At an SEIU 775 executive board meeting about a year and a half ago, board members were discussing gay union members and consumers, and a member asked if anyone knew someone living in the closet, or hiding their love for a same-sex partner.

Executive Board Member Dave Lindberg knew he needed to say something, but his heart beat fast from nervousness. He took a deep breath and started speaking.

He recalls, “I opened up, and shared my experience of living in the closet. I told them that many years ago, society said you get married, you have a family, you live according to how society says,” he explains. He’d had a wife and four kids. But it wasn’t OK to be gay, or love who you wanted to love. “You’re ashamed of who you are, you aren’t comfortable with who you are, and feel there’s something’s lacking. It’s like going to Pike Place Market and being surrounded by hundreds of people, but feeling all alone.”

But he doesn’t feel that way today. Speaking up created a turning point in his life. “It turned my life around completely,” he says. As he spoke, he looked around the room and noticed eyes welling with tears, and a feeling of acceptance came through from fellow board members.

“I felt totally accepted,” he says. Many fellow members told him how proud they were of him to take the steps to come out of the closet – or reveal his identity – to everyone at the table.

Now, Lindberg, 70, lives in Everett and cares for his son, who lost his kidneys in 2001. Although he’s worked in restaurants, offices and even fixed copy machines for a while, he says home care is very rewarding, as is his time on the union board.

“It’s so important to be open-minded and non-judgmental,” he says. “Accept people as they are, and don’t assume anything.”

He says if some-one were caring for him, he’d want someone open enough to accept him, and not push him back into the closet through offensive terms or acting differently around him.

Over the Rainbow

Dave Lindberg was one of the speakers at the daylong “Over the Rainbow” summit, held on Sept. 17, 2013, and sponsored by SEIU 775 and a number of other community and advocacy organizations.

More than 200 attendees discussed how to meet the unique needs of an aging, openly LGBTQ-identified population.

Dave Lindberg and his son, Tim, enthusiastically document their lives in photography. (Photo by Inye Wokoma)

This population needs in-home or institutional long-term care, but one-in-three LGBTQ seniors worries about facing discrimination as they age. The summit presented best practices for LGBTQ seniors, understanding retirement and government benefits for seniors, and population-specific needs within the LGBTQ community.

About 69,000 LGBTQ seniors currently live in Washington state, but that population is expected to swell to nearly 111,000 by 2030, according to statistical trends. SEIU 775 began planning the event after Washington state’s voters passed Referendum 74, which legalized gay marriage.

The summit presented expert speakers such and LGBTQ-identified Home Care Aides. In 2010, the federal government funded the creation of the first LGBTQ national resource center (www.lgbtagingcenter.org) to provide training and educational resources to LGBTQ people and care providers.

SEIU 775 and the Training Partnership are working together to develop the best curriculum for caregivers so they can affirmatively care for LGBTQ consumers. To that end, in March, the Training Partnership will re-lease two new online Continuing Education courses on the topic of meeting the needs of LGBTQ consumers.

About LGBTQ Consumers

By 2030 more than 4 million older adults will identify as lesbian, gay, bisexual, transgender or queer (LGBTQ), according to Karen Fredriksen-Goldsen, an expert on LBGTQ aging and a professor of social work and director of the Institute for Multigenerational Health at the University of Washington.

Fredriksen-Goldsen present-ed a slideshow at the event that offered information that can help HCAs understand and provide better care to consumers: Concerns about discrimination or fear of abuse lead almost one-fourth of LGBTQ seniors to hide their gay, lesbian, bisexual or transgender status.

But the American Medical Association warns that if physicians don’t recognize identity and patients don’t tell their care providers, the secrets can lead to medical misdiagnosis. Being aware of a health care consumer’s sexual orientation in a long-term care service setting has been identified as critical to providing appropriate, sensitive and individualized care.

Awareness helps to ensure that LGBTQ older adults don’t feel misunderstood, unwelcome and shut out from seeking care and services.

If shut out, their health and well-being may suffer. LGBTQ seniors rely more on friends and caregivers for help, and less on spouses, children, parents and other family members for their care.

Most LGBTQ individuals over age 60 are single, compared to only a third of heterosexual seniors nationwide, and may be estranged from (not speaking to, not in communication with) family members due to discrimination. About one in three lesbian and gay “Baby Boomers” identify discrimination based on sexual orientation as their biggest concern around aging.

A recent study indicated seniors that identify as LGBTQ may be five times less likely to access needed health and social services because of their fear of discrimination.

Unique Needs

“Most services fail to take into account the unique needs facing LGBTQ older adults and their caregivers,” says Fredriksen-Goldsen. Some of those unique needs and issues include higher rates of disability and more mental distress, accord-ing to Fredriksen-Goldsen’s research.

Gay consumers are more likely to live alone than the general population. Living alone can create poor health and premature death, due to isolation from friends, family and society. Many LGBTQ adults served in the U.S. military, and may face war-re-lated post-traumatic stress disorder.

Most have suffered from abuse, prejudice or discrimination in the work-place, from family, or others in the community, which can contribute to suicide rates. Gay consumers are at-risk for serious problems, due to disparities in physical mental health, the impact of bad life experiences (such as abuse or assault), and barriers to care and services, such as an inability to reveal their identity.

Although the term LGBTQ is used as an “umbrella” term for the populations, each population also has distinct needs and services. Some populations even have their own unique issues.

Lesbian and bisexual women are at higher risk of cardiovascular disease and obesity. Gay and bisexual men may suffer from poor physical health due to smoking and alcohol use. LGBTQ consumers rely heavily on friends and life partners.

However, friends can’t always do everything – such as long-term care, when decision-making is required. Big changes have taken place in society in the past few years. For example, in Washington state, individuals can marry their same-sex partners, transgender veterans can get care that matches their needs, and an LGBTQ individual’s partner can visit him or her in the hospital and help make medical decisions.

But about a third of LGBTQ seniors lack a will and a durable power of attorney for healthcare.

What’s Next

If you’re aware of a health care consumer’s sexual orientation or gender identity, you’re able to provide better care. Specifically, offer a sensitive ear to listen to their needs, and tailor your care.

Awareness reassures your LGBTQ consumer that they feel accepted, understood and welcome – and their health and well-being is important to you and society. But care providers need to work quickly – baby boomers are now aging into consumers, but research, policy and practices are not yet in place.

More research must be done by federal, state and local government on the strengths and challenges around aging, sexual orientation and gender identity. Using this information, guardians and caregivers can receive awareness and training on the needs of LGBTQ older adults.

Enforcement of laws banning discrimination based on sexual orientation and gender identity is also important, whether in senior centers or long-term care facilities (such as nursing homes).

As well, additional laws could affirm access to LGBTQ-friendly health care, or federal and state benefits. Amending the Family and Medical Leave Act (FMLA) could cover LGBTQ caregivers and family, whether related by blood or marriage.

Right now, because the FMLA doesn’t recognize same-sex partnerships, an employer does not have to offer FMLA leave to an employee, even if his partner is sick or in the hospital.

Home Care Aides are important to creating supportive care facilities – so HCAs can sign up for cultural competency training and help develop plans to combat discrimination based on sexual orientation or gender identity.

Washington’s Department of Social and Human Services, aging network and long-term care providers are developing outreach and services that are culturally sensitive to the needs of LGBTQ older adults.

The SEIU Healthcare NW Training Partnership, the Washington Area Agencies on Aging and Jewish Family Service have begun efforts to provide LGBTQ-sensitivity training and family caregiver support programs for LGBTQ individuals, respectively.