Caring for Your Same-Sex Partner at Home

The headline this past August read: “Gay Caregiver Spouse Deported” and the story went on to tell of how a couple was being torn apart because of their marital status not being recognized by the United States.

While many senior care and caregiving issues are the same for heterosexual couple and lesbian, gay, bisexual, and transgender (or LGBT) couples, sometimes there are significant legal, financial and personal differences for LGBT caregivers.

“Neither of us do have any support from family,” said Ken Prag, 68, who lives with his partner, Steve Collins, in San Francisco. The couple has been together for 25 years, and prior to their meeting, Steve experienced short-term memory loss and mobility issues after a severe case of encephalitis and later contracted HIV. Steve’s sister has cut off communication and his adult son is rarely in touch, Mr. Prag said.

Since Collins is in a wheelchair, Prag says that they go to every doctor’s appointment together, and are almost always questioned about their relationship. “They ask me, ‘Why are you here?’” he said. The fact that they are not married also complicates records access, he said.

A 2010 MetLife study titled, “Still Out, Still Aging” found that nearly two-thirds of LGBT baby boomers say they have a “chosen family,” a group of people they consider family, even though they are not legally or biologically related. It also found that a significantly higher proportion of LGBT Boomers live alone.

“Striking similarities are also found between LGBT Boomers and general population Boomers, including shared fears of aging and caregiving responsibilities,” the study noted. “Members of the general population are more likely to be in a couple/partnership, but are less likely to say they rely on close friends for advice and support.”

Such relationships can provide a wealth of emotional and physical support, but can also not be legally recognized and might lead to complications if someone in need of care cannot speak for him or herself. The Family Caregiver Alliance has two online in-depth articles outlining “Legal Issues for LGBT Caregivers” and “Special Concerns of LGBT Caregivers” along with links to various organizations around the country that can provide advice.

One article points out that in January 2011, new federal regulations took effect that allow patients at most hospitals in the United States to determine who can visit them and who can make medical decisions for them, regardless of sexual orientation. Also, even though the federal Family and Medical Leave Act that allows heterosexuals unpaid leave from work to care for ailing family members, people who are LGBT should also check their employer’s policies and benefits. Many private companies now offer domestic partners the same benefits as legally married couples.

Already the awareness of discrimination has made the LGBT population prepare for old age and being cared for, the MetLife study found. “A higher percentage of LGBT Boomers have completed living wills, health care proxies, rights of visitation, and partnership agreements, in comparison to the general population,” authors wrote. In addition, LGBT boomers were found to have more end-of-life discussions with siblings, parents, and other relatives.

Prag is not at all surprised that there are some positives when it comes to caring for a same-sex partner at home. “The main benefit is that I am so closely bonded with his life and his thoughts,” he said. “It’s easy for me to anticipate what’s going to happen, what he needs.”

Pushing his partner in a wheelchair, Prag sees it as good exercise--even when he has to assist Collins to walk up a flight of stairs and then lift and carry the wheelchair up the stairs.

“It could be very wearing on a caregiver if someone were depressed,” Prag said. “But Steve is a naturally happy person and we make the best of every situation. We laugh a lot and his great sense of humor helps.”