Tick Tock, Tick Tock…

Let’s face we are all getting old but it sure beats the alternative, pushing up daisies, but when you are LGBTQ+ our care is limited. This is an old article but it is still informative.

How to find care for LGBT seniors
PBS News
By Leah Eskenazi, Family Caregiver Alliance
June 11, 2015

I clearly remember the first time I met Herb. He had beautiful white hair framing a handsome face with an inviting smile. But he greeted me with decidedly exhausted eyes.

He introduced me to Charles, who sat in the wheelchair Herb was pushing towards the church entrance where the local dementia day respite program met. As the director of Caregiver Services for a local community hospital — sponsor of the day respite program — my staff and I learned to respect Herb’s fierce independence. He clearly was determined to manage all of the care Charles needed — meal prep, bathing, toileting, dressing, emotional support and more. But the stress was taking a toll on Herb’s health. On the advice of his doctor, Herb finally agreed to take advantage of the two afternoons a week the day program afforded him. It wasn’t until Charles’ death about four years later that we learned, at the memorial service, of Charles and Herb’s 47-year committed relationship.

Twenty-five years ago, when I first met this couple, a community health and social version of ‘don’t ask, don’t tell’ was common. Herb and Charles grew up during the McCarthy era when any indication of homosexuality was met with pervasive stigma, destructive branding and legal and economic consequences. In select older lesbian, gay, bisexual and transgender (LGBT) age groups, and in certain geographic areas and social settings, people remain selective about who and when it feels safe enough to reveal one’s authentic LGBT self. Some individuals may even choose not to disclose their sexual orientation or gender identity to their medical doctor, therapist or community service agency, leaving them unable to gain the full benefit from the services provided. Health and social service professionals at all levels can even contribute to this problem by ignoring or not having time to discuss an older adult’s emotional health concerns and altogether avoiding sexual health in their assessment.

I think the hardest thing about getting help with seniors… is the first step, where to find help. The first step in finding someone to clean, finding someone to take care of your basic home care needs, or for that matter someone to fix the small things around the house.

The LGBT community and long-term care

Today, thanks to dedicated social and political activism fermented in the 1960s and ’70s, LGBT adults reaching their 50s and beyond are seeing incremental improvement in acceptance and assistance by mainstream health practitioners and long-term care community service providers.

Before I came out I used to “Sanitize my house” before family and friends came over to remove anything trans or LGBTQ+ from around the house. Things like the Pride and Trans flags magnets from the refrigerator. As we get older do we need to “Sanitize” our living arrangements? Do we need to take down photos of loved ones from the cleaning crew?

Caregiving
The support that a caregiver receives from friends and family is often critical in relieving stress that can be part of caring for someone who has a chronic debilitating health condition. LGBT caregivers may find that they have less support than they would like from their own — or the care receiver’s — biological family members. Historically, to fill in this gap, many LGBT people have formed strong “families of choice,” a support system comprised of trusted friends, relatives and supportive community service providers.

I have an amazing group of friends, as my mobility has decreased they have helped me clean and do small projects around the house that I can no longer do.

Who will have my Power of Attorney who will have the power of life and death over me? I had my father’s Power of Attorney and one thing that they never tell you is that you are the one to say “Pull the plug.”

I cried, and I cried, and I cried. My father had aspiration pneumonia with some food getting lodge in his lungs. When the doctor and social workers told us that my father’s changes of getting better were almost non-existent I had to say the words. My brother and sister-in-law were with me and we were in agreement but it still came down to me. I had to say the words… pull the plug. It left a scar on my mind that is still there.

Health care and financial decision-making
It is important for LGBT seniors and their caregivers to complete a few key legal documents establishing the right to make care decisions and to document treatment preferences for hospital and health care providers.

Rules governing resources to plan for and pay for long-term care remain an obstacle. We know that same-sex partners do not have access, as married older adults do, to federal family leave benefits, equivalent Medicaid spend-downs, Social Security benefits, bereavement leave, or automatic inheritance of jointly owned real estate and personal property. In addition to spousal impoverishment depending on the state, there may also be differences in how assets in same-sex couples are treated in regard to Medicaid liens, asset transfers and estate recovery.

One last thing…

Dementia
LGBT community members are living longer and with this increase in life expectancy comes the risk of Alzheimer’s disease and related dementias…

A trans friend went in a coma and when she came out of the coma, she didn’t remember that she was trans and then she saw that she had Gender Confirming Surgery. She freaked out! What would happen if her memory didn’t come back?

That affected me greatly… what will happen if we get Alzheimer’s disease and we don’t remember we are trans?

I asked Perplexity AI that question and its answer in part is…

In terms of memory problems specific to transgender individuals with dementia, it has been noted that they may forget aspects of their gender transition. For example, they might forget that they have started or completed gender-affirming surgery or hormone therapy. This can lead to distress and confusion, both for the individual and their caregivers

[…]

Overall, while there is evidence of cognitive decline and dementia among transgender individuals, more research is needed to fully understand the unique challenges they face, including the potential for forgetting significant aspects of their gender transition.

Our minds are very fragile and some times they go before the rest of the body.