Well into a training program to help a senior living community staff better understand LGBT residents came the part that really explains why so many older people fear they'll have to go back in the closet if they move to senior housing — history.
Rose Tree Place managers were asked to read a three-page timeline of being gay in America developed by SAGE, the advocacy organization for LGBT seniors behind the training. Many of the Media community's residents were born in the 1920s and '30s, a time when police raided gay bars and the Navy persecuted gay service members, when gay men in Nazi concentration camps wore pink triangles. In the 1950s, the United States banned gay immigrants and the American Psychiatric Association listed homosexuality as a mental disorder. Then came the AIDS epidemic, years of activism, and, finally, marriage equality. Yet acceptance remains far from universal.
Tim Johnston, director of national projects for SAGE, and Mary Beth Farrell, the mother of a transgender daughter and director of risk and corporate compliance for Watermark, Rose Tree's owner, asked for reaction.
"It's literally in my father's lifetime that all this happened," said Mike Rasmussen, Rose Tree's marketing director. "We are literally barely out of the primordial swamp in so many ways."
Rose Tree is among a growing number of retirement communities and aging organizations that are seeking certification from SAGE (Advocacy and Services for LGBT Elders) to show they are inclusive, or are at least raising awareness that LGBT residents may need special care. While leaders say this mostly grew out of the "person-centered care" movement, they also know that the estimated three million LGBT people over age 55 are an underserved market. Residents in their 80s now may be reticent about their sexuality, but the coming wave of baby boomers will likely include more people who are out and expect senior communities to accept and support them.
"Why would you just rule out a whole segment?" asked Kevin Bradley, associate director of online learning for Leading Age, which represents many nonprofit retirement communities. It has encouraged members to better serve the LGBT community, and interest has picked up in the last three or four years, he said. There are a few communities that cater primarily to the LGBT population, but more hope for a diverse mix of residents.
The trend is occurring at a time when overt discrimination against gay elders continues. In Missouri this summer, a married lesbian couple filed a lawsuit against a retirement community that refused to accept them because it believed the Bible restricts marriage to the union of a man and a woman. LGBT advocates are closely following a lawsuit filed by an Illinois woman who said fellow retirement community residents bullied her after they learned she was lesbian.
Terri Clark, a Philadelphia woman who serves on the American Society on Aging's leadership council on LGBT aging and is also a SAGE trainer, said bias against gay residents can also be more subtle. A staff member may take longer to answer the call bell or let daily grooming slip. It can escalate to name-calling and more. "We've heard of people being prayed over in hospice care" by staffers who thought gay residents needed to repent before they died, she said.
Advocates say that open discussion of LGBT concerns helps not only current and potential residents but also employees and gay relatives of residents.
Tucson, Ariz.-based Watermark is seeking SAGE certification for all of its 52 communities. So far, about 40 percent, including the Watermark at Logan Square, have completed the process. It includes a four-hour training for managers and online training for most of the remaining staff. The campaign has not been universally popular, said Shannon Ruedlinger, a managing director at Watermark. "We're going to offend some and we're going to appeal to some," he said, "but this is the stand we're taking."
SAGE teaches staff to use open-ended language that allows for the possibility of same-sex partners. Johnston said his favorite conversation starter is "Tell me a little bit about yourself." Trainers like him spend a surprising amount of time explaining the meaning of LGBT and other letters used to describe nonheterosexuals. One useful piece of advice: While young activists may like the word queer, many elders grew up at a time when it was a slur. Many aren't fond of homosexual either because of its clinical connotations. Companies learn how to create inclusive forms for residents and employees and how to make ads that signal a welcoming environment. At the end of the program, organizations can display a rainbow insignia. Some fly rainbow flags and begin including more LGBT-friendly programming.
Henry Weitz, 86, moved to Rose Tree in June 2017 with his husband, James Macleod, 76. They picked it largely because it was near friends and they liked the food. Weitz was only a little worried about how straight residents would react to a gay couple. "If anybody talked behind my back, two things: I didn't know and I didn't care." Macleod is now quite ill and Weitz is so busy being a caregiver that he can't devote much time to making friends, but he is happy that Rose Tree recognized that LGBT residents might need special attention. "I think it would be very good for Rose Tree," he said of SAGE training.
Janice Moore, 82, and her wife, Emily Sonnessa, 89, talk to senior organizations for Garden State Equality about the needs of LGBT seniors. They're planning to stay in their house in Ocean Grove, N.J., as long as they can, though Sonnessa is now on oxygen 24 hours a day. The couple have been together for almost 49 years and were the subject of the short documentary, Love Wins.
Moore said seniors have reason to worry about care they might receive. "The LGBT community is going to have to search longer and harder for places that are accommodating," she said. SAGE certification would matter to her in picking a community. "SAGE is saying, 'We've got your back,' " she said.
Only a few groups in this area, including the Alzheimer's Association Delaware Valley Chapter and the Montgomery County Aging and Adult Services, have official SAGE certification.
Wesley Enhanced Living at Stapeley in Germantown is completing the process. Executive director Ken Beiler decided he had to do more about a year and a half ago, when he saw part of the film Gen Silent, a documentary that explored why many older people go back in the closet. "It really just left an impact on me," he said.
As a gay man, Russell Mast, executive director of the Rydal Park retirement community in Jenkintown, said the issue is personal. He is currently exploring SAGE certification. "When I hear that people sometimes feel the need to go back into the closet in their later years, that's unacceptable to me. To me, it's a moral imperative," he said. "I'd love for this to be the kind of place where people can fully be free to be themselves."
Rabbi Erica Steelman, staff chaplain and director of the LGBT+ initiatives at Abramson Senior Care, has worked with SAGE but has not officially sought certification. Instead, her center has HEI (Health Equality Index) leadership status from the Human Rights Campaign. Abramson now has 36 single-stall "all gender" bathrooms. There's a rainbow flag in the synagogue. "It may sound small, but that's huge," said Steelman, who identifies as LBGT+. (The + avoids the Q for queer.) "People look for signals. Is this place sensitive?"
Ada Bello, 84, a 13-year resident of Cathedral Village, doesn't think her retirement community, which tends to attract well-educated liberals, needs to do much more to serve the LGBT community. A longtime lesbian activist, she has always felt comfortable there. "This has been a sort of ideal solution for me because I don't have a family and I don't have a partner," she said. "I have lots of friends." About a dozen people now participate in monthly LGBT dinners. Word has gotten around about Cathedral Village, she said. "Plus, it's been advertising in gay news for a long time."
Residents who came of age at a time when it was acceptable to treat LGBT peers badly may be harder to reach than staff. Some leaders think staff can set community culture, but others, and SAGE, are considering how to bring more straight elders into the conversation.
Vassar Byrd, CEO of Rose Villa Senior Living in Portland, Ore., took on the issue after she met a lesbian couple who moved in a few years ago. They were on the verge of moving into another, more rural facility when the marketing director told them, "You know, when you move, you're going to need to be roommates or sisters."