Getting It Right for LGBT

Roseanne Azarian: Welcome to Front Door, a My Place CT Podcast. My Place CT is a free web-based resource from the State of Connecticut that helps people live life independently. Learn more at myplacect.org.

Hi, I’m Roseanne Azarian, the host of Front Door, where older adults, people with disabilities and the professionals who help support them come for information and inspiration. Subscribe to Front Door on iTunes or the Apple Podcast app, Stitcher, Google Play or wherever you get your podcasts. Front Door is a production of the Connecticut Department of Social Services and Mintz + Hoke.

Today’s episode is about Getting It Right for LGBT older adults. Imagine what it’s like to feel afraid to be who you are in your own home. Why? Because you’re afraid of the repercussions…like being mistreated by a professional during a home care assessment. Imagine, you hide the fact that you’re gay while at a care facility. Why? Because you’re afraid of being bullied by other patients. And your long-term partner stays away–even though comfort and compassion from your loved one is what you need. Sadly, this is all too real a scenario for many of our LGBT neighbors.

Joining us to talk about this is Molly Rees Gavin, President of Connecticut Community
Care or CCC, a care management nonprofit organization that serves Connecticut residents, particularly older adults and individuals with disabilities. CCC also implements the Getting It Right initiative to help LBGT individuals find equality in accessing long-term Services & Supports.

Molly, welcome to Front Door.

Molly Gavin: Thank you, Rose. I’m delighted to be here.

Roseanne: We’re glad to have you here. My question to you is, was there a turning point when you knew…we have to do better if we want to serve LGBT individuals?

Molly: Absolutely. I would say about five years ago now, Rose…the University of St. Joe’s sponsored a program one evening on a movie that’s called Gen Silent—G-E-N Silent. And I would encourage all of your listeners who are able to access this film to see it. It’s a movie about a handful of elder individuals—men, women, black, white—individuals who are telling their own story about their LGBT experiences as they age, and it was one of the most compelling films that I’ve ever seen. We followed up at St. Joe’s with a panel, and we had local people present their perspective on the issues, and by the end of the evening, a whole group of us said, we can’t leave here tonight without having the next step.

And so, we passed around a sheet of paper and everybody put their name and phone number on it, and we started out LGBT advocacy initiative at that moment in time.

Roseanne: What kinds of things did you hear from these folks?

Molly: First and foremost, a good sense of the historical perspective in which these older adults lived and worked…Everything from talking about Stone Wall back fifty years ago, to their current everyday experiences. I learned from these individuals in this movie what kind of discrimination and fear they face on a daily basis, so that literally, Rose, people who have spent most of their adult life quote “coming out of the closet” in some instances, unquote….the minute that they interact with the long-term care system in the community and in facilities, they fear that they will not be accepted and they withdraw into a situation of isolation that is not in their best interest…and we don’t want to see that happen anymore.

Roseanne: And in many instances, these are folks who need the services perhaps more than the general population. Is that right?

Molly: Absolutely, Rose. Statistics suggest that LGBT elders are far less likely to have adult children to support them, and in addition to that, far less likely to interact with the social service system because of their fears of recrimination.

Roseanne: So back then there were certainly problems in trying to get Services & Supports….back in fifty years ago. It was a climate where there was, you know, the anti-war movement, the civil rights movement, Stone Wall as you mentioned…and it seems as though, fifty years has gone by—what are the challenges that LGBT individuals face now versus then?

Molly: You know, Rose, it’s interesting. Part of the challenges include the fact that LGBT individuals often feel like the rest of society doesn’t know their history. So, you and I might sit here and talk back and forth about Stone Wall, which is probably something that a vast majority of your listeners don’t even know what we’re talking about. It’s code in the LGBT community for the kind of discrimination and the police, you know, involvement that happened fifty years ago at a bar in New York City that was called Stone Wall….it was a gay bar, and… the police came to the facility. Circumstances got out of hand; people were injured; people consider that to be the beginning of the gay rights movement in the United States…and that’s what Stone Wall means.

So, one issue for elders and for individuals with disabilities, Rose, is the fact that their history and their story isn’t known.

Roseanne: And that, those were riots, so it was violent.

Molly: It was violent. Absolutely. Absolutely.

Roseanne: So, take us to today. What are the challenges that we’re seeing?

Molly: On the positive side, let’s acknowledge that we’ve seen tremendous change in the country in last several years regarding LGBT issues, and the exceedingly important Supreme Court decision that struck down some aspects of a particular piece of legislation that prohibited gay marriage has now been eliminated and gay individuals are able to marry freely in our society, and there are a number of other very, very positive changes.

