HJNO Sep/Oct 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2021 47 Jeré Hales Chief Operating Officer Lambeth House of fear and legalized discrimination. Clos- eting was a necessary skill for survival. In many cases, they lost family, friends, jobs and careers and even housing solely based on their sexual orientation or gender iden- tification. For these generational cohorts, conversion therapy and other attempts to “de-gay” individuals were not uncom- mon. As late as the 1970s, homosexuality was considered a diagnosable psychiatric disorder. Only in 1973 did the American Psychiatric Association acknowledge that being LGBT was not a mental illness, al- though years of humiliation and rejection had left its psychological impact. Decades of stress associated with living a closeted existence left some LGBT older adults at higher risk for depression, alcohol and drug abuse, social isolation, certain can- cers and overall poor health outcomes. The consequences of these experiences: a hesitancy to disclose their LGBT identity and a diminished trust in a healthcare sys- tem that branded them sick or mentally ill and then attempted to “cure” them. The good news is that LGBT Silents and Boomers are extraordinarily resilient, and the future is not necessarily indicative of the past. Meaningful progress has been made with respect to equality and social acceptance of LGBT Americans, so LGBT inclusion in aging services and long-term care settings are a logical extension of the movement. Jennifer Credeur, LCSW, Direc- tor of Social Services at Lambeth House, encourages healthcare professionals and long-term care providers to develop a comprehensive strategy to support aging LGBT adults. The strategy should include improvements in communication and a commitment to education. Credeur urges providers to start by asking the right questions so the senior’s preferences can be identified and hon- ored. For instance, close-ended ques- tions such as, “Are you married?” or, “Do you have children?” may not accurately address an LGBT senior’s actual sup- port network since they are two times as likely to live alone and four times less likely to have had children. Directly ask- ing the LGBT older adult who they would like included in their medical decisions or inquiring about their family of choice may open the door to a more open con- versation about the senior’s true support system. Small shifts in the way healthcare professionals communicate with LGBT seniors can make a difference. The way providers talk and the way they listen de- termines how supported the senior feels. Additionally, experts agree that educa- tion is critical to understanding the unique aspects of LGTB aging and for fostering inclusion. Companies such as LeadingAge and SAGE offer both in-person and online cultural competency training options for staff and providers who seek a deeper un- derstanding of the needs of LGBT seniors. Being mindful that LGBT seniors have faced unique challenges that are specific to their history and that these challenges have been molded by their experiences is key. Knowledge and understanding of these aspects may help identify ways to alleviate apprehension about moving to nursing care or assisted living environ- ments and in seeking aging support ser- vices in general. Though multifaceted in nature, the challenges of today’s aging LGBT adult can be addressed. Today’s LGBT senior has weathered the worst of the storm. With some support and understanding, they can age without denying who they are and without fear of returning to a clos- eted existence. n “Decades of stress associatedwith living a closeted existence left some LGBT older adults at higher risk for depression, alcohol and drug abuse, social isolation, certain cancers and overall poor health outcomes. The consequences of these experiences: a hesitancy to disclose their LGBT identity and a diminished trust in a healthcare system that branded them sick or mentally ill and then attempted to ‘cure’ them.”