Helping gay and transgender people as they age
By Andrea K. McDaniels
Unable to care for herself and not particularly close to her family due in part to her sexual orientation, Taylor's former lover had no one else she could turn to for help.
"She had several illnesses — some of it mental, some of it coping skills, some of it physical," said Taylor, a 52-year-old sign language interpreter. "She needed someone to be with her."
Taylor's story is not uncommon among lesbian, gay, bisexual and transgender people who are aging and thinking about who will one day care for them. To address the need, Chase Brexton Health Services has begun offering new services for the older gay population, in what they believe is the first comprehensive program of its kind in the Baltimore area.
In many respects, the gay and transgender community faces the same issues as anyone else as they age. But they also have some unique needs.
Many find themselves alone. While the world has become more accepting of the gay and transgender community, those who are elderly sometimes continue to live under the radar — their lives still shaped by an era where they were ostracized and disowned by family and friends because of their sexual orientation. Others, like Taylor's ex-girlfriend, suddenly find themselves sick with little or no support.
Gay, bisexual and transgender "older adults really grew up and came of age in a time that is very different from the social landscape today," said Nate Sweeney, executive director of the LGBT Health Resource Center of Chase Brexton. "The change in laws and social acceptance that is shaping the landscape today doesn't necessarily rewrite all the past experiences that they have."
Three million gay and transgender people in the United States are aged 55 and older. They are twice as likely to live alone, three to four times more likely to be childless and 40 percent said their support networks have shrunk over time, according to the national nonprofit Services & Advocacy for Gay, Lesbian, Bisexual & Transgender Elders — better known as SAGE.
As a result, some may not get the care and support they need as they get older.
Under its new program, Chase Brexton will offer support groups and counseling as well as medical, legal and financial assistance. The health care provider is partnering with SAGE, which is devoted to improving the lives of older members of the community.
Most of the services will be offered to caregivers like Taylor, who end up caring for their peers who don't have children and are estranged from family.
About 80 percent of long-term care in the United States is provided by unpaid caregivers such as a family member or friend, according to the U.S. Administration on Aging. In the lesbian, gay, bisexual and transgender, or LGBT, community, 1 in 4 adults will become an informal caregiver, compared to 1 in 5 heterosexual adults.
The program also will help people plan for their future — to get them thinking about who will take care of them if they get sick as well as other potential medical issues that come up later in life. The goal is to help them enjoy a better quality life in their later years.
At age 76, Nancy West sometimes worries about the future.
Although she goes kayaking two or three times a week and is in relatively good health, the Baltimore woman knows she is getting older and will one day have to think about end of life care. She has no spouse or partner and lives alone. A daughter lives out of state.
West had been married for 20 years before she fell in love with a woman and came out as gay at age 45. Some family members didn't speak to her at first. Her mom eventually came around, but would never address her sexual orientation directly. She's one of the lucky ones who has some family support. But she has friends who don't.
"A lot of people don't have the deep connections," she said. "They aren't used to socializing after having been closeted for so many years and made fun of or rejected."
Still, West said, Chase Brexton's services could one day prove helpful.
"In Baltimore, our elders face many challenges including transportation, food access, medication management, ability to afford required home repairs and home modification services," said Arnold Eppel, Baltimore's director of the Division of Aging and Care Services. "It is wonderful to know that those older adults who may face an additional discrimination or have worries about accessing care and services, have a new way to connect to the services they so vitally need."
The Chase Brexton program is an example of the growing awareness by health care providers that the LGBT community has different needs. The National Resource Center on LGBT Aging was created in 2010 with funding from the U.S. Department of Health and Human Services to bring attention to the issue. The Alzheimer's Association Greater Maryland Chapter is looking to create a support group specifically aimed at gay and transgender people.
"It is really about sensitivity and understanding the world from the point of view of the LGBT community," said Ilene Rosenthal, program director for the Alzheimer's association. "Understanding that we have to craft our message to ensure the community that this is a safe and welcome place."
Research has found that older LGBT people may feel uncomfortable going to a doctor or other medical provider because they fear being judged or discriminated against. Forty percent say that their doctor doesn't know their sexual orientation or gender identity, according to SAGE.
The fear stems from a time when people lost their jobs or were even lobotomized if found to be gay and transgender, Sweeney said. Some won't go to a health center for services unless they know it is welcoming and receptive.
"Many of them have not come out yet and they are not about to now," Rosenthal said. "They grew up in a time when they were discriminated against and they don't want to face that again."
Years of laws that prohibited gay men and lesbians from marriage and sharing each other's benefits also may have set people back financially and possibly hindered their access to health insurance. Sweeney cited one study that found that 14 percent of Marylanders couldn't afford healthcare, compared to 21 percent in the LGBT community.
Officials with AARP Maryland said they plan to support Chase Brexton's new program. For example, they already have provided food during a support group meeting. There is definitely a gap in services for older LGBT people, said Tammy Bresnahan, the organization's advocacy director.
"We know it is a community that is somewhat alienated and isolated from programs and services that are available," Bresnahan said.
Paula Murphy, 65, recently put her partner of more than 30 years in assisted living because she suffers from Alzheimer's disease. The couple was one of the more fortunate because they had supportive family and each other to get through their older years.
But Murphy said she knows many others who are not so fortunate. They don't have supportive families or children. They depend on a network of friends.
"It is difficult for them because they have no one to talk to," she said.
Taylor has helped her ex-girlfriend with basic care, but also got her enrolled for insurance under Obamacare. She has been helping her to get disability benefits too.
Taylor said she plans to use Chase Brexton's new services and that it can be beneficial to others who find themselves in the same predicament. Chase Brexton needed to establish something like this as their clientele gets older, she said.
"It provides a comfortable place," she said. "I am not going to a place where people are trying to understand me. I am going to a place where people do understand me."