When a person requires care in the home, their needs typically do not have
gender, racial or sexual orientation distinctions, but for people who
identify as lesbian, gay, bisexual or transgender (LGBT) there are concerns
when it comes to receiving care.
“One thing a lot of people don’t realize is that many of the
positive advances for the LGBT community have been very recent,”
said Tim R. Johnston, PhD, Manager of Education and Training at Services
& Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE) and at the
National Resource Center on LGBT Aging. “Older adults who are gay, lesbian, bisexual or transgender carry
this much longer history of living in very hostile environments. What
this means is that they are much less likely to seek out something like
healthcare and they are concerned that they will receive quality or competent
Understanding the Differences
On the face of it, running errands, providing medication reminders, and
being there to help alleviate feelings of loneliness are all the same,
regardless of someone’s LGBT status or not, but Dr. Johnston points
out why this population can be unique:
- “Soon 50% of the people who are HIV+ will be 50 years of age or older,
and that figure is not restricted to the LGBT community,” he said.
“Care providers will have to know how to manage and appropriately
provide care for people who are HIV+.”
- “Not all but some transgender identified people use medical means
to alter their bodies and those procedures can have specific health ramifications
later on in life,” Dr. Johnston explained. “It’s important
that they feel comfortable being open about their medical history to get
appropriate care. For example, if you have a transgender woman who was
born male, but who lives as a woman, she will still need prostate cancer
- While Mr. Johnston said that he doesn’t know of any specific numbers
on whether people in the LGBT population lose touch with their biological
family or are ostracized because of their sexual orientation, the result
is isolation or living with a “family of choice” that is filled
with friends of about the same age. “If everybody is 85 years old
then it will be more difficult for them to care for each other,”
Dr. Johnston said.
- According to Dr. Johnston, many people who have spent their life “in
the closet,” fear that if someone comes into their home to provide
care, they will assess personal belongings such as artwork and determine
someone’s sexual orientation. “The thought of having somebody
come into your home is frightening and stressful for many LGBT older adults,” he said.
Seeking Equal Care for All
When a family caregiver or friend can no longer provide adequate care for
a loved one who is part of the greater LGBT community, there are steps
to take to decrease the chances of discrimination.
Dr. Johnston recommends a search on the National Resource Center on LGBT
www.lgbtagingcenter.org, to find providers who have undergone training with them.
“Get in touch with local LGBT organizations and ask for recommendations,”
he said. “When assessing somebody to be a care provider, check that
they have sexual orientation and gender identity in the patients’
rights agreement and other public-facing materials.”
As the Baby Boomer population ages and rights for the LGBT population gain
traction, there will be more people who are gay, lesbian, bisexual or
transgender in need of elder care. This means that caregivers will need
to increase awareness and training to meet the needs of this group.