MA nursing home to cater to LGBT elders

Barry Berman, executive director of the Chelsea Jewish Nursing Home Foundation, is working to provide a new model for the care of LGBT elders that could end the days when LGBT people who enter nursing homes feel pressured to go back into the closet. Berman and the foundation are currently engaged in a capital campaign for the construction of the Leonard P. Florence Center for Living, a nursing facility slated for construction on Chelsea's Admiral's Hill consisting of 10 "houses," semi-autonomous residential centers that will provide specialized care to different types of elder populations. One of those houses, the Elsie Frank House, will focus on addressing the needs of LGBT elders.

The Florence Center is designed to be a "Green House," a model for elder care facilities designed by the Texas non-profit Eden Alternative that emphasizes smaller, social, homey settings for elders rather than large hospital-like nursing homes. Berman said the idea behind a Green House is to break from the institutional feel of a nursing home and create a space that works to meet the needs of residents as individuals. He said at most mainstream nursing homes, including the Chelsea Jewish Nursing Home, a 123-bed facility, residents' daily routines must conform to the institution's schedule.

"Someone's routine in a nursing home today is everyone, whether they're ready or not, have to be in the dining room at 8 o'clock. And this is throughout the nation. They get woken up. You have nurses' aides going into resident rooms starting at 6:30 in the morning waking these folks up because the food truck is coming up at 8 o'clock and you have to be in that dining room. ... We were part of that whole culture. We were part of that whole problem. We used to applaud ourselves for getting the meals served with military precision," said Berman.

By contrast, the 10 houses at the Florence Center will each have their own kitchen facilities, giving staff the flexibility to prepare meals on a schedule of the residents' choosing. While most nursing home residents share bedrooms, each resident of the Florence House will have their own bedroom and bathroom. Instead of a sterile corridor with a nurse's station, each of the rooms will open onto a common living and dining area designed to feel more inviting than the typical nursing home common room.

By splitting the facility into 10 "houses," each of which will occupy half a floor of the proposed five-story facility, Berman said the Florence Center will also cater to elder populations with specialized needs. One house will focus on residents with amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, and another will focus on people living with multiple sclerosis. Berman said when the Chelsea Jewish Nursing Home Foundation was brainstorming other elder populations they could target, someone suggested LGBT elders. He reached out to both the LGBT Aging Project in Jamaica Plain and New York's Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) to learn about the challenges that LGBT elders face. Both organizations signed on to consult with the Florence Center to help make the Elsie Frank House a culturally competent facility for LGBT elders.

Lisa Krinsky, director of the LGBT Aging Project, said that while some nursing homes have worked to become LGBT-friendly environments, she believes the Elsie Frank House is the first nursing facility designed to meet the specific needs of LGBT elders. She praised Berman for prioritizing the needs of LGBT elders in the new facility.

"We appreciate his thinking about the LGBT community and wanting to create an inclusive safe space for folks ... We want to ensure that they're going to be able to provide the best LGBT-focused care that they can," said Krinsky.

In traditional nursing homes, Krinsky said, many LGBT elders feel pressured to go back into the closet. Most nursing home residents share a bedroom, and Krinsky said LGBT elders often worry that their roommate or other residents of the nursing home may not be LGBT-friendly. They may also worry that nurses and other staff, people they depend on for care, may harbor anti-LGBT sentiments.

She said she knows of at least one case where a man who had been openly gay and who had a circle of gay friends immediately went back into the closet after entering a nursing home.
"When he went into a nursing home his friends came to visit him and he refused to come down and visit them," said Krinsky. She said they brought him LGBT-themed books and magazines, but he refused to accept them.

"For some folks there's a real sense that that is going to jeopardize my being here, and so they find themselves going back into the closet," said Krinsky.

Berman said the Elsie Frank House will be a space where no one would feel pressured to go back into the closet. Although there will be no requirement that residents of the house be LGBT-identified, the house will focus around the specific needs of LGBT residents, and all of the staff will be trained in meeting those needs. He said people living in the facility will feel comfortable decorating their rooms with photos of their loved ones and friends, reading LGBT-themed books and magazines, and watching LGBT-themed movies.

"It's going to be catering to the needs, the psychosocial needs, of the LGBT disabled and elderly, and this would be the first in the nation that would have this," said Berman.

The Elsie Frank House is named after the longtime elder advocate, and mother of Congressman Barney Frank, who co-founded the Committee to End Elder Homelessness and served for more than a decade as president of the Massachusetts Association of Older Americans. Frank, who passed away in 2005, was also an active supporter and member of PFLAG both at the local and national level, and she was outspoken about her support for her gay son. Congressman Frank told Bay Windows that as president of the Massachusetts Association of Older Americans his mother worked with many elders who had gay children, and her example helped them learn to accept their children. Congressman Frank said his mother would be proud of the work of the Elsie Frank House, and he and his siblings agreed to the Chelsea Jewish Nursing Home Foundation's request to name it after her.

"I was very gratified on behalf of my mother ... To have it be the LGBT wing, I like both the general concept and the way in which he's going with it," said Congressman Frank.
Berman said he worked with Frank in her role as an elder advocate, and given her work on both elder and LGBT issues, it made sense to name the LGBT house in her honor.

"She was very, very focused on caring for the elderly, and she got very active in LGBT issues, so it just made sense to us to honor her good name," said Berman. The Florence Center is named after the late Boston-area philanthropist Leonard Florence.

Currently the Chelsea Jewish Nursing Home Foundation is engaged in a $26 million capital campaign to construct the facility, and they have already raised $18 million. Berman said groundbreaking on the facility could happen as early as the end of this year, and the construction process is likely to take 14 months.

The foundation is looking to hire someone to do fundraising for the Elsie Frank House within the LGBT community, and Berman urged potential candidates to contact him directly. He said the goal is to raise enough funds so that the Florence Center is free or nearly free of debt, which he said is crucial to ensuring that the facility is affordable for all prospective residents.

"The beauty of it is, by us doing the fundraising now, we expect 85 percent of the folks who live there will be on welfare, MassHealth ... The only way we can offer a beautiful product to [the] 85 percent [of residents on] MassHealth is to not have any debt, or have very little debt," said Berman.