LGBT Advocate Sees Hurdles Ahead

America's older population is growing, and so is the number of lesbian, gay, bisexual and transgender (LGBT) adults who are moving into their later years. In the next several decades, LGBT adults age 65 and above is expected to double, reaching more than 3 million by 2030.

See Also: Finding LGBT-Friendly Care

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Older gays and lesbians are half as likely as their heterosexual counterparts to have family to lean on for elder care.

In my job as executive director of SAGE (that's for Services & Advocacy for Gay, Lesbian, Bisexual and Transgender Elders), I'm constantly hearing about the unique challenges facing our community. These are the five main things we need to change if we want our society to be prepared for the full diversity of its aging population:

1. Basic Health Care

In the United States, about 80 percent of long-term care for older people is provided by family members, such as and spouses, children and other relatives. But LGBT elders are only half as likely as their heterosexual counterparts to have close family to lean on for help. This means that they rely heavily on the services of professional health care providers — doctors, pharmacists, or hospital and nursing home staff — who might be uncomfortable with or even hostile toward LGBT elders and who are not trained to work with them. In SAGE's experience, even when these providers are supportive, fear of discrimination prevents many LGBT older people from seeking out the care they need.

2. Caregiving Issues

Can you imagine not being able to care for a longtime partner or spouse, or have any say in your loved one's medical care? It's unthinkable for most of us. Because the support systems of LGBT elders — their partners and their families of choice — often are not recognized under the law, LGBT people frequently are not granted family or medical leave to take care of a sick or terminally ill partner. Furthermore, LGBT people can be excluded from decision-making on a partner's medical care and funeral plans, unless they have put specific legal arrangements in place. Unfortunately, many people don't make such arrangements, either because they can't afford the legal costs or because they, like so many Americans, think they can put them off for another day. (Here's a link to resources that can help you get those documents prepared.)

3. Financial Insecurity

LGBT older people are less financially secure than American elders as a whole. For example, poverty rates among elder lesbian and gay couples are 9.1 percent and 4.9 percent, respectively, compared with 4.6 percent among elder heterosexual couples. Several factors contribute to higher poverty rates, including employment discrimination and barriers in Social Security, Medicaid, and pension and retirement plans that deny same-sex couples key retirement benefits afforded to the broader population. In addition, state laws can shut LGBT partners out of an inheritance, or can require them to pay steep taxes on an estate that a surviving heterosexual spouse would inherit tax-free.

Next: More elder LGBT issues. >>

4. Social Isolation

Despite creating families of choice and other support networks, many LGBT older people still experience high rates of social isolation. They are twice as likely to be single and to live alone, and three to four times as likely to be childless. They are also less likely to feel welcome in the places where many older people socialize, such as senior centers, volunteer centers and places of worship. Research and SAGE's experience show that the harmful effects of this include depression, delayed care-seeking, poor nutrition and premature mortality.

5. Access to Aging Services

LGBT older people often do not access aging services out of fear of harassment or hostility. Few aging services providers plan for, or reach out to, the LGBT community — and few are prepared to address insensitivity or discrimination aimed at LGBT elders by staff or other older people.

Fortunately, such attitudes are changing. A recent survey of aging services providers shows that a growing number of respondents would welcome LGBT elders, but lack the proper training. Resources such as the federally funded National Resource Center on LGBT Aging have been created to provide training and tools to aging providers, LGBT organizations and LGBT older people themselves, ensuring that our community increasingly will be able to age with the dignity and respect we all deserve.

Michael Adams is executive director of SAGE, the nation's largest and oldest organization working to improve life for LGBT older adults.