Abstract The marginalization of lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) content in health and human services education is well documented and varies considerably due to instructors’ attitudes as well as government and institutional policies intended to censor conversations about sexual orientation and gender identity. Lack of LGBTQ+ content in the curriculum may require creative solutions to fill the gaps in mainstream education which often goes unchallenged due to dominant heteronormative theory, literature, and teaching. Without adequate training, service providers may not have sufficient knowledge and skills for competent practice with LGBTQ+ older adults. This presentation bridges critical pedagogy with emancipatory gerontology to reflect upon a student led “queering gerontology” campaign to raise awareness about LGBTQ+ aging. Applying principles from participatory action research, the presenters analyze personal narratives in combination with program evaluation data to describe our process conceptualizing, implementing, and evaluating the campaign. We found that students are eager to learn about LGBTQ+ aging experiences and have innovative ideas to close the gaps in knowledge caused by heteronormative educational contexts. Supporting student led learning, intersectional coalition building, and intergenerational wisdom sharing were central to combatting programmatic and institutional constraints that limit LGBTQ+ content in the curriculum. The presentation concludes by highlighting future teaching and research directions that support students in their pursuit of knowledge while challenging heteronormative structures of higher education.

The global population is rapidly aging and people of all genders and sexualities around the world are living longer, healthier lives. This chapter examines the historic, institutional, cultural, and political contexts that shape the lives of lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults over the life course, and implications for social work practice, research, policy, and education. Using a critical gerontology lens, the authors review selected areas of social work practice with older adults, including health and wellness; economic security, work, and retirement; and caregiving and long-term care. Throughout, we discuss implications and strategies for improving social work practice with LGBTQ elders, including person- and family centered practice, culturally competent and anti-oppressive approaches, community-based research, advocacy, and policy practice. As with all social work clients, LGBTQ older adults have multiple, overlapping social identities – including gender, race, class, age, ability, nationality, and faith – that intersect with age, sexual orientation, and gender identities. We draw on intersectionality theory in order to better understand individual experiences in the context of socio-structural constructions of privilege, power, and oppression. Finally, we share emerging literature, resources, and tools to help social workers in their practice with LGBTQ elders.

This chapter applies a queer gerontology framework to analyse the processes and mechanisms through which heteronormativity seeps into gerontological practice, research, and policy to shape our understanding of family and leisure across the life course. First, we describe how family and leisure has been conceptualized in lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities historically. Next, we explore family relationships through the ageing process using theoretical frameworks of queer gerontology and a newly emerging queer life course approach. Finally, we examine the age-friendly community movement to discuss how a broader understanding of family and leisure informed by critical theory can shape practice and policy goals to promote and improve the lives of LGBTQ older adults. We argue that ageing-related research, policymaking, and social movements should be committed to representing complex and intersectional lives of older adults as they interact with the structures relevant to their social and physical ecologies.

Abstract The majority of aging network service providers are unprepared to deliver targeted services to lesbian, gay, bisexual, or transgender (LGBT) older adults. In 2017, California legislature mandated ongoing LGBT sensitivity training for congregate living providers. Services and Advocacy for GLBT Elders (SAGE) developed a specialized training, Creating Inclusive Communities, for congregate living staff to learn the unique needs of LGBT elders. This secondary data analysis compared pre-test knowledge and attitudes of training participants in two states, one mandating LGBT aging sensitivity training (California, N=328) and one without the mandate (New York, N=622). Preliminary results show that prior to receiving training, California participants demonstrate significantly less knowledge of LGBT aging issues compared to New York participants; t(948)=-3.808, p<.001. Attitudinal differences were also demonstrated. These results suggest that laws mandating LGBT sensitivity training may help reach providers with greater training needs. Policy and practice implications will be discussed. Part of a symposium sponsored by Rainbow Research Group Interest Group.

The social positioning of lesbian, gay, bisexual, and transgender (LGBT) older adults is influenced by a constellation of historic and contemporary policies that shape the way they interact with the world around them. Although the past few decades have witnessed several legislative decisions that reflect a more open stance toward LGBT individuals, there remains a lack of federal policies that protect them. This paper provides a critical analysis of the LGBT Elder Americans Act of 2019, a bill amending the Older Americans Act of 1965 to include LGBT older adults in the definition of those with “greatest social needs” for the purpose of service planning and implementation. As a theoretical framework, we apply a life course perspective and an equity lens to examine the promise and limitations of the LGBT Elder Americans Act in meeting the needs of LGBT older adults. It is critically important for social work practitioners, policy makers, and scholars to understand the principles that drive policy debates so that they can advocate on behalf of the most vulnerable members of the population. We offer three recommendations for future policy making: i) Apply a life course perspective to understand the lived experiences of LGBT elders; ii) Apply an equity lens to public policy; and iii) Expand research to guide and advance policy development.

