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Episode 15: Challenging The Senior Care Model For LGBTQ with Sarah Haggerty

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“Curiosity should be at the heart of what we do. We’re in the industry of caring for people so it’s important to know what makes them tick, in addition to thinking about how we are going to manage their needs.

Sarah Haggerty, Ombudsman, Denver Regional Council of Governments

And we’re all about challenging the status quo here at Maverick’s Headquarters! Welcome to the Challenging The Way We Age podcast by the Mavericks of Senior Living. We are two innovators and entrepreneurs who have huge hearts and passion for our older adults. And we see all kinds of opportunities to improve today’s system and create hope for the way we age. We tackle hard topics with the goal of creating conversation and generating curiosity and ingenuity to solve these problems.

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This episode is brought to you from Colorado Assisted Living Association’s Fall Conference 2019, where we spoke with Sarah Haggerty, Ombudsman for Denver Regional Council of Governments.

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Below is a transcript of the episode, modified for your reading pleasure. For more information on the people, sources and ideas in the episode, see the links at the bottom of this post.

Francis: Good afternoon, Mavericks. It’s Francis, your Chief Curiosity Maverick. And we are here at CALA.

Katherine: And this is Katherine, you Chief Inspiration Maverick.

Francis: And we are fortunate to have a very insightful forward thinking guest with us, Sarah Haggerty, who is the Ombudsman for DRCOG, which is not an actual doctor. (Laughing.) It’s the Denver Regional Council of Governments. Sarah, thank you for joining us.

Sarah:  You’re welcome. I’m happy to be here. And I do want to clarify that I am not the long-term care Ombudsman. I am a long-term care Ombudsman. I believe right now we have 14 Ombudsmen on staff between the long-term care Ombudsman program and the PACE Ombudsman program. Long-term care Ombudsman specifically visit assisted living homes and nursing homes, and the PACE Ombudsman visit the PACE Centers, which is the Program for All-inclusive Care for the Elderly. First and foremost, we advocate for residents in long-term care.

Francis: How you get into being in with DRCOG, being an Ombudsman?

Sarah: Well, in college, I studied gerontology or aging studies and worked in a continuing care community. I was a recreation assistant and a dietary aide. And that introduction to the world of gerontology, really it put my career on that path. And when I got my first full time job after college, it was as a program coordinator for Sage of the Rockies, which is the services and advocacy for LGBTQ Elders. And I ran recreational and social programs as well, providing information and assistance for lesbian, gay, bisexual and transgender older adults for two years at the center. And from there, I served on the Aging and Disability Resource Council Advisory Council for DRCOG. And that’s sort of how I got introduced to the organization. And at that point in time, I knew that eventually I really wanted to work for DRCOG.

Francis: We need more youthful, young creative injection and we need more young people to go into the aging services. And let’s remind our audience that it’s not just providing direct care, it is doing things like Sarah’s doing the advocacy. The Ombudsman, there’s a lot of opportunities in that aging service because we don’t have enough people. We need more. So let’s just dive right into it. What are what are the diversity challenges that you see for the LGBTQ community?

What Are The Challenges You See For The LGBTQ Community?

Sarah: I think they’re enormous. I think the one of the biggest challenges and hurdles for providers is first recognizing that they are serving the LGBTQ population at all. Many providers don’t recognize that they’re serving these individuals. And statistically it is the case, regardless of whether you know it or not or whether that person in your community is out. And how we approach the issues of cultural competence, working with LGBTQ people will impact the quality of care that we’re able to provide for everyone because it’s an invisible minority. You may not know that you’re serving people from the LGBTQ community. You may not ever know, but how you approach it and your attitude will really show whether or not these people can be comfortable being who they are within the community.

Sarah: The second biggest challenge I can identify is many people will say, especially in the health care industry, that we treat everybody the same. Well, I think that equity isn’t about treating everybody the same. It’s not even about treating others how you would like to be treated. It’s about treating others how they would like to be treated.

Sarah: Finding a good provider is just one of the hurdles. The other hurdles are getting acceptance from the people who are providing care for you. I think the people that you’re living with and really the issue of being treated with dignity and respect and acknowledged for being who you are and your whole person, not just what people recognize on the surface.

Francis: We already have a lot of social isolationism for seniors in general. Do we have an even further risk of that?

LGBTQ, especially older adults, are far more likely to be isolated. 80% actually live alone well into their older adult years, and they are 4x less likely to have children. Ninety percent of LGBTQ people over the age of 60 do not have children, which means that the traditional familial support structures that we think about being able to support us as we age don’t exist for a vast majority of LGBTQ older people.”