That being said, for the average LGBT individual, interacting in a new healthcare-related environment is extremely frightening. You’re talking about people needing to share intimate details regarding their diagnoses, their health status, their ability to bathe themselves—any number of issues that frankly you and I wouldn’t really be that comfortable sharing with strangers to begin with, much less if we felt we had an additional burden because we were LGBT.

So, some of that has not changed, Rose. We still have miles to go to have the general community be aware and sensitive to the issues that LGBT elders and individuals with disabilities face on a daily basis.

Roseanne: Before we dig into this topic a bit more, let’s take a break and we’ll be back with Molly Gavin after this.

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Roseanne: We’re back with Molly Gavin from Connecticut Community Care.

Talk to me about how Getting It Right. I know the program began in 2013. What does it do?

Molly: Getting It Right evolved from Connecticut Community Care’s commitment to get it right in terms of our own services to LGBT elders and individuals with disabilities. We were very fortunate for several years to be funded by the Noble Trust for the work that we wanted to do.

And what we realized was that before we could sing the song for somebody else, we had to get our own house in order. And getting our own house in order meant everything from working with our Board of Directors to changing our public relations and marketing materials, and most importantly to doing the work that we had to do regarding our elder and individual with disability consumers who we are interacting with as care managers.

And so, we really had to look at our own sensitivity, our own openness, how we address certain issues with individuals. It was a full-blown, you know, spring cleaning, if you will, of the entire house of Connecticut Community Care, to be sure that we were working hard to get it right with our individuals.

Roseanne: So, it is a training protocol, but it sounds like it’s more than that.

Molly: Much more than that. So, we’re looking at our hiring practices to be sure that everything that we do speaks to openness in hiring LGBT individuals at Connecticut Community Care. It is very important that our marketing materials and our public relations materials speak specifically to this issue….and in our annual reports and in other publications of the last several years, you can see a decided difference in the fact that we are making it very clear in our own materials…we are an open and affirming organization. That’s kind of the jargon that we use. We say we’re open and affirming.

And our consultant, Joan Twiggs, likes to say that an LGBT-responsive organization comes out first. The organization has to come out first. We have to give the cues to the general public, and most importantly to our consumers and their families—give them the cues that we are an open organization, where people are going to be very reticent to acknowledge their LGBT status with us.

Roseanne: Molly, can you tell me a little bit about the outreach to the community in terms of your marketing and public relations materials?

Molly: So, what we realized after we really started working on getting our own house in order—and that was no small feat, I might add—but when we did that, we recognized that our consumers, our clients, are working with provider agencies in the community, and our efforts are only as good as the efforts and the follow-up of the provider organizations with which we work.

And so, for the last year or two, we have been doing presentations, participating in conferences, working with the State Department of Social Services, working with the Ombudsman Office, to get the word out there that we can provide holistic training in a train-the-trainer kind of a model for providing organizations throughout the state that are interested in Getting It Right for their own consumers as well.

Roseanne: I understand that you’re partnering with LGBT advocacy groups?

Molly: Correct. One of the things that we learned early on was that we certainly don’t have all the answers about what is the right way to quote “Get It Right” and so we have been working intimately with the LGBT advocacy group that started as a result of that movie that I mentioned earlier. We work with that group in helping to be sure that we are representing what we should be representing regarding this very important topic.

Roseanne: How would you measure, so far, the success of your program?

Molly: I would say we measure it one life and one family at a time. The proportion of LGBT individuals in the cohort with which we work is relatively small. We’re looking at single-digit percentages of how many individuals in our universe of consumers are LGBT. However, that does not include the family members and the friends of a specific client.

So, one example of a success story to me was a care manager who went out to do an assessment on a, with a consumer, for one of our many programs and the consumer herself was an elder mom and she lived with her daughter and her daughter’s wife. The care manager didn’t know that when she got to the house and came in and we have outstanding materials that we share with every single client when we make the visit that includes our affirmation page, if you will, about us being an open and affirming organization. The daughter took one look at the page with open and affirming information on the page. Her eyes grew wider and wider. She picked up her cell phone. She called her wife at work and said, “This is the very first time in our lives that anyone has ever come to see mom or to help take care of mom who is appreciative about our lifestyle and life choices.”

And that daughter, who was the most important part of her mom’s plan of care—obviously, the informal caregiver—felt that she was accepted and that we were listening to her and wanted to know what she wanted us to know about mom, and she felt the comfort of being able to be herself in that kind of caregiving experience.

