Caring for LGBT older adults

The Administration on Aging estimates that there are 1.5 million LGBT older adults in the United States and that the number will double by the year 2030. Combined with a growing aging population, it’s clear that more medical research must be dedicated to identifying and addressing health disparities in the LGBT community.

In the meantime, it’s important for older adults, their families and caregivers to understand the challenges that LGBT older adults face and work together to find ways to meet their diverse needs. Talking to your doctor or nurse practitioner is always the first step to addressing any health-related needs. Below you’ll find a few points that might be worth asking about at your next visit.

1. Social Determinants — Many social factors contribute to health outcomes over the course of a patient’s life, like housing, economic status, education, transportation and health care; these factors are called social determinants, and affect everyone differently. According to Healthy People 2020, many of these determinants are often tied to discrimination against the LGBT community, including a shortage of social programs, health care professionals, and legal protections for LGBT people. The scope of these determinants are changing as the landscape of American social justice evolves, so it’s important to discuss any needs or concerns with your provider.
2. Mental Health Care — Social isolation is a high risk for LGBT adults, because social circles and engagement tend to decrease as people age. Though many adults report that they feel more socially open and accepted in recent years because of American cultural and political shifts to protect the LGBT community, it’s important to address how social stigmas can affect people’s mental health. Finding empowering communities is critical for the wellbeing of all aging adults, but especially those who have or currently feel discriminated against.
3. Health Disparities — A study in the American Journal of Public Health showed that LGBT adults are at higher risk for chronic conditions and STDs, as well as less likely to seek health screenings in the early stages of a developing condition. Access to care and improved health literacy can encourage LGBT older adults to take charge of their health outcomes, but caregivers, family members and medical providers have to take the time to empower them to do so. Answering questions, listening intently and including people in their health decisions are all ways to improve health literacy long-term.
4. Cultural Competency — Many states have legislation that requires cultural competency training and regulations for all medical providers, in order to ensure quality care for all patients in the LGBT community. The Affordable Care Act followed suit in 2016 when the Department of Health and Human Services established federal anti-discrimination provisions that protect LGBT patients when seeking health care and services.

In 2011, the Institute of Medicine released a report that said, “while LGBT populations are often seen as a single entity for research and advocacy purposes, each [lesbian, gay, transgender, bisexual] is a distinct population group with its own specific health needs.” Addressing these needs are a critical part of ensuring that LGBT adults age happily and healthfully.