Caregiving in the LGBTQ+ community


The issue: LGBTQ+ people are more likely to become adult caregivers than the rest of the population, according to a 2015 AARP/National Alliance for Caregiving report.And the caregiver challenges they face can also differ. “Many older adults kept their sexual orientation a secret from friends, family and even doctors and have a distrust of medical and social institutions,” AARP reports. “As they age, their small circle shrinks further.”

According to a study by SAGE, a national LGBTQ+ advocacy organization, about one in three older LGBTQ+ adults live alone, and 40 percent say their support networks have become smaller. SAGE offers supportive services and consumer resources to LGBTQ+ older adults and their caregivers.

In what way does being an LGBTQ+ caregiver differ?: Here’s one way: “If you are in a non-married LGBTQ+ relationship, your relationship is not recognized by law,” says the Family Caregiver Alliance. “Under these circumstances, biological family members sometimes step in, take over decision-making authority, and exclude partners and close friends from being involved in the care of your friend or loved one.”

Take action: “Certain steps should be taken to legally acknowledge if you want your chosen family to take charge of your care,” FCA says. “At the very least, you must state your wishes in writing, authorizing particular persons to act for you in the event that you are unable to make decisions on your behalf in the future.” That document is called an Advance Healthcare Directive.

For further information on the documents you must execute, including powers of attorney for health care and for finances as well as other necessary legal documents, see the FCA fact sheet Legal Issues for LGBTQ+ Caregivers.

AARP’s comprehensive Prepare to Care: A Planning Guide for Caregivers in the LGBTQ+ Community also offers this advice: Be aware of legal obstacles. “If you are not your loved one’s legal spouse or next of kin, you will likely need specific legal documents in place to carry out parts of this plan. Advance directives, such as a health care proxy or living will, ensure that your loved one’s wishes will be followed should they become unable to communicate or make medical decisions.”

The guide also recommends a caregiver becomes knowledgeable about a release of information (ROI) and a do not resuscitate (DNR) directive. Each of these documents vary somewhat from state to state, but most are fairly easy to complete and do not require legal assistance.

Resource: At aarp.org/advancedirectives, you can download,for free, state-specific advance directive forms and instructions, including California’s.

Keep in mind: The FCA notes that The Caregiver Advise, Record, Enable (CARE) Act helps protect LGBTQ+ caregivers in particular. The law allows a patient to name a caregiver — including a non-family member — to be notified about hospital discharge and briefed on home-care needs.

“The CARE Act enables family caregivers to provide safe and effective home care to older adults,” says the FCA. “In particular, it supports family caregivers when their loved ones are admitted to the hospital, and helps them to learn how to safely provide care at home once their loved ones are discharged from a medical facility.”

The CARE Act contains three central provisions:

  • The name of the family caregiver is recorded when a loved one is admitted into a hospital or rehabilitation facility.
  • The family caregiver is notified if the loved one is to be discharged to another facility or back home.
  • The hospital or rehabilitation facility must provide an explanation and live instruction of the medical tasks — such as medication management, injections, wound care, and transfers — that the family caregiver will perform at home.

Read more:

  • AARP offers a resource page, Finding LGBTQ+-Friendly Care
  • Family Caregiver Alliance compiled the information-packed LGBTQ+ Caregiving: Frequently Asked Questions
  • See the LGBTQ+ Aging Issues Network page on the American Society on Aging’s website.
  • The San Diego LGBTQ+ Community Center has information on resources on its Senior Services webpage. You can also contact The Center’s Senior Services coordinator at (619) 692-2077, x205 or seniors@thecentersd.org.
  • SAGE has a caregiver resource page on its site, including links to such publications as an LGBTQ+ Caregiving Fact Sheet and a guide to customizing your own caregiving plan with Create Your Care Plan: An LGBTQ+ Person’s Guide to Preparing for Medical Procedures.
  • The National Resource Center on LGBTQ+ Aging offers information and resources on a variety of topics, including caregiving.
This article originally appeared in Fire News on May 19, 2018.
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