So that’s just one example, and that’s not the consumer being an LGBT individual. We have a couple of very, very moving stories of individuals who…I don’t know, Rose, if you’ve ever heard the phrase…but people say that LGBT individuals have to quote, “straighten their house” before somebody comes in—quote, “straighten” meaning if they have photographs of two women together or two men together, they take them off the counters, the refrigerator. It’s not unusual for a care manager to go into a kitchen, and you know the little plastic frames that people have on their refrigerators? Sometimes the frames are empty when the care manager gets there. People literally have taken pictures out of those frames because of their concern.

Roseanne: Probably if you open the drawer they’ll see several of these pictures.

Molly: Exactly. Exactly.

Roseanne: But they feel they have to cover up.

Molly: Absolutely.

Roseanne: Hide who they are.

Molly: Absolutely. And so, with one gentleman in Hartford in his seventies, the care manager sat with him, again, when she went over the paperwork and showed him the pamphlet that talks about Connecticut Community Care as an open and affirming organization. The gentleman literally excused himself, went to the other room, came back with an entire box of old pictures of himself and his now-deceased partner, and spent the next half hour sharing those pictures with that care manager and told her he had never been able to do that before.

So, to me, I’m happy to count one example of success after one example of success.

Roseanne: And I also think it’s important to realize that we all know you’re not just helping a client…a family member, the friend, the neighbor. So, to have an all-inclusive environment empowers everyone.

Molly: Everyone in the environment. Absolutely.

Roseanne: And that has to help the ultimate goal—a positive outcome.

Molly: Absolutely. And we find also, Rose, it’s interesting that while our younger individuals…younger individuals often with some type of disability—they may not have been alive for Stone Wall; they may not be as intimately connected to parts of that history, but they’re also confronting challenges in the long-term Services & Supports world. So, this isn’t exclusively an elder issue. It is an issue for all LGBT individuals who are trying to access the care system.

One of the challenges that we face with provider organizations when we approach them about our Getting It Right initiative is their initial reaction, which often is, “We treat everybody the same. It doesn’t matter to us if someone is black or white or LGBT or straight. We treat everybody the same.” And then our challenge is to help that organization to understand that this is not about treating everybody the same. This is about recognizing the unique aspects of various cultures in our population and recognizing the differences—celebrating the differences—not treating everybody the same.

Roseanne: So, in fact, that’s what person-centeredness is all about.

Molly: Absolutely. That’s exactly what person-centeredness is all about.

Roseanne: Molly, what is your vision for LGBT older adults who are receiving Services & Supports?

Molly: Rose, my vision is an openness and an acceptance and an affirmation on the part of all the providers who are supporting our older adults and individuals with disabilities. The doctor’s office, the hospital admissions department, physicians and nurses in the acute care hospital setting. I envision a world where two men can walk into a residential home because they would like to look at it, and the receptionist doesn’t say, “Oh, you two are brothers…where the receptionist has the confidence to say, “Would you like to share with me how you’re connected to each other?” Not, “Are the two of you brothers?”

This may sound a little corny but I’m gonna say it. I envision a world in which assisted living facilities and skilled nursing facilities celebrate LGBT Pride Day the same way they celebrate St. Patrick’s Day, Cinco de Mayo. On March 17th we all say everybody’s Irish on St. Patrick’s Day. So, on an LGBT Pride Day, could we say everybody’s LGBT on such-and-such a date?

So, to me, it’s helping to move society forward one step at a time in support of individuals that have too many challenges to be able to do it all by themselves.

Roseanne: Do you see what you’ve learned with the older individuals, how it can translate to LGBT individuals of all ages and abilities?

Molly: You know, Rose, there are far more similarities than there are differences. When you work as hard as we worked to educate our own staff on how to ask interview questions, how to be open with LGBT individual…they’re not looking at whether or not the person is elderly, or whether or not the person is a young person with a disability. Once you develop that skill set, you’re using it no matter who the individual is with whom you are working. So, it is, there are universal aspects to what we’re doing that encompass every population.

Roseanne: Absolutely. Well, we could spend…I don’t know—how long do you have? Thank you so much, Molly. That’s a real eye-opener and gives considerable food for thought just in terms of how we all interact with one another—everyone. So, I thank you so much for coming in today.

Molly: Thank you, Rose. My pleasure to be able to do this with you.

Roseanne: Thank you.

Thanks so much for listening to Front Door, a My Place CT Podcast. Please subscribe, rate or review the show on iTunes. And you can access all the episodes as well as transcripts and the show link at myplacect.org. Stop by Front Door for our next episode. And remember, our door is always open.

Anncr: Front Door is a production of the Connecticut Department of Social Services and Mintz + Hoke.

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