Finding and Financing Care for LGBTQ Individuals

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Finding and Financing Care for LGBTQ Individuals

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Over 39 million people in the U.S. are over the age of 65. An estimated 2.4 million of those seniors are part of the LGBT community. LGBT is an acronym that pertains to a grouping of four different sexual orientations, including the lesbian, gay, bisexual, and transgender communities. Older LGBT adults experience unique economic and health disparities as a result of their sexual orientation and gender identity. 

Older LGBT adults are disproportionately impacted by poverty and physical and mental health conditions. They are also more vulnerable to neglect and mistreatment when it comes to their care. If the person you care for identifies as LGBT, odds are they have encountered the following obstacles at some point in their lifetime: 

  • Dual discrimination due to age and sexual orientation/gender identity.
  • Lack of legal protections.
  • Social isolation due to increased changes in living alone, being single, or having no children.
  • Social stigma.
  • Fear of aging services.

In addition to your day-to-day caregiving duties, it is also your responsibility -- as your loved one's ally -- to stay informed about the specific challenges this community faces and to be diligent when assessing local care agencies or aging care facilities. 

In recent decades there have been steady gains in social acceptance and legal rights for LGBT individuals. Unfortunately, many healthcare providers remain underprepared to meaningfully support this community. Furthermore, because many of our aging LGBT individuals lived through periods of strong negative social stigma and discrimination, they often fear the use of healthcare and care facilities. They may delay or avoid care due to these past negative experiences. This can make it more difficult for caregivers to bring in the appropriate level of support needed for their aging loved one’s care needs. Affirming feelings that are the result of experiences with otherness, rejection, and trauma can go along way in making the person you care for feel safe and comfortable.

For more information on the steps needed to improve care for LGBT older adults, watch Caring for the Stonewall Generation.

It is important to recognize and acknowledge the intersections of selfhood and disparities faced by LGBT adults when they identify with other minority groups. These can include age, race, ethnicity, military status, socioeconomic status, and religious/spiritual status. You can support your loved one in finding and maintaining a strong sense of acceptance, community, and security as they age by recognizing discrimination and seeking out resources that prioritize inclusivity.

For more information on the ways gender identity and sexuality affect caregiving relationships, read Caregiving in the LGBTQ Community.

What does inclusivity for LGBT older adults look like?

If you are a caregiver looking after an LGBT older adult, please use this as a guide when searching for senior care and auxiliary care services to confirm that they are inclusive:

  • Overt and positive LGBT pictures/language on websites, brochures, and artwork. 
  • Intake forms that address variations in sexual orientation, marital/partnership status, and gender identity. 
  • Inclusion of families of choice, or those that LGBT people often choose to include in their inner circle, in care plans and decisions. 
  • The sponsoring or highlighting of LGBT community events, programs, and organizations.
  • Non-discrimination policies in place. 

What kind of financial assistance for long-term care is available to LGBT older adults and their caregivers?

Since the partial overturn of the Defense of Marriage Act (DOMA) in 2013 by the US Supreme Court, the federal government now recognizes legal rights for same-sex couples. This means that LGBT couples can benefit from federally sponsored aging programs like social security. Unfortunately, some states still do not recognize same-sex marriage leaving many LGBT people vulnerable to discrimination and without full legal protections. Make sure to check your state’s policies and laws to ensure you know your aging loved one's rights. 

Here are some options that you and your loved one have when it comes to paying for long-term care

  • Older veterans and their spouses now are eligible to receive veteran’s benefits through the Department of Veteran’s Affairs.
  • Explore pertinent tax deductions .
  • Leverage your aging loved one’s home if it is owned can provide some strategies for income. 
  • Investigate current long-term care insurance (LTCI) policies (if there is one in place). Make sure they cover the services that your loved one will use or evaluate if it make sense to cash out on the benefits.
  • Search for paid family caregiving opportunities (such as certain Medicaid Waiver programs).
  • Explore local nonprofits or community resources that may have applicable grants or services that provide access to care and assistance to offset financial costs.
  • See if there are programs under the Medicaid umbrella that may cover waivers or additional resources. 

Care costs differ depending on where your loved one is on the care continuum. Caregivers should assess care needs as their loved one travels the journey along the long-term care path. Additionally, the methods of paying for care needs across the care continuum can differ. For example, veteran’s benefits may cover adult day services, but not other forms of companion care. You can stay empowered by knowing your loved one’s care options!

Key factors in providing a positive aging experience for our aging LGBT loved ones include welcoming communities, accepting resource centers, and increased cultural competence of service providers. Caregivers of LGBT people should look for the signs listed above that agencies and facilities are inclusive in their policies and practices to make the best choices surrounding their loved one’s care. Many LGBT people define “family” as a system of partners, neighbors, and/or friends as opposed to parents, children, and siblings. Because of this distinct definition, it is vital that senior care agencies and communities recognize and include these members of an aging LGBT person’s family of choice. 

LGBT seniors have paved the way for current generations to come out. They are the reason that younger generations have some of the safeguards and security to be more open about their sexual orientations. Our aging LGBT population is enthusiastic about activism and community efforts that support equitable, successful aging which transcends sexual orientation, race, and other minority groups. This is another reason why resource centers and communities are important to aging LGBT people. Caregivers can set their loved ones up for success by looking for welcoming communities and guiding them down the right path to access to needed resources. 


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