Caregiving is an emotionally taxing and difficult task for loved ones to undertake. It requires a level of dedication, intimacy and love that goes above and beyond relationships in which partners are healthy and able to care for themselves. That being said, caregiving for members of the lesbian, gay, bisexual, or transgender (LGBT) community often is even more challenging because those relationships are not always out in the open as heterosexual relationships are.
Lack of support makes grief more complicated for LGBT caregivers
Eboni Green, Ph.D., is a registered nurse and family caregiver. She also is a member of the LGBT Aging Issues Network (LAIN) Editorial Committee for the American Society on Aging (ASA). According to Dr. Green, "the lack of acceptance of gay and lesbian relationships can complicate grief both while caring for a loved one and once the loved one has passed away." She also explains the "distinct challenges associated with coping with grief when the person left behind cannot openly discuss feelings regarding the love shared between them and their partner because others find it uncomfortable, or when access to support is limited or nonexistent."
In fact, LGBT caregivers often find themselves unable to access the resources necessary to fully expressing and exploring their feelings, which leads to complicated grief, "a persistent response to losing a loved one, with a general disengagement from participation in everyday life activities, which can last for six months or longer."
Legal complications add further complexity
Even more challenging for the LGBT caregivers after the death of their loved one is the fact that many states do not recognize their relationship from a legal standpoint. Not all states have legal same-sex marriages, which means that LGBT caregivers may find themselves losing their homes and personal belongings when the family of the deceased handles the estate.
With an uncertain future being added to the grief over the death of their loved one, LGBT caregivers often feel isolated and angry. Dr. Green explains "they may find they are not only facing living alone for the first time, but that old friendships and other sources of support have been greatly diminished because of the long-term commitment to providing care for a loved one."
The most important thing an LGBT caregiver can do to help himself after the death of a loved one is to find resources to help work through his feelings. Attending a support group with other LGBT caregivers or reaching out to family and friends often are the most beneficial ways of coping with the loss of a loved one and avoiding complicated grief.
Other challenges facing the aging LGBT community
Imani Woody, Ph.D., serves as the chair of Services and Advocacy for GLBT Elders (SAGE) in Metro Washington, D.C. In the blog post, "The Ins and Outs of LGBT Caregiving," Dr. Woody reveals that "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."
It is more common, therefore, for LGBT community members to have to go to care facilities as they age because they do not have family members or adult children to act as their caregivers. But, the care facilities are not known for being especially friendly places for the LGBT community.
2010 study investigates psycho-social challenges in long-term care settings
In fact, a study conducted in 2010 identified the psycho-social challenges the LGBT community faces in long-term care facilities and community settings. Participants reported a fear of being rejected or neglected by healthcare providers, especially personal care aides. They also had a fear of being rejected or at least disrespected by other residents.
Additionally, those not yet in a long-term care facility were afraid they would have to "go back into the closet" if they were placed in a facility. Study participants identified a preference for gay-friendly care and suggested facilities conduct training for staff to promote acceptance and respect for homosexuals.
They also expressed a desire for gay-specific and gay-friendly living arrangements to avoid the fear, stigma, judgment, and potential harassment of living in a typical long-term care facility. As Dr. Woody puts it, "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."
Concerns abound regarding access to services and acceptance
Dr. Woody spoke with adult children of LGBT elders and learned exactly what the LGBT community faces when entering care facilities. The adult children also shared their experiences related to accessing services for their elder parents. One man reported, "They [staff in nursing homes or assisted living facilities] told me that it would be better to hide this aspect ... the identify of my father." The adult children admitted "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." Dr. Woody's findings clearly show the need for facilities to provide resources and training for staff to create safe environments for LGBT elders and their children.
While there are many facilities implementing sensitivity training programs and even LGBT-specific retirement communities and other senior living communities cropping up, there's still a road ahead until we reach a point at which every LGBT individual can enter her senior years without fear of judgement, discrimination, or other concerns. And as many adults who grew up in an age during which open sexual orientation has been more widely accepted, these are issues the senior living industry must address in order to adequately meet the needs of our aging population.