Susan Messina on Podcast: Move or Improve? – Challenges of LGBTQ Aging

Iona’s Deputy Director Susan Messina recently spoke with Debbie Miller on her podcast, “Move or Improve: The Baby Boomer’s Guide to Housing Options.” The podcast tackles important issues about housing for the aging population. In their 30-minute episode, entitled “The Rainbow has a Silver Lining: LGBTQ Aging Issues,”Susan and Debbie discuss the specific challenges Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) older adults face as they age, especially when it comes to housing and social isolation. Susan also highlights programming Iona offers, funded by the DC Office on Aging.

You can listen to the episode on Spreaker below, or on iTunes. If you’re unable to listen, or would like to follow along with text, a transcript of the episode is provided below.

Listen to “The Rainbow has a Silver Lining LGBTQ Aging Issues” on Spreaker.

Debbie Miller (DM): It’s a real pleasure for me today to have Susan Messina. She’s the deputy director at Iona Senior Services in Washington, DC, which is a locally based nonprofit. As an out lesbian, she’s secured funding for and co-facilitated LGBTQ aging-related workshops, and serves as a co-chair of the LGBTQ Aging Services Network, as well as many other LGBTQ-related outreach programs, and I’m so pleased to have her today because we’re going to focus on the LGBTQ community and their issues with aging and having a full life and what their problems are that they may have to overcome. So thank you so much for being my guest today, Susan, I really appreciate it.

Susan Messina (SM): I’m delighted to be here, thanks for having me!

DM: Let’s start, because I don’t know how many of our listeners are gay versus straight, let’s define if you would the acronym LGBTQ, what does that acronym stand for?

SM: Sure. LGBTQ stands for Lesbian, Gay, Bisexual, Transgender, and the Q can mean Queer, which is a term that younger people have taken back, used to be a slur, taken back and being used with pride, sometimes it’s also used for questioning, maybe someone who isn’t quite sure of their sexual orientation. So it’s quite an alphabet soup but we try to use it to be very inclusive of everyone’s experience with same-gender attraction.

DM: Interesting. I’m glad you defined that for everyone so we’re trying to educate as well as find out the other issues that people in the LGBTQ community are facing. So could you talk a little bit about what some of the specific challenges are that are faced by LGBTQ older adults? Why are they more likely to be aging alone?

SM: Sure. There’s some new research on this, there’s lots of anecdotal conversation, it’s a rich area that people are very concerned about these days. So based on my knowledge and reading of that I’ll say that some of the issues are childlessness and low marriage rates, so you know, people who are 30, 40, 50, are probably getting married at a much higher rate than someone who is now 75, 80, 90, who really experienced living through times of great oppression here in America, where they could not get married, and certainly having children was very hard. And so many people rely on their children or their partners to deal with aging, obviously, that community is just gonna have less. There’s another issue I’d like to tell you about, which is possible estrangement from family of origin. Many, many of our older LGBTQ community members lived through times where being gay was so wrong and they were literally shunned from their families. Many moved to the coasts or moved to cities, and many of them haven’t had contact with family in decades.

DM: It’s very sad but it’s true.

SM: Exactly. There are other issues; social isolation is one, if you are gay or lesbian you may or may not have made deep friendships; many did, many have had huge, important communities of chosen family, that’s a term that we use. But for other folks, you know, who are more quiet, introverted, or shy, or just didn’t make those friends, it’s not easy to make friends when you get older, it’s not easy to find folks with your same orientation, potentially. And then there’s just the things that happen in life, people get older and their friends move away or they pass away. I would be remiss in not mentioning the HIV and AIDS epidemic which took thousands and thousands of lives, cut them short. I have one client here at Iona who talks all the time about how he lost one hundred friends to the epidemic.

DM: Oh.

SM: Yeah. He’s virtually the only survivor. So he’s made new friends, but he has virtually no friends that he’s known for more than 10 or 15 years.

DM: It’s very sad. And I imagine they face more discrimination with healthcare and caregiver issues, is that true?

SM: Yeah, there’s a huge worry about that. I don’t know if I’ve seen empiric evidence that it happens all the time, I’ve certainly heard anecdotal evidence that it happens, I don’t know if we have the research to back up, but it’s irrelevant whether there’s research to back up, the fear is there and the fear is real, and the fear keeps people from reaching out for the help and services they might need. So we definitely know that people are concerned about access to healthcare, it’s a big issue whether or not they can be out and open about who they are, whether or not they’ll get good quality health care, those issues are compounded for trans individuals whose bodies may not match their presentation and have to deal with doctors who may or may not understand that. That’s a whole other podcast for you, Debbie.

