Are We Caring For the LGBT+ Elderly?

In the US alone, there are an estimated 3 million LGBT+ people over the age of 65, that number is expected to double by 2030 – and it’s expected to reach more than 1 and a half million in the UK by the same year. 

LGBT+ seniors have never been properly recognised as a group of people with their own unique needs before, as they grow both vocally and in numbers, this is something that drastically needs to change. According to a study by the Centers for Disease Control and Prevention, LGBT+ people face health disparities due to stigma, discrimination and violence, this is coupled with the fact that they are twice as likely as their straight counterparts to live alone, twice as likely to be single, and three to four times less likely to have children, according to research from SAGE. LGBT+ seniors are emerging as an isolated group of people needing specific care.

"They've been relatively invisible, undercounted and underserved," said Dr. Karen Fredriksen Goldsen. "We're talking about a major public health issue."

"We've found a constellation of high-risk factors, including a history of victimization and not getting access to the services they need," said Fredriksen Goldsen, professor and director of Healthy Generations Hartford Centre of Excellence at the University of Washington.

"LGBT+ seniors have been relatively invisible, undercounted and underserved. We're talking about a major public health issue." 

13 percent of LGBT+ seniors have reported they were denied proper healthcare because of their sexual orientation – that number jumps to 40 percent when it comes to elderly transgender people.

A recent study found that elderly LGBT+ people who were HIV positive had a 50 percent to 100 percent higher risk of heart attack or stroke compared with people who are negative for HIV.

Many LGBT+ seniors are also finding they have to go back in the closet when they go into nursing homes – something incredibly uncomfortable for baby boomers who were on the frontlines of the gay rights movement.

“Boomers are the first generation to live in a post-Stonewall world where there is acceptance of being gay and recognition of gay relationships,” says psychiatrist Dr. Loren A. Olson, author of Finally Out: Letting Go of Living Straight.

"Boomers don't want to have to go back into the closet to receive health care," said Lisa Krinsky, director of the LGBT Aging Project at Fenway Health, a Boston-based health care, research and advocacy centre. "But if they perceive themselves as being in an unsafe place, they may have to go back."

“Sometimes I have felt scared. You don’t know if people are going to have a problem with you. They might not but that’s how I feel and there often isn’t anyone to talk to,” explains Helen Rickedds, a 60-year-old lesbian living with Parkinsons in the UK.

“Getting older and also being ill makes it worse. You feel different and even more isolated. I have been in hospital recently and didn’t feel I could be open about it.”

Rickedds has yet to make the transition to a nursing home, and worries about what that will mean for her if she does.

“I feel like I would have to be careful about who I told,” she said. “I’m still affected by the past. I hope things are different now but I think there needs to be more awareness and greater support.”

“Sometimes I have felt scared. You don’t know if people are going to have a problem with you." 

Richard Green, a 66 year-old also in the UK, has said he’s had LGBT+ friends who have had terrible experiences with aged care.

“There is a fear about going into care homes because who knows what the future holds for us,” he said. “I knew someone who got cancer and went into hospital where they discovered it was terminal. The care was there but there was no recognition of his sexuality and who he was.

“He tried to have a conversation with one of the nurses about it and she responded saying it was a private matter and she wouldn’t be talking about it. He found that quite alienating.

“We visited him quite regularly to keep him up to date with the LGBT community. In the care home, the staff were excellent but the link to the community was really important to him. Without that I think it would have been really isolating.”

Another man explains how he was separated from his partner and treated differently from heterosexual couples in the home: “The staff in the home very rarely gave us any time alone together and on one occasion Arthur was taken seriously ill and transferred to hospital without them notifying me. The man I love could have died and I wouldn't have been there or even known.”

“(These) sorts of experiences… highlight the importance of creating an inclusive environment where people who are lesbian, gay, bisexual or trans can feel safe, secure and accepted for who they are,” said Caroline Abrahams, Charity Director at Age UK, who has put together a comprehensive guide for healthcare professionals to meet the needs of LGBT+ elders.

“These sorts of experiences highlight the importance of creating an inclusive environment where people who are lesbian, gay, bisexual or trans can feel safe." 

“As we go grey, we don’t become less gay, but sometimes we can feel less visible and more vulnerable,” said Sally Knocker, Consultant Trainer with Dementia Care Matters and Opening Doors London Rainbow Cafe Coordinator,who worked on the guide.

“My hope is this guide will encourage teams to realise that it is often the simple things that can help those of us who are LGBT to feel confident that we can be open about our lives and not feel judged for who we are.”

The needs of LGBT+ seniors need to be acknowledged and effective training for aged care professionals needs to be implemented. 

Across the United States a movement has sprung up to create LGBT-specific nursing homes. There are around 20 currently running, with a slate of new ones just announced. 

“I’m surprised there aren’t more LGBT senior living communities than there are,” saidDave Hughes, author of Design Your Dream Retirement: How to Envision, Plan For, and Enjoy the Best Retirement Possible. “And even with the ones we have, there are challenges we must address.”

As the number of vocal LGBT+ seniors only increase, these challenges will have to be met sooner rather than later.

By Tim Gibson

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