Care crisis for LGBT elders

A critical and hidden emergency faces Pennsylvania’s LGBTQ community: How will we care for the state’s aging LGBT population and the myriad problems those Pennsylvanians are facing every day?

According to the U.S. Census, 16 percent of the country is aged 65 or over — more than 40 million people. The baby boomer generation — people born post-World War II between 1946 and 1964 — is the fastest-growing elder population in the U.S., with 80 million people born in those years.

Pennsylvania has the second-largest demographic in the country of people aged 65 and over — more than 17 percent of 13 million people. Among those nearly 2 million Pennsylvanians are more than 150,000 people who identify as gay, lesbian, bisexual or transgender, among an estimated 2.5 million or more LGBTQ elders nationwide.

Where will they go as they age? Who will take care of them? How will they integrate into heteronormative nursing homes and assisted-living facilities? How will they be treated by management, staff and other residents? Who will pay for their care?

According to a report by SAGE and the Movement Advancement Project titled “Understanding Issues Facing LGBT Older Adults,” LGBT elders experience economic and health disparities that their heterosexual peers do not. LGBT elders are disproportionately affected by poverty as well as physical and mental health conditions due to a lifetime of stress associated with being a marginalized group. LGBT elders may be more vulnerable to neglect and mistreatment in aging care facilities. Generational differences and lack of legal protections may cause older LGBT adults to be less open about their sexuality or gender identity, making access to appropriate care more difficult and emotionally taxing.

Many LGBT elders are still dealing with the impact of decades of homophobia, biphobia and transphobia. Violence, threats of job loss, harassment from law enforcement, familial estrangement — these are all part of the histories of many LGBT elders. Fear of aging in a hostile environment is a primary concern of those PGN interviewed for this series.

At 74, Jack Winston said he doesn’t feel old. But when his partner, Harry Coleman, died suddenly in 2018 after a brief illness, he said he felt “alone in a way I never had. You don’t realize how much a part of your daily life someone is until they are no longer there. It’s not even about talking or doing things together — they are a presence. Who they are is part of who you are.”

It “sounds trite,” Winston said, but “I am missing a piece of myself, now. I didn’t expect it, and I wasn’t ready for it.”

Winston and his partner had been together for more than 30 years. “We both survived the [AIDS] epidemic,” he said. “We first met in a direct action group — we had dead friends in common. We were the lucky ones. It seems churlish to say, given that we had all those years that others didn’t, that I wanted more. But really — I wanted more.”

His voice broke when he said, “I miss him so much.”

Winston explained that even his grieving has been impacted by being gay. He began attending a support group for spouses who have lost long-time partners in the New Jersey arts community near where he and Harry had both taught before they retired. But everyone is straight. “I am now like a gay mascot to all these straight ladies,” he laughed wryly.

He said the group is helpful and at a church within walking distance of his home, but “I wish I could be in a group with other gay men. I feel like an outsider in the group I am in because I am the only gay man — I wasn’t someone’s wife,” he explained. “But I also didn’t lose a wife. We just need our own queer supports.”

What concerns Winston most now that he is widowed, is how he will continue to age alone. “I can’t face the thought of a nursing home,” he said.

Social isolation is a major concern for LGBT elders because they are more likely to live alone, more likely to be single and less likely to have children than their heterosexual peers, according to the MAP and SAGE study.

While there is a growing trend in the U.S. toward aging in place, between 5 and 10 percent of American elders live in assisted-care facilities, nursing homes and retirement communities.

But according to data from Dr. Nii-Quartelai Quartey, National LGBT liaison for AARP, a study from AARP, “Maintaining Dignity: Understanding and Responding to the Challenges Facing Older LGBT Americans” details the fears people like Jack Winston have about their futures as they age.

Quartey explains that three out of four adults aged 45 and older who are lesbian, gay, bisexual or transgender say they are concerned about having enough support from family and friends as they age. The AARP study also determined that many LGBTQ elders worry about the treatment they might receive in long-term care facilities, particularly the homophobia, biphobia and transphobia they might face. Most, the study found, want specific LGBT services for older adults. As Quartey noted, for many LGBTQ elders, during their lives, “If you were honest about who you are, you could be killed.”

That became a reality for Marcia Wetzel, now at the center of a groundbreaking legal case that could define law on LGBT elders. In 2014, after her partner of 30 years died, Wetzel, 70, moved into Glen St. Andrew Living Community for Seniors. An out butch lesbian, Wetzel was open about her sexuality with staff and residents. Soon after she moved in, Wetzel said other tenants called her derogatory slurs and made violent threats against her. Tenants were also physically violent, spitting at her and striking her in the head.

Wetzel filed a lawsuit with Lambda Legal, claiming St. Andrew violated the Fair Housing Act and had failed to protect her from harassment.

“Gay hate. When is it going to stop?” Wetzel said in a video she made for Lambda Legal. “I look out the window, and there’s a cemetery there. That’s when I’ll stop being made fun of because I’m gay.”

According to Lambda Legal, in August 2018, “the Seventh Circuit Court of Appeals ruled that a landlord may be held liable under the Fair Housing Act for failing to protect a tenant from known, discriminatory harassment at the hands of other tenants.”

The Court also found that after Wetzel complained about harassment, St. Andrew staff began a series of reprisals against Wetzel, restricting her to a smaller dining room and banning her from the lobby except to get coffee. These actions violated a tenant agreement Wetzel signed with St. Andrew when she began living there. The trial will begin in November 2019, and, if found liable, St. Andrew would likely pay damages, according to Lambda Legal.

Wetzel’s case could affect — and protect — other LGBT elders from harm. Research conducted by the National Institutes of Health suggests long-term care facilities and nursing homes often do not have trained staff or protective policies to discourage discrimination, advocates and doctors said.

Advocacy groups for LGBT elders like AARP and SAGE are working to improve conditions and expand options for LGBT elders. Facilities for LGBT elders have opened in Philadelphia, Chicago, Baltimore and San Francisco. SAGE staff are also training providers at nursing homes and elsewhere to provide a more supportive environment for elderly LGBT people.

If you feel you have been abused or discriminated against as an LGBT elder, you can contact the PA Elder Abuse Hotline: 1-800-490-8505 or Lambda Legal: 1-866-542-8336.

Some names were changed to protect the privacy of the respondents. Next week: LGBT aging: Fighting depression, substance abuse and STIs. 

This article originally appeared in Philadelphia Gay News on November 13, 2019.