DM: I’m very willing to discuss that because I think it’s important to educate the public about these issues, and there’s so much that happens that it’s very difficult to cover it all in thirty minutes, that’s for sure. But I know you had said that there’s a report that said the three biggest concerns of aging LGBTQ adults are finding adequate support systems and the quality of the long term care facility services, and access to those specific older adult services.

SM: Yeah.

DM: What does Iona Senior Services provide that people would be interested in knowing about and can they find those types of services in other places in the country?

SM: Okay, that’s a multi-part question so come back if I don’t answer it all. I’ll start by just wanting to highlight, absolutely, people are very worried about where they can age if they have to leave their homes, which of course virtually nobody wants to do, but if people do decide they need to move, are they going to move to a facility that is accepting and kind and will they be discriminated against, even if the staff is friendly, will the other residents accept them? Will they have to go back in the closet? That’s a term we use a lot: re-closeting.

DM: I have gay friends who say, well, I really don’t know if I want to go there because, first thing they’ll ask me is how many children do you have and do you have grandchildren, and they don’t relate to that, so it makes it very difficult, it’s a sensitive topic.

SM: That’s exactly right. Even staying in your home, I’ll pause there for a second, even if you want to and can stay in your home and can afford the home health aides you might need, many of the home health aides, certainly where I live in Washington, DC, wonderful, mostly women who are immigrants, many of whom do not come from countries where being LGBTQ is accepted, and in some cases where it’s not even legal. People have deep concerns about bringing people into their home who might not be understanding or accepting of their gay paraphernalia, their rainbow flag, their partner’s photographs, all kinds of things. It’s a huge issue. In terms of finding out whether or not a facility in your area is LGBTQ competent, is that the second half of the question, Debbie?

DM: Yeah, if someone listening today doesn’t live in Washington, DC, because our broadcast does go further out along the east coast and some areas of the west coast, I just wanted to know if you could make a suggestion to them as to how they could locate services in their area. I’m sure they may already know if there are some, but it’d be good to let the word out more.

SM: Yeah, I wish I could just say “go to, you know, www.blank.com and find out the answers.” I have to give a couple of other resources because there is no one place to find out where good LGBTQ competent services are. But one place to start would be with the local area agency on aging. There’s a federally-funded website called the Eldercare Locator, which you may have talked about in other podcasts, so you can google “eldercare locator” or phone it at 1-800-677-1116, that’s 1-800-677-1116, that’s the Eldercare Locator. Whether they have a handle on LGBTQ resources, I do not know, but at the very least you could start with the list of facilities in your area and then start phoning them, and honestly I think some of that due diligence is just calling up and saying, “I am a gay or lesbian person. I am thinking of moving into or buying into whatever your facility is, talk to me about how culturally competent you are.” And if the answer is “uh, I don’t know, what,” that’s a bad answer. And if they have an answer, that’s the beginning of some hope and help on that.

DM: I’m just agreeing with you 100%, I think this is so great.

SM: Good. So another place to look for LGBTQ specific resources is trying the National Resource Center on LGBT Aging, which is run by SAGE, which is a national organization looking at older LGBTQ issues. According to my sources here, it’s not completely comprehensive, but it’s a good starting point. So that’s the National Resource Center on LGBT Aging, there’s no Q in that one. Some LGBTQ community centers or local SAGE chapters also have their own local resource lists, so I would say if anyone is wanting to be a friend or an advocate to the community, a thing to do would be start making some phone calls and doing some googling just in your local area and seeing what you can find. Chances are at least in every major city there’s going to be at least one CCRC or one nursing home, one LTCF that is taking the lead on wanting to reach this community and therefore has done some training and has done some publicity around that.

DM: And if they have friends who have already made the decision to move, for example, into a care facility, the word would spread that way as well, just by personal referral, is that correct?

SM: That’s absolutely right. Word of mouth would be something to really rely on. Because you know, there’s another point I want to make, any organization can slap a rainbow flag on the flyer or their front door. And that does not mean the staff has had any training, or that the residents have had any, not so much training but have the residents understood that they are living in a place that welcomes everybody. So you really want to dig around and ask hard questions. And asking residents who currently live there is probably the best way to get the info.

DM: Yeah, this is very true. Just so that our audience listeners understand, is SAGE an acronym and if so what does it stand for?

SM: I think it was an acronym and I honestly can’t remember what it stands for. SAGE, all caps.

DM: Well, they can google it. I just want to make sure people know how to get the information. But how are these challenges compounded by race and economic situation? Like some people are poor, some people are very wealthy, some people fall in the middle.

