LGBT Elder Population Health Awareness

At this month’s annual conference of the Gay and Lesbian Medical Association, NN/LM PNR Network Outreach Coordinator Patricia Devine and NN/LM SEA Emerging Technologies/Communications Coordinator Tony Nguyen will be presenting a poster entitled “LGBT Elder Population Health Awareness: Building Collections and Connections to Improve Health, Safety and Well-Being, based on the following resources.

Please contact Patricia at: devine@u.washington.edu or Tony at: tnguyen@hshsl.umaryland.edu.

Background

• LGBT elders experience health disparities arising largely from societal stigma and institutional discrimination.
• Health practitioners, public health, and social workers may have limited or no familiarity with resources for the LGBT senior population.
• Deficits related to providing high-quality LGBT care create a unique challenge to accessing the information needed to provide care.

The following is an overview of the health disparities experienced by elder LGBT people and informational resources to access to provide needed care.

Methods

A PubMed literature search was conducted selecting published articles within the past 10 years to identify common themes in elder LGBT populations. Resources were identified and selected to support the needs of this population.

Results

The following common themes were identified among the selected articles:

1. Psychological Distress ^{1, 2, 3, 4, 5, 6, 8, 9}

• Past experiences of inequity can cause mistrust of health and social service network due to marginalization and oppression.
• Under the present social context, prejudice continues to be apparent in many social and institutional environments toward elderly LGB populations.
• Invisibility of senior LGB populations is common and causes them to avoid discrimination by not coming out when seeking care.

     2. Physical Health ^{4, 5, 7, 9}

• HIV/AIDS impacts older LGBT individuals; however, prevention programs do not support the senior population.
• LGB elders may have higher rates of tobacco and alcohol use which may negatively impact their health.
• Transgender seniors may experience negative health outcomes as a result of long-term hormone use.
• Chronic conditions like obesity and asthma are common among LGB women than heterosexual counterparts. Bisexual men have significantly higher incidence of diabetes.
• The population group is less likely to engage in preventative health activities like flu shots, STD testing, and other health screenings.

     3. Long-Term Care/End-of-Life Services ^{1, 2, 4, 5, 6, 9, 10}

• Issues of sexuality are often overlooked by health care providers causing discomfort in discussing this topic with the aging population.
• LGBT seniors who require care need assurance that the values of agencies, institutions, and professionals respect and reflect who they are and their unique needs.
• Elder LGBT have difficulty finding LGBT-friendly nursing homes, assisted living, mental health counselors, and social workers that would be knowledgeable and support their needs.

     4. LGBT Communities and Other Social Factors ^{1, 2, 4, 5, 6, 9, 10}

• Within the lesbian and gay communities, few services and programs exist for elder populations.
• Concerns of ageist attitudes dominate gay and lesbian communities preventing seniors from feeling accepted.
• Fear of loss and a lack of family or social support among many aging LGBT persons may cause them to feel loneliness and isolation leading to depression.
• A lack of informational resources for LGBT seniors makes it difficult for them and their caregivers to gain knowledge about support programs and resources available.

Selected Resources

The following resources were selected to support the themes identified:

• MedlinePlus.gov: Gay, Lesbian, Bisexual and Transgender Health
• MedlinePlus.gov: Seniors’ Health
• SAGE: Services and Advocacy for GLBT Elders
• GLMA – Find A Provider
• National Resource Center on LGBT Aging
• Transgender Aging Network
• LGBT Aging Issues Network (LAIN)

Conclusions

• Education and awareness-raising campaigns are critically important to improve services and service access for LGBT seniors.^{2, 4, 9}
• The resources presented are meant to educate and address some of the disparities for the aging LGBT population.

Bibliography

1. Brotman S, Ryan B, Collins S, Chamberland L, Cormier R, Julien D, Meyer E, Peterkin A, Richard B. Coming out to care: caregivers of gay and lesbian seniors in Canada. Gerontologist. 2007 Aug;47(4):490-503. PubMed [citation] PMID: 17766670. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17766670.
2. Brotman S, Ryan B, Cormier R. The health and social service needs of gay and lesbian elders and their families in Canada. Gerontologist. 2003 Apr;43(2):192-202. PubMed [citation] PMID: 12677076. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12677076.
3. Czaja SJ, Sabbag S, Lee CC, Schulz R, Lang S, Vlahovic T, Jaret A, Thurston C. Concerns about aging and caregiving among middle-aged and older lesbian and gay adults. Aging Ment Health. 2015 Aug 6:1-12. [Epub ahead of print] PubMed [citation] PMID: 26247917. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26247917.
4. Ettner R. Care of the elderly transgender patient. Curr Opin Endocrinol Diabetes Obes. 2013 Dec;20(6):580-4. doi: 10.1097/01.med.0000436183.34931.a5. Review. PubMed [citation] PMID: 24468762. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24468762.
5. Fredriksen-Goldsen Karen I. et al. “The Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults.” 2011 May.
6. Fredriksen-Goldsen KI, Muraco A. Aging and Sexual Orientation: A 25-Year Review of the Literature. Res Aging. 2010 May;32(3):372-413. PubMed [citation] PMID: 24098063, PMCID: PMC3789531. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24098063.
7. Fredriksen-Goldsen KI, Kim HJ, Barkan SE, Muraco A, Hoy-Ellis CP. Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study. Am J Public Health. 2013 Oct;103(10):1802-9. doi: 10.2105/AJPH.2012.301110. Epub 2013 Jun 13. PubMed PMID: 23763391; PubMed Central PMCID: PMC3770805. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23763391.
8. Gonzales G, Henning-Smith C. Disparities in health and disability among older adults in same-sex cohabiting relationships. J Aging Health. 2015 Apr;27(3):432-53. doi: 10.1177/0898264314551332. Epub 2014 Sep 23. PubMed [citation] PMID: 25253727, PMCID: PMC4368471. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25253727.
9. Later Adulthood. In: The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. Washington (DC): National Academies Press (US); 2011. Bookshelf [chapter] Bookshelf ID: NBK64800. Available at: http://www.ncbi.nlm.nih.gov/books/NBK64800/.
10. Smith LA, McCaslin R, Chang J, Martinez P, McGrew P. Assessing the needs of older gay, lesbian, bisexual, and transgender people: a service-learning and agency partnership approach. J Gerontol Soc Work. 2010;53(5):387-401. doi: 10.1080/01634372.2010.486433. PubMed [citation] PMID: 20603750. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20603750.