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Facing Aging Challenges in the LGBT+ Community

Affordable housing, estate planning and social connections take on heightened importance

By Laura Neikrug

Will Watson, 68, is of the LGBT+ generation first impacted by HIV. "Most of my peers are gone. I lived wildly and carefree. I tested positive for HIV by the mid-eighties," he said, adding that he hid the test results from his family.

Two people smiling and laughing in a group setting. Next Avenue, Queer Elder, LGBTQ and Aging resources
Maintaining a support system that includes both younger and older friends can ease feelings of loneliness and provide decision making support for older LGBTQ+ adults   |  Credit: Centre for Ageing Better

Although Watson's family did not know his diagnosis, he recalled a big family dinner when his brother-in-law "took the plate and silverware and the glass I had been using and threw it in the trash in front of everyone." [His family] assumed being gay made you an HIV carrier.

"Who would you ask to pick you up at the hospital if you weren't allowed to take a taxi home?"

Watson lives alone in Chicago. According to SAGE (Advocacy and Services for GLBT+ Elders), older gay adults like Watson are twice as likely to be single and living alone, and four times less likely to have children than their heterosexual counterparts. In addition, LGBT+ elders are more vulnerable to social isolation when living alone.

Linda Scaparotti, a California-based lawyer who specializes in estate planning and family law, said that often LGBT+ elders have no children or extended family members to serve as agents for written Power of Attorney (POA), health care directives, wills and trusts. This impacts who will take on legal or conservator-type roles if LGBT+ elders become disabled or suffer cognitive decline.

Frederick Hertz, who also practices law in California and has expertise in premarital and cohabitation agreements and mediation of dissolutions, explained that if LGBT+ elders have no friends or relatives to step in, or if they remain closeted, they may avoid, or be fearful of, completing these essential documents.

Who to Trust with Decision-Making

Though not unique to the gay community, Hertz said "these [legal] problems are often harder to manage because of the history of oppression and lack of community."

Who to trust with decision-making can be challenging and overwhelming. Hertz recommends answering a straightforward question: "Who would you ask to pick you up at the hospital if you weren't allowed to take a taxi home?"

According to Hertz, there are critical legal rules impacting unmarried LGBT+ elders if they are alienated from their families. First, decision-making authority goes to legal relatives if the POA and health care directive doesn't exist. "The laws may slightly vary state to state, but not in any significant way," he said.

Second, if you die intestate (without a will), your property will be inherited by legal relatives. "If you don't want your relatives taking over your care or, upon your death, inheriting your assets, you need to have a signed POA and health directive as well as a will or trust," Hertz said.

Professional fiduciaries can be appointed to fulfill these roles, said Scaparotti, adding that more LGBT+ people under 60 are needed to become professional fiduciaries for the older population.

Scaparotti recommends setting up a trust instead of a will, as trusts are harder to challenge; they are "privately administered and do not have to be filed with the court and become public record," she said.

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Finding Affordable and Welcoming Housing

Housing protections vary, according to SAGE: "Twenty-one states and five territories have no explicit laws prohibiting housing discrimination (based on) sexual orientation and/or gender identity."

Finding LGBT+-friendly assisted living facilities is challenging. Hertz notes that many gay people, especially those with complicated medical histories, feel uncomfortable in conventional nursing homes, like religious, working-class and Medicaid nursing facilities.

LGBT+ elders who left home when they were younger often settled in more accepting metropolitan cities, albeit more expensive, so without the financial resources for higher-end facilities, those who don't qualify for Medicaid, for example, may be forced to leave familiar surroundings for affordable institutional care, explained Hertz.

Watson's ability to afford housing suffered because of his increased medical expenses upon retesting positive for HIV, requiring medication. He had to "spend down" to qualify for assistance programs.

After a year of "couch surfing," Watson said, he received housing help from CEDL (Center for Disability and Elder Law) and began receiving Medicaid and Social Security once the Affordable Care Act became law.

"I would love to hang out with gay people my age ... I'm lonesome in that sense. I don't know how else to describe it."

He now lives in subsidized senior housing with straight and gay residents. Watson is out, but many LGBT+ residents in similar facilities live in the closet; according to SAGE, "34% of LGBT+ older people worry about having to hide their identity to access senior housing."

Watson, who describes his housing as transitional because the building has fallen into disrepair, says that for the past five years he has been on a waiting list for Section 8 LGBT+ housing. "I have that in my back pocket," he said.

The Importance of a Support Network

While money may solve tangible situations, it cannot solve the intangibles of loneliness, fear and decision-making support. For LGBT+ elders, Hertz recommends these strategies:

  • Work to maintain a support system, one that includes younger, socially responsible friends
  • Engage in community interaction that provides long-term support like a church, synagogue or political association
  • Anticipate problems in advance: "Do I have enough money? Do I have a place to live?"

Watson has a health care directive and POA; he said he trusts one woman in her 40s, a fellow church choir participant, to serve as his agent. He plans to make a will through CEDL, as he is concerned that his niece and nephews may try to inherit money from him.

After losing his last two gay friends during the pandemic, Watson is independent, but lonely. Although no longer singing in the Chicago gay men's chorus or church choir, he remains a churchgoer.

His female friend is married and has a three-year-old boy. Watson calls him "his heart."

"I adore him ... but loneliness exists because I don't have a partner," said Watson. "I would love to hang out with gay people my age. I would love to sit on a park bench and shoot the breeze. I'm lonesome in that sense. I don't know how else to describe it." 

Laura Neikrug
Laura Neikrug is a longtime occupational therapist and recent founder of OT Day and Night, a series of instructional self-help videos for families, caregivers, and adults 21 and over with chronic disabilities. She lives in Wilmette, Ill. Read More
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