SM: Absolutely. Well, on the racial issue, I want to highlight this really good report that AARP put out just this March; it’s called Maintaining Dignity: Understanding and Responding to the Challenges Facing Older LGBT Americans. So that’s AARP, wonderful survey put out by their research shop, asks a whole bunch of questions. But around the black and Latino concerns in particular, it seems that you can’t separate out concern about healthcare discrimination due to their sexual orientation or gender identity from their concerns about discrimination based on their race. It’s a double whammy. So the research says black LGBT adults age 45 and over are equally likely to worry about each of these aspects, both their race and their sexual orientation. Altogether, aging as an LGBT person of color is more likely to carry reasons for concern compared to their white counterparts. So race and ethnicity in America is very complicated and showing up in this study as something that is equally as concerning as sexual orientation and gender expression.

DM: Interesting. Well, is there a variation that exists among lesbians, gay men, bi people, and trans people in terms of their challenges and fears of aging? Does each segment have their own particular concerns?

SM: Yeah, some things I can highlight. It sounds like, again from this research study, that they call the trans community the gender expansive community, right, so folks who don’t fit into a gender binary, that they really do face unique challenges and increased fear of discrimination as they get older. And this also is fascinating—according to this study, while many large cities have gender identity equality laws to help protect people, most transgender people do not live in big cities. So there’s this idea that cities are all liberal and where all the interesting people would go, and in fact our trans friends are around the country and that’s a big rural country too.

DM: Interesting.

SM: This is interesting—one more interesting thing about the differences. Lesbians tend to be living with a partner or married at much higher rates than gay men. So gay men tend to be more or may be more isolated than lesbian women, which is not a complete surprise when you think about how women tend to affiliate and make friendships, and men have more of a challenge with that sometimes.

DM: Interesting. Very much so. Well, what kinds of questions should LGBTQ older adults ask relating to housing, as far as if they have to have a caregiver come in or they’re seeking a retirement community or a LTCF, should they have a list prepared of specific items that they need to have addressed as well as generic questions about it?

SM: Yeah, great question. So I think some of those questions would be, just starting big, “Do you have a non-discrimination statement? Do you literally say that you will serve everybody?” and ask to see it, or it should be in their material. “Has your staff had specific cultural competency training or just even training around LGBTQ issues? Do you have any out members of the administration or other staff? How comfortable do you think your gay and lesbian, bisexual, transgender participants or residents feel here? Do you have current families that I could talk to?” Those are some of the questions I would ask.

DM: I would think that would be a big question, at least that I would have, is being able to talk to others in the community about how they’re treated and how they feel.

SM: That’s right. And also I just want to throw out, I’m sure this would not be a surprise to you or most of your listeners, these issues really affect everyone. There are many, many straight people who have gay parents, who have gay siblings, who have gay children, and they want to know that they would be welcome to sit in meetings and make decisions and visit and all of that. So really, being an LGBTQ inclusive and culturally competent institution is only going to help everybody.

DM: I absolutely agree, but there seems to be a lack in some areas about a feeling of inclusion and welcoming people regardless of their sexuality. But what do you hear specifically in your position at Iona from the LGBT community of seniors about what their needs and concerns are from their standpoint? What issues come up repeatedly that you would like to mention?

SM: Sure, happy to answer that question. We do a lot of work with small groups of LGBTQ older adults, so these questions come up a great deal. One of the top things we hear about is social isolation, the need to meet people, how to connect, how to make friends, how to find romantic partners as well. And as I think I mentioned earlier, a lot of those resources may have dried up—maybe I didn’t mention earlier, it was a conversation I had this weekend with some people—a lot of those resources have dried up, a lot of LGBTQ bars have closed. Whether a bar is a place you want to hang out or not, whether you drink or not, it used to be a gathering place, and there are just fewer of them. Here in DC, we used to have a wonderful older lesbian conference once a year that drew people together to plan it and then host it and have it, and that went by the wayside 15 or so years ago. So finding new friends and connections is hard. I already talked about housing and the challenges of moving into a different place, but a lot of it boils down to “who is going to drive me to my colonoscopy? Who can I trust to be my financial POA? I have no children, and I have no spouse, and my sister lives in California, or my sister lives two towns away but hasn’t spoken to me in 30 years, you know, who’s going to be there for me?”

DM: Yeah. This is very true, and I know that Iona Senior Services’ mission is to help people with the challenges and opportunities of aging, and they’ve been doing that since 1975. But I know some of the programming that you have personally spearheaded at Iona and otherwise for LGBTQ older adults—what kinds of programs do you have and what is that process like, and just chat about things that you are doing. I know you are just a wealth of information and expertise on this topic, and I’d like you to share with the listeners what you have done through Iona.

