private owner of an apartment building in Sault Ste. Marie accepts this money and discriminates against an LGBT couple, that would be against the rule.” The agency has also included questions about discrimination against LGBT people in its National Housing Discrimination Survey for the first time; results were not available as of press time.

Federal agencies aren't the only government entities taking an interest in the state of Michigan's LGBT elders. In what may be a surprise to those who are familiar with the state legislature's anti-equality actions, Michigan's Office on Services to the Aging has conducted the first state survey in the country to assess the needs of LGBT seniors.

According to Public Affairs Specialist Phil Lewis, the survey was a separate part of a broader needs assessment survey required by the federal Administration on Aging. “The Older Americans Act, the federal law that basically supports most aging and disability systems in the US, outlines the LGBT community as a group for whom special efforts should be made in light of the challenges they face, so we put resources toward that,” Lewis explained, and added that the help of the LGBT Older Adult Coalition and GEM was critical in promoting the survey and getting more than 700 respondents. “We will be compiling the results over the next several months. We're currently operating under our State Plan for 2011-2013, so the results will go into the plans that begin in fiscal year 2014.” Lewis added that the state plan is another federal Administration on Aging requirement.

Additionally, Lewis said, “We're going to do our best to raise the level of knowledge of this community (LGBT elders) with the legislature. We have a great relationship with them—we work with them on a lot of issues facing elder adults and people with disabilities. Our focus is putting together some really good data so we can go to them with that data and do what we're charged with doing under federal law.”

The Michigan Office on Services to the Aging hasn't limited itself to surveying LGBT elders. As part of Michigan's Aging Network, the office works with Area Agencies on Aging to hold trainings for service providers, informational workshops at senior centers, and sensitivity training sessions and events. The Area Agencies on Aging are also working on printed materials outlining long-term care resources for the LGBT communities.

Despite the progress of the past few years, both the evidence and the people working on the issue indicate that there are still serious challenges for current LGBT seniors. Private facilities that don't accept HUD money are still free to discriminate against LGBT citizens under state law. The PrideSource Yellow Pages and the Older Adult Coalition's Modern Family Guide collectively list only one home care provider, one rehabilitation and skilled nursing care facility, and one “Active Adult Community” as of the deadline for this issue. Not every facility will send representatives to Natalie Pearce's trainings.

While all LGBT elders in Michigan face similar hurdles, the fact remains that wealthier, mostly white community members are better able to put together the legal documents necessary to protect themselves and their relationships, while their less well-off counterparts, especially those living south of Eight Mile Road, struggle with deteriorating city services and much higher rates of both crime and unemployment.

And unlike some states, Michigan has not extended the spousal impoverishment protections available under Medicaid to same-sex couples. These protections prevent healthy opposite-sex spouses from having to spend down the family finances to well below poverty level to qualify one of them for long-term care under Medicaid; without them, the healthy partner in a same-sex relationship can be left “...homeless, penniless, and without a living-wage income,” according to the 2010 publication LGBT Older Adults and Long-Term Care Under Medicaid, published by the movement advancement project, SAGE, and the Center for American Progress.

“The bottom line is the law, the policies are bad in our state,” Kaplan admitted, though, “there is some receptivity to look at this issue. I wouldn't say [Michigan is] the worst state, but I could think of other states where people would want to go because our policies are so bad right now.” Still, Kaplan added, there are agencies serving elders that see becoming LGBT culturally-competent as a wise economic move . “It's a good marketing tool.”

Another factor that presents challenges is that the current cohort of LGBT elders came of age during a time when, as Pearce explained, “They experienced a lifetime of events that have shaped them and made them fearful. Only in 1973 did 'homosexuality' cease being considered a 'mental illness'. In addition, 'gender identity disorder,' a term used for transgender folks, is still considered a 'mental disorder' in the DSM (Diagnostic and Statistical Manual) of the APA (American Psychological Association).”

Despite these ongoing challenges, though the tide is turning – even if slowly-- for Michigan's LGBT elders. Bartus, for example, counts his appointment to the State Commission on Services to the Aging as, “an incredible statement.”

While he was appointed on the basis of his decades of work on aging-related issues – and not to represent the LGBT community – Bartus said that, “I clearly stated that I was a sixty-five-year-old, partnered gay man,” in his materials to the commission. “I think it's an incredible statement that you can be open about your life history in such a context.” He added, “The good news is that my cohort of LGBTs is pretty used to getting what we want to out of life, so if we don't like a particular vendor ,we'll go somewhere else to get what we want, and in the future we won't have a history of being in the closet in our community. I feel there's no going back on the accomplishments of the past couple of years. We're pressing service provider awareness, we're having more discussion, and we have more involvement of LGBT elders in the issues involving them. No one can take this away.”

LaTosch also sees signs of progress. In her Coalition work, she said, “We go in and we meet with someone who is in the position to make decisions and we talk about the issues and concerns and the disparity that LGBT elders are facing. In every single meeting – literally – people are very concerned and caring and want to make a difference and want to help.”

Still, LaTosch added, “There's one issue we haven't had a chance to wrap our arms around – housing. We still don't have any LGBT friendly or competent places identified yet. And there are (LGBT) people who don't just want to live with other LGBT people, just in a place that's affirming and friendly. Maybe we just need to build a welcoming and affirming place or find one that already exists — one that would partner with us. I'd love to see a retirement community come forward and say, “We want to be a welcoming, affirming place.'”

“If someone were to call me after reading your article and say, 'We want to be that place,' it would be my magic wand.”

"Many LGBT seniors, and those approaching retirement, wonder how safe it is for them to stay out of the closet as they become increasingly dependent on others to see to their needs."