Aging as LGBT

If you've been following this blog, following me on Facebook or Twitter, or if you've chatted with me in person, by now you've learned some of the issues I feel are especially important to focus on, what issues I feel have become cliche, and my general musings on caregiving, aging, and elder care as a geriatric care manager in NYC. 

Sometimes, the resources and advice I give take on different levels of importance for different people. That's especially true for LGBT seniors, and I think it's worth writing about here.

This has been written about before, so I'll try to be concise with this blog. My aim is to give concrete and specific resources and tips to LGBT seniors and those caring for them. This blog will be far from exhaustive, but I hope it helps spark a conversation or two, or inspire you to learn more. Here are 3 of many examples of things I feel are important for LGBT adults to consider as they age.

• Advance Directives: This is the issue that jumps at me first when I think about aging and LGBT partners. According to the Washington Post, "In most states, an estranged sister would be appointed proxy before a same sex partner" in the absence of a written healthcare proxy. Heterosexual married partners, in contrast, are usually considered the default healthcare proxy. Even in states where same-sex marriage is legal, there have been reports of hospitals not honoring next-of-kin laws. While that obviously needs to change, it cannot hurt for anyone to be overly-prepared. For unmarried LGBT partners, there is an obvious need. Check out my blog on healthcare proxy to learn more. 
• Financial Support & Caregiving: Older LGBT adults are twice as likely to be single and 3-4 times more likely to be without children than their heterosexual peers. The risks of social isolation and poverty are subsequently higher. Ensuring a social support network is important for all elders, but perhaps is more acute for the LGBT community.
• Medicaid: By far and away, Medicaid is the best long term care insurance policy anybody could have- provided you meet the qualifications for it. It also provides certain spousal impoverishment protections, which help prevent spouses from depleting their home or nest egg in order to qualify for Medicaid. Unfortunately, these protections do not always apply to same-sex couples. Same-sex couples are subsequently strongly encouraged to meet with an elder law attorney or consider purchasing long term care insurance policies to better prepare for potential long-term care needs.   

The real and significant impact of discrimination, unique health care challenges (40% of elderly LGBT adults say their primary care doctor isn't aware of their sexual orientation), and unequal laws unquestionably puts LGBT elders at a disadvantage. We must work to improve this, and in the meantime, we should prepare accordingly. If you are an LGBT elder or family member considering working with a geriatric care manager, be sure they are sensitive to these unique needs from the get-go.

The experts on the issues affecting LGBT seniors is SAGE, and they're based right here in NYC. Visit SAGE's website to learn more, and to get involved on their great advocacy efforts. 

If I've left anything out (and I'm sure I have), please leave a comment. Let's keep the conversation going.