SAN FRANCISCO — On Lok and Openhouse released results from a groundbreaking new report by the University of California, San Francisco (UCSF), which aims to tackle a wide range of unique challenges LGBTQ seniors face in accessing aging services in San Francisco. In the Needs Assessment of LGBTQ Senior Health in San Francisco report, Jason Flatt (PhD, MPH at UCSF), sought to determine the most effective ways to serve the area’s growing LGBTQ senior population – especially when considering the fact that one in five don’t use aging services because they feel unsafe or unwelcome.
“In many respects, LGBTQ seniors in San Francisco face an uphill battle when it comes to accessing many vital services. These include choosing lower quality services to accommodate fixed incomes, experiencing discrimination, having unique emotional and social barriers, and surviving trauma associated with either being victimized and/or living through the HIV/AIDS epidemic,” said Flatt, assistant professor in residence at the Institute for Health & Aging in the UCSF School of Nursing. “These new findings provide a strong rationale for a one-stop shop program that integrates case management, LGBTQ-identifying staff, use of trauma care approaches and social activities/programs that reflect the diverse interests and backgrounds of the LGBTQ community.”
Through focus groups and a comprehensive community survey, comprising opinions and experiences of 100+ LGBTQ older adults and their caregivers, the report identifies key themes that reflect the needs of this senior segment. Key barriers to accessing the individualized care LGBTQ seniors need range from prohibitive costs to poorly designed or discriminatory services. Additionally, many participants experienced poor quality care (including long waits), discrimination from service providers, homophobia, transphobia, racism and a lack of specialist HIV care. Among the most-requested services to meet LGBTQ seniors’ special needs: wellness programs, adult education, in-home support, recreation and transportation.
“Many seniors aren’t accessing necessary support because services are simply not inclusive, affordable and customizable to meet their broader needs,” said Flatt. “We’ve heard first-hand from seniors and their caregivers that their deep desire is to access critical services and thoughtfully designed programs. They want a nondiscriminatory welcoming environment that’s created with their unique set of needs in mind.”
According to a recent study by the Department of Aging and Adult Services (DAAS), LGBTQ seniors are four times less likely to access aging services. Important reasons include:
- 1 in 5 feel unsafe and/or unwelcome
- Nearly half have mobility limitations
- 1 in 4 report difficulty accessing transportation
- 1 in 6 report lower quality social activities
Key recommendations for LGBTQ-inclusive Adult Day Services include:
- Culturally tailored programs (especially for transgender people and LGBTQ people of color)
- Specialized health and case management services
- Supportive programs for caregivers
- Services that are free or at a reduced cost
“These findings validate the need for us to listen to LGBTQ seniors as we develop new programs to meet their expectations. Our new partnership, from which Openhouse + On Lok Community Day Services was created, is structured to help solve these challenges,” said Grace Li, On Lok CEO. “The report emphasizes the critical need to co-design a program by and for LGBTQ seniors and that’s what we’re doing with Openhouse. It’s paramount to provide inclusive services that focus on social, wellness and education programs, as well as group activities that are based on the unique interests and cultural background of diverse LGBTQ seniors. As we design our programs, we want to factor in all perspectives, such as the personal challenges faced by the transgender community and LGBTQ people of color. We’re opening up the design process to the public for creative input to ensure we’re meeting the needs of this diverse community.”
Older adults are the fastest growing age group in San Francisco. By 2030, it’s estimated that nearly 1 out of 3 San Francisco residents will be age 60 or older. More than 12 percent of older San Francisco residents (around 20,000) identify as lesbian, gay, bisexual and/or transgender and queer.
“With the significant demand for patient-centered care and services for LGBTQ seniors, Openhouse is excited to work closely with On Lok in the months and years ahead,” said Karyn Skultety, executive director of Openhouse. “The partnership kicks off early next year at our new community center at 75 Laguna Street, which also includes 79 new units of LGBTQ-welcoming senior affordable housing. We’re thrilled to offer compassionate programming and services that are designed with community input, making this initiative widely accessible to all who stand to benefit from it.”