Supporting LGBTQ+ Older Adults: Tips for Caregivers

As our population ages and society continually evolves, awareness of the diverse needs of different communities of older adults has increased. LGBTQ+ rights have undergone some major changes over the past few decades, and while there have been great triumphs, there have been many challenges as well, including some that are particular to older individuals. Caregivers must be aware of these specific challenges and provide holistic, inclusive support to ensure the well-being of their LGBTQ+ older loved ones. Here are key considerations and strategies for caregivers dedicated to supporting LGBTQ+ older adults.

Understanding the Unique Challenges

LGBTQ+ older adults often face obstacles that can impact their health and well-being. Many have lived through periods when their identities were stigmatized or, in some cases, even criminalized, leading to distrust of the institutions that mistreated them. The slow response of many entities, including the health care industry, during the AIDS crisis has made many LGBTQ+ older adults wary about whether they’ll be treated with due care and dignity. This history can result in reluctance to seek necessary care, making it essential for caregivers to create a safe and accepting environment.

Additionally, LGBTQ older adults may lack the traditional family support systems that other older adults rely on. Many have experienced estrangement from family members. Others find themselves to be ‘elder orphans,’ or aging without the support of children or a partner/spouse. Caregivers need to recognize this potential isolation and work to build a robust support network.

For more information about these and other challenges, check out our article about LGBTQ+ older adults.

Providing Inclusive and Affirming Care

In response to this fraught history, creating a supportive and affirming environment is crucial. This begins with using inclusive language and respecting an individual's preferred names and pronouns. However, you should also be aware that many older adults may not be "out” to certain individuals and communities. They may or may not want certain healthcare providers to be aware of their sexuality or gender identity. Respect their choices and feelings when it comes to their privacy, and recognize that to them, it may be an important safety issue. 

Educating yourself on LGBTQ+ issues can also enhance the care you provide. Seek out training programs that cover these topics, and stay informed about what health risk factors LGBTQ+ adults may experience to a greater degree than other populations. If you’re caring for a transgender older adult, remember that they may still be at risk for conditions associated with their assigned gender at birth, such as cervix or prostate cancer.

Building a Trusting Relationship

Trust is essential to caregiving. If your loved one doesn’t believe they can turn to you with sensitive issues, or thinks that you might discriminate against them in some way, it will be difficult to truly help them. Prioritize open, non-judgmental communication, and listen actively while validating their experiences. This is not to say that you can never have disagreements—most caregivers butt heads with their loved one from time to time—but if you cannot fundamentally accept who they are, you’ll be unlikely to foster enough of a sense of safety and trust to provide effective care.

Caregivers of LGBTQ+ older adults may also find their role requires a degree of advocacy. You might need to stand up for your loved one against discrimination in healthcare settings, and ensure they have access to LGBTQ+ friendly providers.

Addressing Mental Health and Legal Security

Mental health is often a concern for LGBTQ+ older adults. Be attentive to signs of struggles and suggest mental health services when needed. If your loved one needs counseling, look into options that offer trauma-informed care, which takes into account how past discrimination, estrangement and social lack of acceptance may continue to impact the person your loved one is now.

Legal issues can also often be more complicated for LGBTQ+ older adults, especially since there are constant attempts at legislation both for and against LGBTQ+ individuals, keeping things in an uncertain state of flux. Keep yourself knowledgeable about the legal rights of LGBTQ individuals, including marriage equality and protections against discrimination. Make sure your loved one receives qualified support with estate planning, social security benefits and documenting health decisions so that their wishes are given the respect they have always deserved.