Lifetimes of discrimination and stigmatization cause LGBT older adults to feel that they may face discrimination, abuse, or neglect in long-term care facilities.
Over 80% of LGBT older adults fear having to go into long-term care facilities such as nursing homes. Lifetimes of discrimination and stigmatization cause them to feel that they may face discrimination, abuse, or neglect because of their sexual orientation or gender identity in these settings.
Most people, LGBT or not, want to age in their own homes or neighborhoods, in places where they are comfortable, things are familiar, and they have supportive networks of friends and family. According to research by the American Association of Retired Persons (AARP), nearly 90% of seniors want to stay in their own homes as they age, often referred to as “aging in place.”
Planning how to remain in your own home as you age is often a difficult and sometimes anxiety-ridden proposition. However, with the explosion in the size of the older-adult population in the U.S. and around the world, things are changing, and often for the better.
The marriage benefit
Edith Windsor, the plaintiff in the case involving the Defense of Marriage Act, among the grand marshals during the annual gay pride march in New York Legalization and acceptance of same-sex marriage contributes to an environment in which couples have more opportunities and supports to help them age together, in their own homes. Without the rights and benefits that go along with marriage, LGBT older adults have faced a lack of social and financial support structures as they age. We have not had access to our partners’ social security, veterans services, pension, and health care benefits. We have faced discriminatory inheritance tax laws that often force the surviving partner from the home that they had shared with their partner for decades.
One recent example of this change for the better is the announcement by the federal Administration for Community Living (ACL) regarding the "place of celebration rule" and the definition of the terms "spouse," "family," and "relative" as being inclusive of same-sex married couples. This change is a result of the Supreme Court’s ruling in the United States v. Windsor case. The ACL guidelines affect organizations and programs like State Units on Aging (SUAs), Area Agencies on Aging (AAAs), senior centers, adult day care centers, home health agencies, organizations that deliver Meals on Wheels, and other entities that make up the aging services network. See more about these guidelines at the SAGE Blog.
Community support services
SUAs and AAAs are the primary vehicle for organizing, coordinating, and providing community-based services and opportunities for older Americans and their families. However, these organizations do not have enough resources to meet all of the needs in their communities. Find out about your local SUA or AAA here. New community-based models of support are springing up everywhere to help fill the gap in those services.
One such model is the Village to Village Movement. Hundreds of “villages” are in existence or are being developed across the country and around the world. Most villages are supported by volunteers who deliver a variety of services and programs. Services can include grocery shopping, running errands, providing transportation to medical appointments, minor household repairs, or just providing companionship.
Many villages offer educational and social programs for their members. Each village has a unique personality; each sets its own goals and services based on its community’s needs and preferences. All of the villages are established to help people remain independent and age in their own homes. Find a village near you by clicking here.
Federal, state, and local governments are taking action to make cities and towns more “age-friendly.” In the U.S., New York City and Portland, Oregon, have been designated by the World Health Organization as age-friendly. A growing number of cities and communities worldwide are striving to better meet the needs of their older residents.
An age-friendly city or community meets certain criteria: accessible housing, ease of public transportation, readily available fresh foods, safe and inviting public spaces, and a vibrant workforce that is aware of issues facing older adults. Other factors are community support and health care, civic engagement, social participation, and communication.
Meeting these criteria translates into practical changes to help people age in place. These changes include doorways that are accessible for wheelchairs and walkers; sidewalks and steps that are safe, so that friends and neighbors can visit; and ensuring that the only market within walking distance carries more than just beer, soda, and expensive, unhealthy frozen meals.
The need for, and value of, communities that are age-friendly was recently highlighted in a letter received by the LGBT Elder Initiative from a consumer about the importance of communication and access to information. He wrote:
As low-income people move from the suburbs to the inner city, they find that they no longer can access TV and radio using an antenna. The buildings around them interfere with the signals. Some low-income people don’t have the option of paying for cable. There should be a law requiring apartment buildings to provide a building antenna or access to basic cable included in the rent, especially in low-income housing. With regard to the internet, it has become indispensable for caring for your health and well-being, besides staying connected to friends and relatives. … I feel completely isolated … If I start adding installation fees and monthly fees for cable and internet, I will end with no disposable income, so I am doing without for now.
Access to information and communication, social services and supports, is as challenging, if not more so, for LGBT older adults in rural areas. Some of the needs of older adults in rural areas are specifically addressed in the Older Americans Act. To date, Congress has refused to acknowledge the unique needs and issues facing LGBT older adults - in rural, urban, or any setting - in that legislation.
Thinking inside and outside the box
Equal rights and marriage benefits, services provided by State Units on Aging and Area Agencies on Aging, new models of community-based support, and personal planning can help make aging in place easier and safer. Designated LGBT senior-friendly housing, whether federally subsidized or not, can provide some LGBT older adults with additional, although limited, options.
Thinking outside the box may be the solution for some same-sex couples and single LGBT older adults. One such solution is the so-called “Golden Girls” option. Communal living can offer social and financial supports that enable us to age in place in a neighborhood or community with which we are familiar and in which we feel safe and welcome. Rose, Blanche, Dorothy, and Sofia can still make us laugh in reruns, and maybe they can give us an example of how to age successfully in place.
For more information on aging in place, check out AARP and The National Aging in Place Council.
By Ed Bomba