June is Pride Month, a time to celebrate and affirm the diverse mosaic of our humanity. Part of this rainbow coalition includes a growing number of LGBTQIA+ elders. Conservative estimates are that there are over 3 million LGBTQIA+ people over 50 living in the US today. According to SAGE, an advocacy organization for the older LGBTQIA+ community, that number is expected to grow to over 7 million by 2030. LGBTQIA+ adults (ages 65 and older) came of age during the McCarthy Era when their identity was severely stigmatized and criminalized. They had to deny who they were and live under a blanket of silence or risk verbal or physical assaults, job loss, discrimination, and ostracization. Since then, several hard-won victories, such as the Equality Act, bans discrimination based on gender identity and sexual orientation.
However, many older adults in the community still face unique obstacles. Elderly LGBTQIA+ adults are less likely to have had the opportunities to parent, reduce their support system, and increase their likelihood of living alone. The resulting isolation has often led to financial insecurity. As they age, they are much more likely to be caregivers for their friends in the LGBTQIA+ community. Because they have experienced many challenges throughout their lives, they have higher incidences of depression, substance abuse, and HIV. Many older LGBTQIA+ adults experience high levels of discrimination in accessing assisted living or affordable housing. In fact, a transition into senior living for many can mean going back “into the closet” as they do not have confidence that senior residences can accommodate their care and safety needs. This is compounded if they have memory issues. Many same-sex partners are still denied visitation rights in hospitals and long-term care residences. Many LGBTQIA+ elders are not candid about their sexual orientation for fear of receiving inferior care from medical providers.
Some positive developments are on the horizon. There are now an increasing number of senior living residences and aging in place communities that are creating more welcoming and inclusive environments. More and more people realize that LGBTQIA+ cultural competency training for a medical, facility, and home care staff is key to developing affirming and inclusive care. On advocacy, we must continue to pressure federal, state, and local governments to include sexual orientation and gender identity protections in existing housing laws. Senior housing providers must be pushed to adopt anti-discrimination policies (SAGE LGBTQIA-friendly housing resources). On a broader level, the community’s unique needs need to be integrated into systems of care across the continuum so that services for older adults are assessed on their ability to be both welcoming for people who are older and who identify as LGBTQIA+. As we continue to evolve into a more inclusive society, it is past time to show our LGBTQIA+ elders who fought for equality the dignity and respect they deserve and acknowledge and affirm that their dreams for aging well matter.
About the Author: Anne C. Sansevero, RN, MA, GNP, CCM is the founder and CEO of HealthSense LLC, an Aging Life Care management consulting practice. She is a master’s prepared geriatric nurse practitioner, and a seasoned nursing professional with over 30 years of experience in the field. Anne has a sub-specialty in neurological disorders and is well versed in all aspects of geriatric nursing. She has particular expertise with communication disorders relating to stroke and dementia and has developed a number of innovative nursing assessment tools and standards to improve the nursing care for frail elders. Anne is a member of the Aging Life Care Association® (ALCA) and Fellow of the Aging Life Care Leadership Academy. She is currently serving on the board of the ALCA, and is Vice President of the New York Chapter. In addition, Anne is a member of the American Academy of Nurse Practitioners and the Nurse Practitioners of New York. Anne is a registered nurse, certified care manager, and a master’s prepared geriatric nurse practitioner.
“Born in Ireland, I come from a strong medical family of physicians and nurses. I was naturally drawn to a career in health care where you can make a real difference in the lives of others. In the 1980s, I was recruited for a nursing career opportunity in the United States and fell in love with the energy and optimism that is part of this country’s cultural DNA. In the acute care work setting, I became very attuned to how stressful hospitalization can be for older, frail adults. I found my calling as a nurse practitioner and Aging Life Care Professional while advocating for the elderly and working to improve their quality of life and to avoid hospitalizations. I have a deep appreciation for the wisdom and resilience that I see in my older clients and feel grateful to be able to contribute to helping them and their families lead happier lives.”