Nancy A. Orel

Gay, Lesbian, and Bisexual Elders: Expressed Needs and Concerns Across Focus Groups

Abstract Although the Gay, Lesbian, and Bisexual (GLB) senior population is growing, there has been little attention given to identifying and understanding the needs and concerns of this growing population. This paper will present results from a series of focus groups and in-depth interviews with GLB elders from three select areas in the Midwest. Content analysis of the expressed beliefs, attitudes, and opinions from participants revealed that there were seven major areas of importance for GLB elders (physical health, legal rights, housing, spirituality, family, mental health, and social networks). The needs, concerns, range of issues, common issues, opinions, and attitudes expressed across the three focus groups are discussed and recommendations are provided.

Successful aging and the epidemiology of HIV.

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, social competence, productivity, personal control, and life satisfaction. Unfortunately, HIV and medication side effects can compromise these factors, thus diminishing one’s capacity to age successfully with this disease. This article explores how HIV, medication side effects from HAART, and lifestyle choices can compromise the factors necessary to age successfully. Implications for practice and research are posited.

Getting the message out to older adults : Effective HIV health education risk reduction publications

Printed publications on HIV/AIDS for an older adult population were obtained from state public health departments within the United States in a previous study that explored the availability of age-specific HIV/AIDS prevention materials. The current study examines whether the HIV health education/risk reduction information contained in these publications is applicable and appropriate to the prevention needs of older adults. Based on an extensive literature review, four major thematic recommendations for designing HIV/AIDS risk reduction print materials for older adults were used as a framework to evaluate the content of these print publications. The results indicate that the currently available publications do not meet all the criteria when assessed using the four thematic categories of recommendations. These findings suggest that greater attention must be given to developing and securing HIV prevention educational materials that adequately address societal attitudes, myths, and biases encountered by older adults.

Investigating the Needs and Concerns of Lesbian, Gay, Bisexual, and Transgender Older Adults: The Use of Qualitative and Quantitative Methodology

Extensive research on the specific needs and concerns of lesbian, gay, bisexual, and transgender (LGBT) older adults is lacking. This article describes the results of both quantitative studies (i.e., LGBT Elders Needs Assessment Scale) and qualitative studies (i.e., focus groups and in-depth interviews with lesbian, gay, or bisexual [LGB] older adults and LGB grandparents) that specifically sought to investigate the unique needs and concerns of LGBT elders. The results identified 7 areas (medical/health care, legal, institutional/housing, spiritual, family, mental health, and social) of concern and the recognition that the needs and concerns of LGBT older adults be addressed across multiple domains, rather than in isolation.

Older Adult Learners in the Workforce: New Dimensions to Workforce Training Needs.

Lower fertility rates and declines in the number of births have created a tremendous labor shortage. This tight labor market has encouraged many companies to recruit and retain a greater number of workers older than the age of 55. Additionally, with the shift to knowledge and technology-based industries, older adult workers are finding that remaining in gainful employment beyond the mean age of 63 has social, financial, and professional benefits. Leadership in the work-place needs to redefine the learning and training strategies needed for successful businesses based on the age and skill set of the workforce.

No One Is Immune A Community Education Partnership Addressing HIV/AIDS and Older Adults

There has been a dramatic increase in the number of new HIV diagnoses among people aged 50 to 64 in the United States, and according to the Centers for Disease Control and Prevention (CDC), in just 7 years (by 2015) 50% of those living with AIDS will be aged 50 or older. To address this public health concern, viable HIV/AIDS prevention and treatment options for individuals over the age of 50 are necessary. This article discusses the No One Is Immune initiative that planned, implemented, and coordinated evidence-based HIV/ AIDS prevention and education programs specifically tailored for middle-aged and older adults. Guided by the health belief model, an educational conference entitled “Sexuality, Medication, and HIV/AIDS in Middle and Later Adulthood” was conducted along with research activities that assessed HIV/AIDS knowledge gained using both qualitative and quantitative measures. This project can be replicated by other providers within the aging network.

The graying of HIV/AIDS: preparedness and needs of the aging network in a changing epidemic.

The number of older adults living in the US with a diagnosis of HIV/AIDS has steadily increased in the past decade. This study examined the extent to which 13 Area Agencies on Aging (AAAs) in Washington State are willing and prepared, and possess the required experience/skills, to serve older adults with a diagnosis of HIV/AIDS and to access the potential impact the further implementation of Aging and Diability Resource Centers (ADRCs) may have on service delivery to this population. Staff were surveyed at AAAs throughout the state. The majority of resondents (84%) agreed that serving HIV+ older adults was consistent with their mission, but few indicated that they had substantial experience with this population. Recommendations for personnel at AAAs and AIDS service organizations are provided.

The Coming-Out Process of Gay Grandfathers: Perceptions of Their Adult Children's Influence

The coming-out process of adolescent and adult gay and lesbian individuals has been examined; however, individuals in late adulthood who come out to family members have been largely overlooked. Specifically, the coming-out process of grandparents to their grandchildren has received scant attention. Guided by the life-course perspective, a qualitative study was conducted to examine the coming-out experiences of gay grandfathers to their grandchildren. Face-to-face, one-time, semi-structured interviews lasting 35 to 90 minutes with 11 grandfathers were conducted to examine their coming-out experiences to grandchildren. Grandfathers reported that their adult children played a profound role in their coming-out process to grandchildren. Adult children were viewed as being a positive force during this process, and grandfathers reported that coming out to their grandchildren was easier than coming out to their own children. Future research would benefit from understanding the grandparent-grandchild relationship from the perspectives of adult children and grandchildren.

Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs

HIV/AIDS research has mostly focused on younger gay men. This cross-sectional study originated from a larger study of 316 respondents to include a subsample of 38 midlife and older gay men living with HIV/AIDS. The study explores physical and mental health utilization rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalized homophobia were also examined. A total of 65.8% of the HIV/AIDS participants received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalized homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are provided.

Lesbian, Gay, Bisexual, and Transgender Grandparents

Researchers have empirically examined the grandparent–grandchild relationship for over 50 years and have concluded that the grandparent–grandchild connection is of value, either directly or indirectly for both grandparents and grandchildren. However, there has been a lack of attention given to understanding the diversity and contextual variation within this intergenerational relationship when grandparents self-identify as LGBT. This chapter provides a brief overview of a life course model on grandparent–grandchild relationships and the current literature that illustrates the emerging picture of the diversity of grandparent experiences within the grandparent–grandchild relationship that includes the salience of sexual orientation on the grandparent role. It also presents approaches and strategies that would enhance programs and services directed toward LGBT grandparents and grandchildren, as well as empower both LGBT grandparents and grandchildren. Finally, it provides suggestions for further research that would address the intersectionality of grandchildren’s gender, parental sexual orientation, class, race, ethnicity, and sociological context.