"Scharlach and Lehning: Creating Aging-Friendly Communities." Journal of the American Planning Association, 85(2), pp. 178–179

Abstract The population of lesbian, gay, bisexual, and transgender (LGBT) adults aged 50 or above is rapidly aging, posing distinct challenges to aging service providers who work to meet their complex health and social needs. In 2011, Services and Advocacy for GLBT Elders (SAGE), home of the National Resource Center on LGBT Aging (NRC), developed and implemented a suite of trainings designed to sensitize aging service providers to the needs and experiences of LGBT elders. This descriptive study examines baseline (pre-test) survey data from individuals trained between 2013 and 2018 (N=10,500). Training participants represent all states throughout the U.S. and vary widely in race/ethnicity, age, and job title. Preliminary results indicate that knowledge measured prior to trainings shows substantial variation across geographic regions, suggesting the need for more geographically targeted approaches to training delivery. Implications for practice, research, and policy with LGBT adults in later life will be discussed.

Abstract The need for health education regarding Alzheimer’s disease and related dementias (ADRD), specifically designed for Latinos, has been well-documented. Many Latino older adults and their families delay seeking formal help for ADRD symptoms due to lack of information and access to culturally sensitive services. This paper presents preliminary findings of community-based participatory research to develop El Barrio SHARE, a culturally-tailored intervention tapping natural helpers (NHs) to address a need identified by community members in East Harlem, NY. It trains people who often interact with elders in the course of their work (e.g., hairdressers, bodega clerks), and are well-positioned to observe and detect ADRD-related problems and potentially link elders to relevant services. Findings from a process evaluation developing the 10-module NH training suggest that (a) participants seek information that debunks myths and stigma surrounding ADRD, and (b) the need for culturally-tailored, participant-centered interventions in marginalized communities is critical.

Abstract Community-based gerontological research plays an indispensable role in identifying and addressing the strengths, intersectionalities, and socio-structural inequities that shape the lives of older adults in multicultural communities around the world. This symposium highlights the innovative, global scholarship of Silberman Aging: A Hartford Center of Excellence in Diverse Aging, as the Center begins its sixth year. Through community-based research and academic-community collaborations, Center researchers examine challenges affecting the health and wellbeing of diverse and often marginalized aging communities in North America, West Africa, and East Asia. The first paper describes and evaluates a CBPR project that trains community-based natural helping networks to identify and refer older adults with dementia in East Harlem, NY. The second study explores the perceptions and strategies of community-based primary care physicians in Ulaanbaatar, Mongolia in dealing with elder abuse and neglect. The third takes a population health approach to the relationship between social capital and health among older adults in Ghana. Fourth, preliminary results from an evaluation of a nation-wide training initiative that promotes cultural-competencies among aging services providers working with LGBT elders. Finally, we present findings from a CBPR study examining barriers to palliative care among racially and ethnically-diverse community-dwelling older adults with serious illness. Although substantively and methodologically varied, these studies all demonstrate the importance of social networks in health in later life, and underscore the value of community-based research that supports collaboration, empowers communities, and ultimately transforms practice and policy to better meet the diverse needs of older adults around the globe.

Abstract Many Latino older adults delay seeking help for symptoms of Alzheimer’s Disease or Related Dementia (ADRD) due to substantial barriers to services. Community-based Natural helpers (NHs) can increase health-related knowledge and can serve as full partners in health education and promotion. This paper presents the process and product of the first phase of a community-based participatory research study to develop a culturally-tailored intervention increasing knowledge about ADRD and services in East Harlem, NY. We describe the results of the initial survey and development of El Barrio SHARE, an intervention that recruits and trains community residents to provide information and referrals about dementia, tapping into natural community networks of people (hairdressers, bodega clerks, mail carriers) who interact with and have longstanding relationships with older adults in the course of their work. NHs are well-positioned to observe and detect problems, and can link elders to relevant, culturally-sensitive resources, accessible support, and treatment.

It is well known that the United States and most other countries throughout the world are faced with an aging population. By 2030, more than one in five people will be older than age 65, and this o...

