We live in a youth oriented, ageist, heterosexist, and "homophobic" world. Most of our laws, our services, and our entitlements deem that our living and dying happen within the context of the traditional family: mother, father and children; even grandparents aren't regularly included in our definition of family. The old are invisible.
Many states require "family" for enrollment in hospice or respite care, and often an LGBT senior's circle of care providers is left out of the decision making process in terms of medical and end of life issues. It is best to live and die in family and community - and many LGBT seniors have neither.
To be an old LGBT person sometimes means going into the closet as the years go on, especially if one is ill and needs a nursing home or some other form of long term care. Institutional residence is often more necessary if one is not living with a partner and has no immediate family and/or is alienated from family.
Some nursing homes are becoming aware that people over 65 are still sexual--or at least in need of sexual/sensual contact. There is a growing acceptance of this - even for people with Alzheimer's disease, whether they are married or not. Full acceptance of seniors (LGBT and heterosexual) includes acceptance of sexuality--it needs to be honored and provided for in nursing homes and assisted living.
A leading nursing home complex in New York City and other more advanced nursing homes and assisted living facilities have developed "safety rooms," where heterosexual couples, even those with dementia, could go to express their sexuality. Health care professionals were given training to make them sensitive to the continued sexual needs of the frail as they became elderly - or the elderly as they became frailer. Unfortunately, such rooms have been provided for men and women, but not for women and women or men and men.
Why not ask your provider to talk to their State Ombudsman Program about including LGBT issues in their trainings and on their check list. Or, see if they would be willing to enroll as an Ombudsman.
Furthermore, long term care residents in Joint Commission on Accreditation of Health Care Organizations (JCAHO) accredited facilities have specific protection against sexual orientation discrimination. But your friends and relatives need to help monitor this. When there is a lack of compliance they should use the JCAHO complaint hotline: 1-800-994-6610.6
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