The Ins and Outs of LGBT Caregiving

We, (those of us older than 50) are now finding out what Bette Davis knew, that “Old age ain’t no place for sissies.” Those of us who are also lesbian, gay, bisexual or transgender (LGBT) may have additional challenges including homophobia and heteronormativity, which can send us running back to the very closets we fought so hard to leave, according to Stein and colleagues in a 2010 article in the Journal of Gerontology Social Work.

Recently I did a study with African-American lesbians and gay males. All study participants experienced a sense of alienation, in the African-American and majority-LGBT communities, described consistently as “a hurt that lasts a long time.” They also talked of a sense of not being wanted in the mainstream population. More than half of the participants had been called names, whispered about or harassed because of being perceived as gay or lesbian. Not surprisingly, a majority of participants were not out to their family, at work, in church or to neighbors. Some revealed that they always “pass” as heterosexuals in the majority environment. This fear of being harassed or discriminated against, the fear of being outed and the lack of LGBT-welcoming photos and brochures in care environments, as well as on websites or in social media, translates into elders trying to stay “safe,” according to Pope et al. in a 2007 article in Adultspan Journal.

So what happens when these closeted elders need to access healthcare and other services, and need the support of family members, including adult children? It remains a difficult situation. Research has shown that a majority of LGBT elders’ age without a partner, compared to less than 40 percent of the overall older adult population aging without a partner, and 90 percent of LGBT elders have no children, compared to 20 percent of the overall older adult population being childless. Furthermore, LGBT elders with children are often estranged from or not out to those children. There is a poignant scene in the film Gen Silent where an older transgender woman needs her son’s support. He has been estranged from her for years. He finally and briefly comes into her life, but is unable to accept his now-female parent as anyone but “Dad.”

Remarkably, adult children who accept and care for their elder LGBT parents seem to be aware of the perceived need for their parents to be closeted. In a qualitative study in 2007 of caregivers of gay and lesbian older adults, one heterosexual adult son observed, “My dad’s generation was more conservative, more guarded… . So they are [more] reluctant to accept help… . My dad wouldn’t want to be stigmatized as a gay.”

Another adult child, a gay son, said, “They [staff in nursing homes or assisted living facilities] told me that it would be better to hide this aspect … the identity of my father.”

Upon further questioning, these adult children articulated that they often faced overt and covert discrimination when accessing services while caring for their elder parents. The discrimination seemed to be based on the perception of the elder being gay or lesbian. In some cases, caregivers were reluctant to leave parents in institutions because of the increased vulnerability of being old and LGBT. Adult children caring for LGBT parents felt the combined perceived or actual oppressions of heterosexism and ageism directed toward their parents.

Clearly, institutions that provide resources and respite to care recipients and caregivers need training in cultural competency to create positive social environments for the closeted LGBT elder and their adult children. Moreover, additional research is required to investigate the outcomes of caregiving among this heretofore invisible group.

 

Dr. Imani Woody is the principal of IWF Consulting, LLC, president and CEO of Mary’s House for Older Adults, Inc. and the SAGE Metro DC representative to SAGENet – SAGE’s network of local affiliates around the country – that work to reduce isolation, improve financial security and enhance quality of life for LGBT older adults. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

This article by Dr. Imani Woody originally appeared on the American Society on Aging’s blog. Read it here.

Other articles in this series from the editorial committee of ASA’s LGBT Aging Issues Network (LAIN)