Sarah Haggerty, Ombudsman, Denver Regional Council of Governments

Sarah: Yes. LGBTQ, especially older adults, are far more likely to be isolated. 80% actually live alone well into their older adult years, and they’re four times less likely to have children. Ninety percent of LGBTQ people over the age of 60 do not have children, which means that the traditional familial support structures that we think about being able to support us as we age don’t exist for a vast majority of LGBTQ older people.

Francis: What we can do differently to engage that, to try to break down that desire to self-isolate or socially isolate?

What Can We Do To Break Down That Desire To Self-Isolate?

Sarah: I think it’s important to ask people what makes them happy and how they find joy and create an environment where people are supported regardless of sexual orientation, gender identity, race, religion. And ask open ended questions to people that we’re providing services or care for. Make no assumptions. When we make assumptions, we automatically knock down a lot of possibilities. So it’s really important when somebody is coming into care or needs a service to ask them, “Are there important people in your life that we can call if you need help?” Rather than saying, “Do you have a husband or a wife?” Because when you ask them something like that, I mean, regardless of whether it’s gay or lesbian individual, that could trigger a negative memory of the loss of a spouse. It could also remind a lesbian or gay individual that they weren’t previously allowed to marry.

Sarah: Or if I need to let them know about a change in your condition to really remembering that our language is so important? And the way that we phrase things make them as open as possible and not specific to certain ways of living that we may be familiar with.

Francis: It’s almost like we make assumptions about how they want to age. And you have a genuine open question about how they — all of our seniors, all of our residents–  want to age. Is that what you mean by that open-ended question?

Creating a person-centered care plan is something that the residents is able to direct themselves and so that they can fill in the blanks for you. In most long-term care models, it’s about filling out the forms and then following the care plan. But if we’re not involving the resident in that plan, it doesn’t work and the person is not going to get what they need to thrive.”

Sarah Haggerty, Ombudsman, Denver Regional Council of Governments

Sarah: Exactly. Asking. Creating a person-centered care plan is something that the residents is able to direct themselves and so that they can fill in the blanks for you. Because, you know, in the clinical model or most long-term care models, it’s about filling out the forms and then following the care plan. But if we’re not involving the resident or the patient in that plan, it really it just doesn’t work and the person’s not going to get what they need to thrive.

Are We Doing Enough To Meet The Care Needs Of Our LGBTQ Population?

Francis: Well said. So with the idea that care plans, are we doing enough to meet the care needs of our LGBTQ population?

Sarah: I would have to say no. I’m not sure we’re doing enough to meet the care needs of any population. And in my experience as a resident advocate I think most providers are falling short of the mark of really being truly person-centered term and everybody has room for improvement. And if we ask the residents or the people that know the resident best, how can we provide the best care for this person? How can we make them happy? What can we do to provide services that can best meet this person’s needs? That’s really where it should be coming from. Not about our ideas of what’s best for the person.

Francis: So would it be almost we need to change like our assessment, our ideas of what an assessment is, our ideas of what a care plan all of us want to be known.

“In a lot of instances, if a person with dementia starts exhibiting a behavior, it’s viewed as something negative that we need to treat and prevent rather than trying to get to the root of why is this happening. What is what are we not doing for this person? Curiosity, I think, should be at the heart of what we do. And getting to know people. If you’re going to be in the industry of caring for people, you should really want to know what makes them tick rather than just thinking about how you are going to manage their needs?”

Sarah Haggerty, Ombudsman, Denver Regional Council of Governments

Sarah: It’s something that we seek — connection. Human beings want to be connected to other people. And I think in a lot of instances, if a person starts, especially with dementia, they start exhibiting a behavior, it’s viewed as something negative that we need to treat and prevent rather than trying to get to the root of why is this happening? What is what are we not doing for this person? Curiosity, I think, should be at the heart of what we do. And getting to know people. If you’re going to be in the industry of caring for people, you should really want to know what makes them tick rather than just thinking about how you are going to manage their needs.

Katherine: That’s powerful. That’s the quote. That’s what we’re going to pull out for this podcast, because that’s the center, the heart of all of this. And it’s the most important thing for us to keep in mind.

Is There Anyone Doing This Well Right Now?

Francis: What you’re doing, and you know that the advocacy for both the residents and the community is really important, but I want to make it more inclusive. So are there any communities that you’re aware of or thought leaders that are doing things a little differently, especially for the LGBTQ?

Sarah: I’m not aware of any specific long-term care providers that stand out as being excellent care providers for the LGBTQ population. I will say that Denver Health has the LGBTQ Center for Excellence for Health Care Providers. They’re culturally competent in working with the LGBTQ population. And additionally, the Center on Colfax, formerly the LGBTQ Community Center of Colorado, has excellent programing for LGBTQ youth and older adults, and they have their wealth of knowledge and resources for people looking to understand those things better.

