For Luis de la Garza, the experience of a nursing home was a throwback to his high school days, when he felt compelled to hide his identity as a gay man. In the institutionalized setting, he remembers feeling “like I was gazing out a window seeing a vibrant world, but not feeling part of that world. Whispers and silence predominated—all of which went against aging individuals who take pride in their self-reliance and independence, and of having led a long life being ‘out’ as gay human beings.”

Luis has seen the same thing happen to other lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors. He witnessed the struggle of his dear friend Benito Moreno, for 28 years the closest member of his chosen LGBTQ family, when he had to enter a nursing home. “Being placed overnight into a contrived space such as this because of a fall or a stroke can wound the psyche. It was difficult and disorienting to the core of Benito’s being not feeling safe to disclose his authentic self. One must question how true to himself one must remain in order to feel safe with live-in strangers and a foreign environment, especially at a time when one is most vulnerable and should be focusing on the physical healing process and recovery,” says Luis.

Many LGBTQ seniors fear having to leave their community and move into a nursing home. According to a study by the National Senior Citizens Law Center:

78 percent of LGBTQ older adults surveyed felt it would be unsafe for an LGBTQ senior to be “out” in a care facility;

More than 80 percent believed that staff and other residents would discriminate against an LGBTQ elder who was out of the closet;

43 percent of interviewees reported personally witnessing or knowing LGBTQ individuals who experienced instances of mistreatment.

For transgender seniors, the risks are even higher, with denial of care common and many reporting thoughts of ending their lives rather than moving into long-term care.

Luis is deeply rooted in San Francisco’s LGBTQ community. It has been an integral part of his identity since 1979, when he visited the Bay Area and realized it was to be his home. Luis had polio at age five and although he relies on his wheelchair for mobility, he has never let his disability define him. “I live alone. I accept offers of help in my day-to-day activities when needed. Once a week I pay a neighbor for help around the house.” Before his retirement, he enjoyed a career as museum collections manager, working for the Mexican Museum in San Francisco; the Smithsonian Institute and the Library of Congress in Washington, D.C.; and the Ethnic Studies Library at UC Berkeley.

Living in the community he loves is key to Luis’ happiness. “I treasure the time I spend in my home and in my neighborhood as a total human being. I write poetry, short stories and personal essays. Here, too, I am able to explore my world of moving around in an environment in my power wheelchair. I feel free in my wheelchair.”

But with the passing years, Luis is beginning to experience more challenges, including chronic muscle pain and fatigue caused by polio and scoliosis. Like many others in the LGBTQ community, he does not have children to provide caregiving support and wonders what the future holds should he become more dependent on daily care. As these seniors age, they face two critical issues: the increasing need to access vital services and the fear that life in an institution would drive them back into the closet.

On Lok and Openhouse: On a Mission to Help Seniors Stay and Thrive in Their Community

Since its beginnings, On Lok has been committed to improving quality of life and quality of care for underserved seniors by empowering them to live with dignity and independence in the community where they feel they belong. In an effort to reach the most vulnerable populations of older adults, On Lok has partnered with Openhouse, another San Francisco-based nonprofit, to co-design a program for LGBTQ seniors.

The mission of Openhouse is to help LGBTQ seniors overcome the unique challenges they face as they age by providing housing, services, and community programs. The partnership brings together On Lok’s expertise in long-term care with Openhouse’s commitment and ability to serve the LGBTQ community.

“We believe LGBTQ seniors who have recorded lifetimes fighting for the rights of our community should not have to face the double-bind of being forced to choose between being ‘out’ or receiving services,” said Dr. Karyn Skultety, Executive Director for Openhouse. “The ideal solution is one that supports LGBTQ seniors to age in the place they call home, surrounded by people they love. Openhouse has long believed we could lead this solution, and we’ve now found in On Lok a trusted partner with deep expertise in aging services to work with us.”

“When Openhouse invited us to share in this vision, it was an easy decision,” said Grace Li, On Lok’s Chief Executive Officer. “LGBTQ seniors are four to 10 times less likely to access senior services. With Openhouse, we now have an opportunity to develop a new program that, by involving LGBTQ seniors early on in the design process, will hopefully help address the issues this community faces accessing vital services.”

The co-designed program is expected to begin in summer 2019, and it will be one of many Openhouse offerings at its new community center at 75 Laguna Street, which is currently under construction along with 79 units of LGBTQ-welcoming, affordable senior housing. The overall project is also expected to be completed in summer 2019. “These essential services fill an unmet need for our underserved LGBTQ seniors,” said San Francisco Mayor London Breed. “I am proud that the City is sponsoring the building of the community center and affordable housing at 75 Laguna Street and I want to thank On Lok and Openhouse for making this innovative approach a reality.”

Working Together to Ensure Everyone Can Age in the Place They Call Home

In the coming months, Openhouse and On Lok will look to LGBTQ community members to help share about their experiences and ideas regarding service delivery and to help shape this program to ensure it meets the needs of the community. For Luis, the On Lok/Openhouse partnership is ideal because it works toward a comprehensive approach for LGBTQ elders to maintain an intact self-worth and sense of well-being. “Staying in one’s house versus an institutional setting can only have better healing outcomes for LGBTQ seniors, since they are surrounded by the familiar and can continue being true to their LGBTQ identity, without having cause to question whether to disclose it or not. The combination efforts of these two programs can only lead to the greater benefit for aging LGBTQ individuals.” g

For more than twenty years, Openhouse has been the only nonprofit uniquely committed to serving San Francisco’s lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors. For more information, please visit www.openhouse-sf.org.