More Blog Posts in This Series...
Adding a Piece to the Puzzle: LGBT Aging Community Surveys
Grandparenting as an LGBT Older Adult
Results and Implications of the St. Louis LGBT Older Adults Needs Assessment
Minnesota and the Twin Cities are aging rapidly. By 2020 there will be more people ages 65 and older than there are children enrolled in kindergarten through high school. Along with this dramatic increase in the number of older Minnesotans, we also need to prepare for a more diverse older population. The UCLA-based Williams Institute estimates 4.7 percent of Minnesota adults are LGBT—20,000 in the Twin Cities. This makes LGBT elders the largest minority in the region, and a group that will no doubt need to use the infrastructure of home- and community-based services designed to support independence as well as institutionally based services (nursing homes and assisted living facilities).
Minnesota’s Aging 2030 initiative places it ahead of many other states in preparing for the coming age wave. However, it is difficult to plan for communities that are invisible and hard to reach. The community of LGBT older adults is one of those constituent groups for which almost no Minnesota data exists. The Catch-22 nature of the problem lies in the reluctance of government, academic research and elder service providers to ask questions about sexual orientation or gender identity.
Twin Cities aging advocates recognized the need to fill the information gap and surveyed the LGBT community about aging issues in 2002, and more recently in 2012. The 2002 community-wide LGBT aging needs assessment showed an alarming lack of confidence on the part of the LGBT community in aging service provider readiness to work with LGBT clients. Only 10 percent of respondents believed they would receive sensitive care if their LGBT status were known.
Those results led to a 2007 collaborative research project with the Metropolitan Area Agency on Aging to assess local elder service providers for their readiness to work with lesbian and gay older adults, “Are Old Lesbian and Gay People Well Served?,” and to the subsequent development of a local older adult service provider cultural competency training program called Training to Serve. The 2002 survey results also informed plans for LGBT welcoming senior housing in the Powderhorn neighborhood of Minneapolis—the Spirit on Lake project.
The 2012 survey provided an opportunity for the community to assess how far it has come in the last decade in addressing the needs of LGBT older adults. As was observed in the 2002 survey, the 2012 survey found a continuing lack of confidence in receiving sensitive care if providers are aware of one’s status as an LGBT person. The percentage of LGBT community members who were confident they would receive sensitive care if their sexual orientation or gender identity were known doubled since the 2002 survey (18 percent compared to 9 percent). However, this is still fewer than one in five people. As was also observed in 2002, the overwhelming majority (92 percent compared to 95 percent) was inclined to use services if they knew staff members had received LGBT-sensitivity training.
The 2012 needs assessment survey was also designed to support comparison with the general Twin Cities population through the Minnesota Department of Human Services’ 2005 Survey of Older Minnesotans. This comparison showed substantial differences between the experiences of LGBT older adults and the general population. Specifically, LGBT older adults were nearly twice as likely to be caregivers, but less likely to have an available caregiver; were more likely to live alone; and were half as likely to have children. On a positive note, LGBT older adults were more likely to have a healthcare directive, and almost twice as likely to be an active volunteer.
The 2012 survey asked a number of questions about experiences with, and perceptions about, accessing senior services, as well as a series of pointed questions about where survey respondents would prefer to receive services: from LGBT-specific service providers or from providers that served the entire community but were LGBT-welcoming. In all but one of nine service areas, a majority preferred to access services from providers that serve everyone. This is an extremely important finding as the region and the LGBT community are faced with planning to meet the needs of the burgeoning older population. It also makes a strong argument for working with mainstream senior service providers to build their skills to serve LGBT older adults, rather than seeking to develop separate LGBT-specific services, or housing, etc.
While this survey and others conducted across North America provide insight into the lives of LGBT older adults, there are important limitations. The Twin Cities surveys, like most others community surveys, recruited subjects through LGBT social and advocacy organizations. By definition the resulting sample reflects individuals who have self-selected, are out enough to have their names appear on an LGBT organization’s constituent list and may be more socially engaged and connected.
Also, because the Twin Cities population of older adults is overwhelmingly white (92 percent), the sample (n = 495) was too small to provide an accurate picture of additional racial and ethnic populations. Nor did it generate adequate data from which to draw conclusions about smaller segments within the LGBT community (heterosexual, transgender, non-LGB-identified individuals). While these are the sampling realities of community survey work, this should not deter policymakers and advocates from using the results to enhance the LGBT aging experience.
The Twin Cities community did a good job of leveraging results from the 2002 survey to drive advocacy, policy and service provision. How will the community build on the results of the 2012 survey? Here are some immediate opportunities:
Like strategic plans, community needs assessments are at high risk for gathering dust on the shelf. The challenge to Minnesota advocates and policymakers is to use recent results to make the experience of aging better for LGBT community members. Key findings from the report show more work needs to be done. They point to opportunities for growth and change that will ensure LGBT individuals have quality support services and care as they age. The findings can be used to engage the aging services sector, individual LGBT community members, LGBT community organizations, individual leaders and elected officials in a dialog on how to effectively serve LGBT older adults whose issues, concerns and needs are largely invisible.
Portions of this blog entry were extracted from the 2012 Twin Cities LGBT Aging Needs Assessment Survey Report.
Cathy Croghan, M.S., M.P.H., R.N., is a geriatric community health consultant and researcher in Minneapolis-St. Paul, Minn. She also serves as chairperson on the Training to Serve Board of Directors. Contact her at email@example.com.
This article was brought to you by the editorial committee of ASA’s LGBTQ Aging Issues Network (LAIN).
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