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It is estimated that 2.4 million Americans over the age of 55 are gay, lesbian, bisexual or transgender (GLBT). GLBT Americans are more likely to live alone without family or friends to care for them. Additionally, GLBT elders are less likely to be open about their sexual orientation than younger generations.
Creating a welcoming environment for GLBT elders in retirement communities allows them to be open and honest about their sexual orientation if they would like to be. Many organizations are opening facilities specifically for GLBT populations or implementing programs to foster inclusiveness.
“If gay and lesbian elders know a facility will be friendly and welcoming to them, they are more likely to self-identify rather than to return to the closet, say those who work with lesbian, gay, bisexual, and transgender elders. They are more likely to have friends visit and less likely to become isolated, lonely, or depressed,” writes Cathryn Domrose in a Nurse.com article.
What types of things has your community been doing to welcome GLBT elders?
The Newshour recently ran an interesting piece on Green Houses. Green houses are “small, homelike settings where care for elders, rather than the demands of the institution, (come) first.” This model is a unique take on culture change that actually changes the physical environment.
According to the Commonwealth Fund there are 4 stages of culture change:
- Stage 1—Institutional model is a traditional medical model organized around a nursing unit without permanent staff assignment.
- Stage 2—Transformational model is the initial phase when awareness and knowledge of culture change spreads among direct care workers and the leadership team.
- Stage 3—Neighborhood model breaks up traditional nursing units into smaller functional areas and introduces resident-centered dining.
- Stage 4—Household model consists of self-contained living areas with 25 or fewer residents who have their own fully functional kitchen, living room, and dining room. Staff work in multi-disciplinary self-directed work teams.
Green houses fall into stage 4. The organization has created smaller houses where there are fewer residents and staff are permanently assigned. Dr. Bill Thomas thinks this is what makes green houses special. He says, “In long-term care, love matters. And the heart of the problem is institutions can’t love.” The setup of green houses allows the group to feel more like a family.
The things that make the green house model different are fairly simple in design. Dr. Thomas notes, “We wanted there to be a heart, a center, a focus of the house. So, you know, what you have in the hearth is sort of food on one end, fire on the other, and a place to share convivium or the pleasure of a good meal sort of in the middle. And this house really does that.”
Green houses are just one of the healthcare models out there to help providers in their efforts to provide more person-centered care. Check out some of the tools available to help you transform your services.
What types of things has your organization done to increase the focus on the resident?
The hurricane season of 2005 taught long-term care providers some valuable lessons in disaster planning. Mainly, be prepared to evacuate and care for your residents yourself; you can not rely on outside groups.
In a McKnight’s article today, Lambeth House, an AAHSA member located in New Orleans, discusses their lessons learned from Hurricane Katrina.
Because of their experiences with Hurricane Katrina, Lambath House changed their emergency preparedness plan. According to Scott Crabtree, executive director, “he has two evacuation sites in Baton Rouge at the ready. He has his own vehicles. And if worse comes to worst, he has an agreement with an ambulance company, and access to a school bus. Beyond his transportation plans, he has no shortage of supplies. These include a generator that is 13 feet above sea level and can run 10 days without refueling. Preparedness also includes food for 30 days.”
You can find their emergency preparedness plan listed prominently on their Web site.
“After Katrina, you don’t know anything for sure,” says Crabtree. It is important to be prepared for almost any scenario imaginable when you are caring for others.
The following tips for lining up transportation in advance of a disaster where given in the article:
- Know your residents. Identify their acuity levels. That will help determine the type of transportation you will need.
- Be a partner with the local emergency preparedness department. Once you establish contracts with transportation providers, run those contracts by the department for review. It should find out if the company will be able to accommodate your needs or is already overly committed.
- Establish a relationship with a local transportation association.
- Keep costs in mind. Decide what you are willing to spend for an evacuation contract with a transportation company. Talk to state transportation association about reasonable amounts.
- Consider talking to local churches or schools about using their means of transportation if necessary.
Disaster planning materials are also available on the AAHSA Quality First Web site. Click here to view them.
