Q&A with Nancy Grimes and Emily Lewis, Boulder County (Colorado) Area Agency on Aging

February 2012

What programs does Boulder County Area Agency on Aging offer that address the needs of LGBT older adults in that community and how long have they been in existence?

Boulder County Area Agency on Aging has a number of LGBT-specific programs. In 2000, we created the Rainbow Elders, a social support group for LGBT seniors; a group of 10-20 folks met monthly for about eight years. We currently maintain a mailing list of area residents who have self-identified as “Rainbow Elders,” and we send a monthly newsletter of social events of interest to this population. When our agency held its first focus groups with LGBT seniors in the early 2000s, many fears about aging were raised, such as:

  • “Where am I going to live?”
  • “How will I be treated in a nursing home if I am ‘out’?”
  • “Who are safe providers in the county?”

These questions led to the creation of the Silver Lining Directory: A Resource Guide for the LGBT Elder Community in Boulder County,” which is published bi-annually and distributed to area senior residences and service providers. A non-discrimination policy that includes sexual orientation and gender identity/expression is required for inclusion. The focus groups and subsequent Directory led to a much more ambitious project: Project Visibility. This cultural competency training was launched in 2004 and includes a film in which local elders and area providers voice their concerns about the aging services network; a 40-page manual of definitions, cultural competency tips and LGBT history accompanies the film.

Additionally, since 2000, our AAA has hosted an annual Lavender Gala to reduce social isolation during the holidays, and we promote at least one educational activity, such as an estate planning workshop, for the community. We have a booth at the local PrideFest to remind our elders that the Boulder County Area Agency on Aging is LGBT friendly. We also collaborate with Out Boulder, our local LGBT center, to encourage elders to participate in activities such as last spring’s intergenerational film project, in which youth and elders’ shared stories were captured on film. We list our events on Out Boulder’s website in effort to maintain senior visibility among their typically younger demographic. We also work with the University of Colorado’s GLBT Center on special events.

How has it been helpful to provide these services through the local AAA rather than an LGBT organization?

With Project Visibility trainings in particular, we benefit from the credibility of county government when booking appointments. Boulder County Area Agency on Aging is, after all, the same office that supplies the Long Term Care Ombudsmen and wellness and caregiver programs for these providers. And while our LGBT programs are primarily privately funded through donations and grants to our department’s Aging Services Foundation (another benefit in itself), the county department provides overhead and supervision for the LGBT Programs, including a mountain of information on aging in general. We know seniors! Our 25 department colleagues are Project Visibility trained, so their understanding of the LGBT elder population ‘trickles down’ through their respective client and agency interactions throughout the county and beyond. We also benefit from the broader support of county government, including value-priced printing, technology services, and professional development.

Our more socially-focused Rainbow Elders is a program that lends itself well to partnership with Out Boulder, our community LGBT organization. We receive tremendous promotional support from Out Boulder, whose database of area LGBTs is ten times larger than ours. We also seek their help with the use of social media in targeting younger elders. We have also co-sponsored an LGBT Grief & Support group with Out Boulder and a local hospice.

How is your programming unique in comparison to other programs working with LGBT older adults?

Our program is unique in that it includes an award-winning educational training component—Project Visibility—for service providers, a social/networking/support component for LGBT elders themselves—Rainbow Elders, The Silver Lining Directory, and the AAA’s LGBT office itself, staffed by out lesbians.

Again, we have the advantage of being an Area Agency on Aging: we have credibility in making appointments with senior service providers, which helps get more people trained. We present Project Visibility to other Area Agencies on Aging in Colorado and in other states. Our program emphasis is educational: we want all senior care providers in Boulder County to be LGBT culturally competent and create an environment in which ALL seniors can age well.

How many participants do you currently serve through your programs?

Project Visibility continues to grow yearly. Since 2004, our staff trainer, Emily Lewis, has trained thousands of service providers in 30-minute to all-day sessions, from CNAs at local facilities to professionals at national conferences. Our materials have been sold to AAAs and community organizations in over 24 states, Canada, and New Zealand. We offer a Train-the-Trainer workshop annually, and we know that trainers are active in several other AAAs in Colorado. In July 2012, we will present a workshop at the n4a (National Association of Area Agencies on Aging) to assist other AAAs in implementing LGBT cultural competency trainings for Home Health Care Agencies, Assisted Living, and Nursing Home staff in their regions. Our primary focus remains to train, and re-train annually, the staffs of Boulder County’s 35 assisted living and nursing homes. It is our hope that service providers who attend a Project Visibility training leave with the ability to better provide the best care possible to all their clients.

Our Rainbow Elders mailing list holds 270 names, including many allies. We continue to receive requests to join the list; more ‘gray hairs’ are present at community events, perhaps, in part because boomer elders are, typically, more ‘out’ and more mobile. Boulder County has a population of 300,000, of which about 10% are 65+ (source: US Census). We estimate that there are about 2500 or so LGBT residents age 60+.

What advice would you give to service providers who are interested in starting services in their local community that support older LGBT adults?

Start small and build. Find a handful of ‘rainbow elders’ to include in an initial planning process; they will enlist their friends. Expect the closet, but delight when it’s gone. Find local younger LGBT and ally ‘movers and shakers’ to support your efforts, both financially and socially. Get buy-in from the top down in any organization you seek to train or influence. Advertise! Collaborate! Network! Get to know your local PFLAG (Parents and Friends of Lesbians and Gays) chapter and LGBT community organizations. Know which churches are ‘open and affirming.’ Build a mailing list of ‘rainbow elders’ and professional allies, among both LGBTs and senior care providers. Be sure area senior centers know about your LGBT Programs, even though this population is five times less likely to use a senior center. Educate yourself on the unique issues of transgender elders and be transgender visible. Always have a ‘snail mail’ option.

From your experiences, what are the key issues that providers should be aware of when working with LGBT older adults?

This is not a question that can be answered in a few short sentences.  LGBT elders’ fears about aging are different from those of heterosexual elders. LGBT elders may want to talk about their lives with someone who understands, though they are often hesitant to “come out” to strangers. To work most effectively with LGBT elders, it is important that all staff—administrators through direct service workers—are culturally competent in the basics of inclusive language, and ideally, that they know something about the unique life experiences of LGBT older adults. Remember the “T” when training. Providers can create a welcoming environment through their marketing, admission, and personnel policies, signs in their entrances, and the materials in their libraries. An LGBT elder will notice something as simple as a rainbow flag, or a ‘partner’ or ‘gender identity’ checkbox. We urge providers to create an inclusive environment that respects all kinds of diversity.

Emily Lewis, M.A. (Political Science, University of Louisville, Kentucky) is the Project Visibility Trainer for Boulder County Aging Services. Since 2004, she has conducted trainings throughout Colorado and the U.S., to all types of organizations, and at state, regional, and national conferences. Project Visibility is the winner of two national awards: The 2006 n4a (National Association of Area Agencies on Aging) Innovation award for Ethnic and Cultural Diversity and the 2006 NACo (National Association of Counties) Innovation Achievement Award.

Nancy Grimes, B.A. (Humanities, University of Colorado/Boulder) is the LGBT Program Specialist for Boulder County Aging Services Division. She coordinates Project Visibility trainings, the Rainbow Elder social support group and its annual Lavender Gala, the Silver Lining Directory of LGBT-friendly senior service providers, and an annual topical symposium such as the recent “LGBT Housing Options as We Age.”