The Needs of Aging LGBTs

Background

Aging populations show an increase in the number of older LGBTs as well. For them, rising longevity
exacerbates the challenges of old age. Many have experienced negative social attitudes and find it
difficult to integrate into regular service frameworks aimed at seniors. They suffer from social isolation,
a sense of rejection in the community, poverty, high morbidity, a fear of moving to regular residential
frameworks for the elderly, apprehensiveness about applying to services and, occasionally, about
rejection by the LGBT community itself.

Goals

The goals of the study were to investigate the special needs of aging members of the LGBT community in Israel, to learn how they cope with various aspects of age-related challenges, and to examine the extent of responsiveness of the service system to their needs. The study will help health and social services, JDC-ESHEL, and other bodies develop responses to improve services for the aging LGBT population and make them accessible.

Methods

(1) A literature review of the unique needs of aging LGBTs and the services and responses offered them, mainly in the US and Europe; (2) In-depth interviews with 12 key figures from LGBT organizations in Israel; (3) Semi-structured interviews with 22 members of the LGBT community aged 55+; (4) An online survey of 104 members of the LGBT community aged 55+; (5) Semi-structured interviews with 12 professionals and service providers in the general community, government ministries and various institutions.

Findings

Aging LGBTs (aged 55+) suffer from a scant family-support network; 58% of them live alone (almost twice the percentage of the general population of that age), and 63% have children (compared with 96% of similar age groups in the general population). They draw on friends for support who serve as a quasi-substitute for family. Old age, characterized by loneliness, can be intense for older LGBTs; 57% reported a frequent or occasional sense of loneliness (twice the percentage of the general population). Among the 70+ age group, the problem is more widespread. Aging LGBTs, in contrast to their peers in the general population, suffer from multiple difficulties and exclusion due to homophobia, ageism, and ageism within the LGBT community itself.

As regards contact with health and social services, most of the respondents to the survey (86%) reported that they had felt no discrimination or rejection in these systems, although about a third said they had felt uncomfortable or apprehensive about revealing personal information; 27% feared that prejudice or discrimination would adversely affect the treatment or service they received, 25% feared exposing their sexual orientation to health-system staff, and 11% reported that they had avoided turning to services for fear of exposure. As other studies around the world have found, the rate of older LGBTs suffering from depression was high – 31% reported a diagnosis of depression or anxiety (versus 8% in the general 65+ age group).

Many LGBTs voiced anxiety about the future, about introducing a caregiver into their home or the need to enter an institutional framework: both eventualities, they said, could “return them to the closet” for fear of not receiving proper treatment as LGBTs. They cited, too, the difficulty of entering a regular residential framework as a couple.

Main Conclusions

The difficulties of old age intensify among members of the LGBT community. They suffer from severe loneliness, and the rate that live alone is high. Their support networks are scant so that they have few people to rely on in old age. Due to their life experience and the secret that some still harbor or find hard to divulge, they are apprehensive about turning to health and welfare services. They are afraid of discrimination or of not being treated properly. They suffer from exclusion as elderly, as LGBTs and as elderly in the LGBT community itself. The study revealed a need for suitable social frameworks and activities, as well as specific residential frameworks due to fear of hetero-normativity in the regular institutions for the elderly. Professionals at health and welfare services are hardly aware of the existence of the LGBT community or their difficulties and special needs.

Based on successful models in the US, Canada and Britain, the first stage of dealing with the problem appears to be instructing and training health and welfare professionals in the treatment of older LGBTs. It also appears to be necessary to make social services accessible, to assist LGBT organizations to address ageism, to develop and adapt services for the elderly, and to adapt residential frameworks for older LGBTs. It is recommended that LGBT organizations be involved in the training of professionals and that consideration be given to integrating the trained professions into the service system.