As global aging brings increased diversity in race/ethnicity, language and culture, ability, sexual orientation, gender identity, and access to economic and other resources, supporting the health and well-being of older adults and their communities is complicated by cultural and geographic diversity, and growing structural inequities. Community-based scholarship plays an essential role in understanding and addressing the needs that emerge from disparities and intersectionalities that shape the lives of older adults in multicultural communities. This symposium highlights innovative research and describes the challenges and rewards of academic-community relations that build knowledge and promote healthy aging through community-based inquiry. First, we present a study exploring long-term and advanced care planning among multicultural members of an urban LGBTQ senior center. Second, preliminary findings are shared from a community-based initiative to address knowledge and service-utilization gaps regarding Alzheimer's disease among urban Latino elders. Third, we describe a university-community collaboration using social network analysis to improve provider knowledge and support for caregivers of individuals with dementia. Fourth, results are shared from a study of intergenerational transmission of cultural identity among older Pacific Islanders in Hawai'i. Finally, we present an ethnographic study of academic-community relationships in a rural U.S. college town, and perceptions of multiple stakeholders who influence the aging experience in their community. Through a variety of methods, these studies share a commitment to community-based research that aims to support collaboration, empower communities, and ultimately transform practice and policy to better meet the diverse needs of urban and rural older adults around the globe.

Transmission of cultural values, beliefs, and traditions from one generation to another rely on multiple mechanisms within a variety of social and environmental contexts. Intergenerational transmission of culture has been conceptualized among Pacific Island communities as relationships and connections across multiple systems from micro to macro to metaphysical. This phenomenological study set in a small community in Hawai’i included in-depth individual interviews conducted with 36 Elders in their homes. Community consultants collaborated with researchers throughout the study to maintain trust and rapport with participants. Qualitative analysis using principles of grounded theory resulted in preliminary findings that suggest community rituals serve as an important conduit for intergenerational transmission of values, traditions, beliefs, and historical knowledge. Culture is a primary underpinning of community life; therefore, the community context is essential for understanding macro and micro social work practice, particularly with indigenous communities. Implications for practice and research will be discussed.

Since 2011, SAGE's (Services and Advocacy for GLBT Elders) National Resource Center on LGBT Aging has trained more than 10,000 aging and LGBT service providers via Web-based and in-person multimodal cultural competency trainings designed to improve the care of LGBT older adults in social service and healthcare settings. This article presents an overview of the in-person aging services provider curriculum, evaluation methods, and significant findings from the 2013-2015 training period. Implications for future research and program development are explored briefly.

AbstractObjectiveResearch on the impact of natural disasters on the mental health of older adults finds both vulnerabilities and resilience. We report on the rates of clinically significant depression among older adults (aged ≥60 years) living in areas affected by Hurricane Sandy in 2012 and the factors associated with mental health need.MethodsThe Sandy Mobilization, Assessment, Referral and Treatment for Mental Health (SMART-MH) program integrates community outreach and needs assessments to identify older adults with mental health and aging service needs. Older adults with significant anxiety or depressive symptoms were offered short-term psychotherapy. Social service referrals were made directly to community agencies. All SMART-MH activities were offered in Spanish, Russian, Mandarin/Cantonese, and English.ResultsAcross the full sample, 14% of participants screened positive for depression. Hurricane Sandy stressors predicted increased odds of depression, including storm injury, post-storm crime, and the total count of stressors. Outcomes varied significantly by age group, such that all Sandy-related variables remained significant for younger-old adults (aged 60–74 years), whereas only the loss of access to medical care was significant for older-old adults (aged ≥75 years).ConclusionsStorm-affected communities show higher rates of depressive symptoms than seen in the general population, with storm stressors affecting mental health needs differentially by age group. (Disaster Med Public Health Preparedness. 2017;11:97–109)

data, 10-g (N=208; 9%) and 1.4-g (N=859; 37%) monofilament insensitivity were associated respectively with 38% and 14% higher total costs/year (both p<0.05) among Medicare claims with costs, adjusted for demographic, body composition, lifestyle, medication and comorbidity factors including diabetes.An average participant had higher adjusted mean costs/year of $2,259 and $805 for 10-g and 1.4-g insensitivity respectively (both p<0.05).Sensory nerve impairment, independent of diabetes and comorbidities, increased Medicare costs.

Older adults with HIV evidence a high prevalence of multimorbidity and depression.We examined these factors in a sample of older adults with HIV compared to the National and New York City Health and Nutrition Examination Surveys (NHANES and NYCHANES).ACRIA's Research on Older Adults with HIV data set (ROAH: n=1000 New York City older adults with HIV in 2006-07) was matched on demographics to 2004-06 NHANES and NYCHANES.Comorbidities assessed were arthritis, hypertension, diabetes, cancer, stroke, heart disease, respiratory disease, depression.The ROAH sample had significantly greater multimorbidity (p < .001)compared to either HANES group.Over half of the HIV-positive sample were classified as depressed compared to 20% or less in HANES.Regression analyses of the combined samples found depressive symptoms significantly covaried with age, HIV, comorbidity, and employment.These data underscore the health disparities, including depression, among HIV-positive older adults, presenting challenges for policy makers, providers and patients.