NORTH CHATHAM – When seniors find themselves needing additional health care support, assisted living or even nursing care, it’s an emotionally challenging time of life. But it’s even more stressful for lesbian, gay, bisexual and transgender elders who also worry about discrimination or harassment.

Broad Reach Healthcare, which operates Liberty Commons and the Victorian assisted living residence, is establishing a “fully inclusive care initiative” to better serve LGBT patients. Broad Reach President and CEO Bill Bogdanovich said there are around three million adults over 65 who identify as lesbian, gay or bisexual.

“There’s been a tragically unmet need for healthcare to refocus on this poorly served demographic, and it has only become clearer since we first started exploring this work some three years ago,” he said. Bogdanovich represents the Massachusetts Senior Care Association on a special legislative panel on LGBT aging issues.

A number of challenges face LGBT seniors in a health care setting. They are sometimes estranged from their biological family members or can even face judgment by their caregivers. Their partners, who may have been a large part of their lives, might be excluded from decisions about their care because they have no standing as a family member.

Among health care providers, some of the discrimination against LGBT people likely stems from the early days of the AIDS epidemic, Bogdanovich said. Back then, the mechanism of HIV transmission was not well understood and some workers felt that working with LGBT patients was a risky activity. From the patients' perspective, it meant that caregivers could be distant.

“Folks tended to feel like the health care system wasn't there for them,” Bogdanovich said.

To address this problem, Broad Reach has started educating its workers – and the community at large – by hosting screenings of “Gen Silent,” a critically acclaimed documentary that follows the lives of six LGBT seniors living in the Boston area. The documentary is powerful and revealing, Bogdanovich said, because it tells the story of seniors who must decide whether to hide their sexuality in order to survive in the long-term health care system. The filmmakers observed that LGBT seniors stay silent about their sexual orientation when they enter a nursing home or assisted living facility, or even go back “in the closet” to avoid discrimination.

The documentary is being screened today, Nov. 1 at 6 p.m. at the Chatham Orpheum Theater; on Nov. 7 in Provincetown; and on Nov. 8 at 6 p.m. at Cape Cod Hospital in Hyannis. Introducing the screening in Chatham will be State Senator Julian Cyr and State Rep. Sarah Peake. The screenings are free but reservations are required by visiting www.BroadReachHealth.org.

Broad Reach is also providing special in-person training for its supervisory staff and online training for all other employees, to help them identify potential biases.

“We'd all like to think that we're not biased toward anybody,” he said, and health care providers pledge not to discriminate. “But what you don't know is where it might be unintentional,” Bogdanovich said. The problem extends beyond the people who are providing bedside care to include other employees “and even those who work in supportive, community-based social work,” like councils on aging or elder services groups, he said. The training helps employees understand what questions to ask and how to have conversations that make patients feel welcome and comfortable, and helps them recognize their own prejudices.

“We make sure they know that it's really not their call to be judgmental,” he said. The training will be conducted by the group Services and Advocacy for GLBT Elders, or SAGE.

Bogdanovich said that “Gen Silent” is a worthwhile documentary for people outside the health care industry as well.
“Certainly for the perhaps estranged family members of folks, if it might motivate even a few to think about reaching back out, if they've perhaps made judgments years back, that would be pretty powerful,” he said.