SM: I’m really proud of what we’ve been able to do in the last couple of years, really very intentionally this past year with a lot of new money. So one thing we did is offer what we call our Take Charge/Age Well workshop for LGBTQ people. It was offered twice. We have a better title in real life, but that’s basically what it was. It was a full-day Saturday, one day in April and one day in May, for 25 LGBTQ folks over 60. We brought them together to begin to think about just what I was talking about before. Who in your network can help you? What do you want to have your aging look like? Where do you want to be living? What are your goals? How can you begin to make that plan? The content was fantastic. It got people thinking about planning for their aging, but equally important, it brought 25 people who share a life experience together. There was so much joy and laughter and connection in those groups. It was really, really wonderful.

DM: And there, with those people, they immediately have a friendship with them, which is wonderful.

SM: That’s exactly right. And at least one gentleman emailed me the next day and said, “Could you give me the email for that guy with I had lunch with?”, and I got permission from the guy he had lunch with and made that connection, so who knows if there was a romance there or not. And then we got funding from the DC Office on Aging, which is our local government aging agency, to offer support groups for LGBTQ older adults over 60. So we’re running 5 of them right now, and they just started. We’ve got a couple of people in each group, and I attended one of them. People are so excited to have a twice a month opportunity to come and sit in a peer support group model. This is not a therapy group, but it’s a little bit different from a social group. It’s an intentional conversation, and it’s facilitated by a trained peer facilitator. And there’s a lot of need for that, to meet that need for decreasing social isolation.

DM: That’s absolutely wonderful. That’s great. How has the older adult community in DC responded to LGBTQ older adult programming? What needs still exist? What do you want to still accomplish?

SM: Well, one of the big issues is how do we reach everybody. There’s no one mailing list. People don’t walk around colored purple. So we have to find them. A lot of it is word of mouth. A lot of it is putting some ads in our local gay press, but not everyone reads that, so it’s really reaching people, and that’s our challenge.

DM: Excellent. I think what you’re doing is absolutely fabulous. I’m hoping that this program will help spread the word about it, and get more conversation out in the open. How hungry are LGBTQ older adults for the community and connection. It seems to me that what you’re doing is really providing a wonderful service by having the twice a month sessions and other things. But how can this be measured as far as the competency in an organization or company or service, surface level and structural, and deeper than that even?

SM: Well, I think to answer the question of how it’s being received: I think there are two broad categories of folks. This would probably be true of almost any service you’re offering. There are the people who really need it, and then there are people who don’t need it. So I don’t want to overstate the case and suggest that every older LGBTQ person in America or DC is, you know, alone and childless and sitting in their room not knowing what to do—many, many, many of my friends have rich and full lives, deeply connected in many communities, professional, face communities, recreational opportunities, and they don’t need a support group, because they actually have enough friends and connections and things to do. And then there are the people who for whatever reasons those connections have frayed, or were never built. And that’s where I think a social service agency like Iona can come in. We have a wonderful gay and lesbian running group in DC—most big cities do—called the Front Runners, and the Front Runners, they run, it’s what they do, and it’s a multigenerational group, and we have people over 60 there, and their needs to have a connection and run are there. Iona can help those who just need a little bit of extra help.

DM: Well, you have been absolutely fabulous about this whole thing. Is there anything else that we can add to help our audience find out more information or just what Iona’s services provide that people would be interested in? Because I know it’s not just for the LGBTQ community but other issues that come up just with the challenges of aging, and we’re going to have another guest come on from Iona who’s going to talk about aging solo, and that’s a universal topic, actually, though.

SM: That’s right. One of the great things about Iona is that we have a helpline, which is answered Monday through Friday, 9-5, by several very well trained social workers. So I’m going to give that number a couple times and then explain what it is again. The helpline is 202-895-9448. That’s Iona’s Helpline. Anyone anywhere in the country can call that number with a question about aging. Now, if you’re local to DC, obviously, we know a billion resources and many of them might be in Iona’s building. But if you’re calling from Colorado because you’ve got a mother who lives in Louisiana and you don’t know how to find her help, we can at least get the first step of where to call in Louisiana. I urge anyone to make that call if they have any questions, really about anything related to aging, we can try to help.

DM: Now, one last thing, Susan, I don’t want to keep you any longer, but you have been a joy to have on the program. Could you provide an email or contact information for people who want to talk to you directly?

SM: Certainly. So my name is Susan Messina, so my email’s pretty simple, it’s [email protected].

DM: Wonderful. Well, I do appreciate so much your joining me today, and we’ll have to have you back, and if you think of some other topic that might be important for this podcast, I hope you’ll contact me, because I think our listeners are very ready to hear what you have to say and you are such a treasure trove of information it’s wonderful to have you.

SM: It was wonderful to be here, Debbie, I wish you a good day!

DM: Thank you, Susan, you too.