Sarah: The Project Visibility training that I just did today was originally created by the Boulder County Area Agency on Aging. And now I provide education to people who want to be trainers like myself or communities in the Boulder County area. I’m trained as a trainer for the Denver metro area. So if anybody wants to request speaking services from from myself, they would be able to reach out to me. And I just also want to plug for my current employer. The Long-Term Care Ombudsman and PACE Ombudsman program at the Area Agency on Aging, Denver Regional Council of Governments has several staff members who are trained as Project Visibility trainers. So you can contact our front desk and request speaking services.

Francis: Can you elaborate a little bit on what Project Visibility is?

Sarah: Yes, Project Visibility is one to three hour training for providers as well as community organizations that strives to create empathy and support for LGBTQ older adults. And it does so through presenting a variety of information about how to support LGBTQ older people, as well as historical context and so on and so forth.

Katherine: And one question, if nothing changes, what do you see happening in this industry? What is our trajectory if we don’t start doing some things that will create hope and make some shift?

Sarah: I don’t think things aren’t going to change because of the baby boomers. If you know anything about them, they don’t settle, they ground break and they will. They will create the change that they want to see as they age into needing care. I think that assisted living and nursing home care will change. I don’t yet know what that change is going to be, but I would imagine that the baby boomers are going to drive it.

Sarah: To speak a little bit to the keynote this morning, Bretagne Pullens, the speaker who was talking about millennials in the workforce. I think that will also be a huge force of change in the long-term care industry as that millennial workforce really takes hold of management positions for him to see a lot of change in how long-term care is operated.

Sarah: A lot of my cohort at Ithaca College in New York, which has an excellent gerontology program, there is excitement being generated on the younger folks in the younger generations regarding long-term care. And I think that the need is often what drives people to go into  workforce troops. I know that’s part of the reason I went into gerontology was because I knew it was going to be very relevant during my lifetime.

Francis: What do you want to challenge? Like if you’re in the driver’s seat, what do you want us to challenge as a society, as a community?

Sarah: I really want to challenge the one size fits all model to institutional care for the aging population.

Katherine: That melts my heart.

Sarah: The Area Agency on Aging is currently trying to figure out innovative ways to provide services to a population that is ever growing, ever changing, and their needs are just going to keep increasing over time. And currently, we can’t afford to put everybody into an assisted living home or a nursing home. We can’t afford that. And we don’t really want that. To be honest, we should try to keep people in the community as long as possible and maybe some ideas about more communal living. Providing ridesharing services to older adults who need to get places and can’t drive anymore. Providing in-home support, providing companionship support. Because I think one of the biggest reasons why people start to fail to thrive is because of that isolation, because of not having that human connection that’s so necessary for all of us to really do our best and succeed and live at home.

Francis: That’s just refreshing me. I haven’t heard anybody say I want to challenge the one size fits all.

Katherine: I want to say I think you’re a real gem and I really think that you’re already changing the world by just doing what you’re doing, saying the things you’re saying. And I know that you will, but keep being a stand for what you’re doing.

Francis: And I think you are just the beacon of hope in my eyes of what we can achieve. And I mean that because we need more people like you that are sharing your ideas, your thoughts, your desire to just help.

Sarah: Thank you so much. You’re both very, very kind to say all of those things. And I just want to say that the best way that we can help others is to empower them to live their best lives.

Francis:] I think we have to create purpose driven lives. Yep. They have to have a purpose behind them. So is there anything that you’d want our listeners to kind of here’s a final wrap up or a final summary?

Sarah: I think that’s what I would really like to drive home right now, is that all of us are unique and we’re all different. And the more that we come to recognize our how our differences make us stronger, the better off everybody is going to be.

Francis: And with that being said, how can they find more about either DRCOG. Cog, the Ombudsman, you?

Sarah: So the best way to find information about DRCOG is by www.drcog.org, and you can find information about all of our different divisions, including the Area Agency on Aging. We also have our fingers and a couple of other pies that I’m sure you would be very fascinated in as well.

Francis & Katherine: That’s great. It’s awesome. Thank you so much, Sarah.

Announcer: Thanks for listening. The Mavericks want to hear from you. Leave us your comments, questions and ideas for future podcasts.

Mavericks of Senior Living is sponsored by Serenity App, Inc. and Assured Assisted Living. This episode was produced by Katherine Wells and Francis LeGasse.   You can subscribe to Mavericks for Senior Living on Apple Podcasts, Google Play or Stitcher. You can also find us on TwitterFacebook, or via email at challenges@mavericksofseniorliving.

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