The Silent Generation: Long-term care is a landmine for LGBT seniors

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Mary Gustafson, McKnight's Staff Writer
Mary Gustafson, McKnight's Staff Writer
Filmmaker Stu Maddux was driven to make a documentary about gay, lesbian, bisexual and transgender nursing home residents because he felt that, as a gay man, he did not have many role models who demonstrated how to age without shame or fear.

“It's not that they weren't there. It's that they were invisible. When I started to look at it, I found that they're silent. They're hiding. That bothered me for personal reasons,” Maddux told me.

Maddux's documentary, called “Gen Silent,” follows six LGBT seniors over the course of the year as they navigate the eldercare system and struggle to figure out whom they can trust. Fear of discrimination and bullying at the hands of caregivers and long-term care providers sometimes forces LGBT elders back into the closet, Maddux says. His film demonstrates just that. After years of living happily in their own homes or with their partners, many seniors opt to conceal their sexuality when they enter a long-term care community. But Maddux is hoping to change that with his film.

Instead of putting the 2011 documentary in wide release, Maddux and his collaborators decided to sell it to libraries, advocacy organizations, aging services groups and long-term care facilities, where it can be screened for thoughtful audiences.

Maddux would love to see more nursing homes embrace diversity training for both workers and residents. While state and federal laws prohibit healthcare facilities from discriminating against residents based on sexual orientation, that doesn't mean LGBT residents are shielded from hurtful comments and behaviors. Maddux knows of situations in which caregivers have approached LGBT elders with offers to pray for a conversion to heterosexuality if they know that a resident is homosexual. This becomes even more hurtful in hospice and end-of-life situations

Acceptance and inclusion “needs to start from the top down — and it has to be more than just sending out a memo and expecting things to change. Facilities need to do sensitivity training because you have to change the culture for the residents and employees,” Maddux says.

Nursing homes and assisted living facilities can get the process started, for instance, by purchasing Maddux's film and screening it for residents and staff. Maddux and his colleagues have developed training materials and workbooks for LTC employees who are interested in facilitating such training. He says that so far, over 200 communities have adopted the materials.

He explains that LGBT seniors have a lot of baggage that they bring with them into long-term care. The gay rights movement has only really taken hold within the last couple decades, so many gay seniors remember what it was like when the medical establishment considered homosexuals to be mentally ill and subjected them to medications and electro-shock treatments. Even though that's not the norm today, Maddux says there are still social workers and other healthcare professionals who won't accept LGBT seniors as clients. As a result, LGBT seniors often say they would rather commit suicide than end up in a nursing home, Maddux says.

In his estimation, less than 1% of nursing homes or senior living communities tout acceptance or inclusion of LGBT residents on their website or in marketing materials, which Maddux says is a huge missed opportunity. He says that when friends and families of LGBT elders are trying to find a facility for their loved one, they screen facility websites for code words such as “inclusive,” “diverse” or “diversity,” and “acceptance” in hopes of identifying a gay-friendly community.

He says that LGBT rights for seniors got a big boost this summer when the Administration on Aging released guidance to aging services networks about targeting LGBT elders for services under the Older Americans Act. The guidance stressed that LGBT seniors have the “greatest social need” for additional services. Maddux says that this action doesn't sound like much to outside observers, but gay activists and social workers were encouraged by it.

According to Maddux, people are just now waking up to the fact that aging can be a much more fraught experience for LGBT seniors.

“It hurts when I see people talking about marriage equality as a moral or philosophical question. It's really a matter of life or death for them.”

Click here to watch a trailer for “Gen Silent,” or visit the film's website for more information on screening the film in your facility and acquiring sensitivity training materials.


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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.