BY SHELBY PATTERSON
Michigan is not prepared to work with LGBT older adults. Federal and state civil rights laws do not include the terms sexual orientation and gender identity, and therefore do not protect these individuals. The Offices of Services to the Aging has proposed inclusion for LGBT older adults in the state plan. However, this is not mandated. Due to the lack of a concrete policy, aging providers are not required to go through cultural competency training. The LGBT older adult population is growing and this community has unique needs concerning later life.
In the U.S. there are an estimated 39.6 million older adults age 65-plus, representing 12.9 percent of the current population. This number is expected to increase to 72.1 million older persons, totaling 19 percent of the population by 2030. Between 1.75 and 4 million Americans ages 60 and older identify as LGBT. By 2030, it is estimated that there will be as many as 7 million LGBT older adults living in the U.S.
LGBT older adults are often invisible, and people are often unaware that this population even exists. Aging service providers often assume that all older adults are heterosexual. The option for selecting LGBT on an intake form is typically non-existent. That is unfortunate, because this is the population that will be utilizing older adult services more often than their heterosexual counterparts.
Most often, LGBT older adults are estranged from their biological families. These individuals are at a greater risk for social isolation; twice as likely to live alone; twice as likely to be single; and three to four times less likely to have children. LGBT elders are more likely to have delayed care, due to fear of mistreatment. This is concerning because this population has higher rates of HIV/AIDS, and chronic physical and mental health concerns.
Generally, older adult living facilities are not welcoming of the LGBT community. There are no Between The Lines newspapers laid out on tables, posters of older gay couples on the walls or any sign of LGBT support in these facilities. LGBT older adults that reside in senior living facilities are most likely to hide their sexual orientation or gender identity. People often fear that they may be ostracized in these settings: abused, mistreated or stigmatized by other residents and staff. Long-term care plans can be stressful to LGBT elders. Current laws and institutional regulations generally prioritize biological and legal family members. Same-sex partners and families of choice that do not fall into the traditional categories of "family" are often denied involvement in the care of older LGBT adults.
Most service providers have not been trained to work with LGBT older adults. In Michigan, aging providers are not required to go through cultural competency training. The Area Agency on Aging 1-B in Southfield has call operators that have actually gone through extensive training. LGBT cultural competence training creates more inclusive environments for all older adults. We need to make changes so that all aging providers are competent in working with this population.
The 2014-2016 Office of Services to the Aging State Plan on Aging has proposed a section called Issue Area V-B Lesbian, Gay, Bisexual, Transgender (LGBT)-Friendly Services. This section is merely a framework for expanding access to long term services and supports to older adults who identify as LGBT. This is not mandated, therefore aging service providers are not required to change their intake forms to include LGBT individuals, go through cultural competency trainings or even change their nondiscrimination policies.
In order to protect LGBT older adults, we need to advocate for policy change. First, federal and state civil rights laws should be changed to include the specific language of sexual orientation and gender identity. The OSA State Plan on Aging should mandate expanding access to long term services and supports to older adults who identify as LGBT. By making these changes, aging service providers will have to follow suit by changing their nondiscrimination policies. We should then require all aging service providers to incorporate cultural competency training in regards to working with LGBT older adults.
We need to train service providers. Judy Lewis, a board member with SAGE Metro Detroit (Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders), is a certified trainer through the National Resource Center on LGBT Aging. She is qualified to provide cultural competency trainings to aging service providers.
The LGBT older adult population is growing rapidly within the U.S. This group has faced a lifetime of prejudice and continues to be an invisible population today. The LGBT population has unique needs in later life. If these issues are not addressed, this vulnerable population will continue to experience greater health disparities compared to their heterosexual counterparts, a lack of support systems and LGBT affirming services, social isolation and, ultimately, an unacceptable standard of living in the journey that is later life.
