In the United States alone, there are an estimated 1.1 million LBGTQ+ adults age 65 and up. They face a unique set of challenges that older adults who are not LGBTQ+ do not generally face. For example, 11% of same sex couples report having their POA forms denied in a medical emergency situation. LGBTQ+ older adults grew up in times when having a partner of the same sex was not only discriminated against, but illegal and punishable with jail time. It was not uncommon for family rejection to occur, and most LGBTQ+ people could not raise children in a same sex relationship. The challenge with this is that many of them do not have the familial support that most non-LGBT elders have as they get older.

Many LGBTQ+ individuals have created a support network of friends and possibly family who are supportive, sometimes referred to as “family of choice” rather than “family of origin”. According to one study, more than two-thirds of LGBTQ+ older adults reported that they have support systems in place and that they had positive feelings about them. But while this secondary support system may be strong in the moral support fashion, the absence of legal familial relationships causes issues with decision making power, insurance hurdles, and other challenges. Also, as friends tend to fall into a similar age group (not always but sometimes), they are usually aging at a similar rate and therefore not always best suited to help care for one another physically or otherwise. A common pitfall of aging is the loss of friends and becoming socially isolated, which is even more prevalent for LGBTQ+ aging adults for this reason.

As important as it is for all elderly individuals to have legal paperwork to appoint a medical and financial decision maker for themselves, it is perhaps even more important to do so in the case of an older adult who chooses a person with whom they do not have a legal familial relationship to be their advocate. Even post 2015 when law changes allowed for same sex marriage nationwide, relationship acknowledgement is still an issue faced by many LGBTQ+ individuals. Therefore, it may be a good idea, in addition to the paper copies of the Power of Attorney Forms, to have an attorney draft a letter that states any institution or organization who disregards the validity of the documents or discriminates against those named in it may be subject to legal action. It is also highly suggested to their other trusted friends an electronic copy of the documents which can be emailed or faxed in a hurry if necessary.

LBGTQ+ Issues in Long Term Care. Regardless of sexual orientation or gender identity, the numbers involved with the need for Long Term Care Services in the United States are daunting. “Long Term Care” refers to care or supervision needed for an extended period of time, generally associated with the effects of aging but could also be needed due to an injury or illness. The US Dept. of Health and Human Services estimates that 70 percent of Americans 65 and older will need long-term care during their lifetime, and 20 percent will need it for longer than five years. Many older adults receive informal care from a family member in order to remain independent in their homes. Because of the lack of familial support sited above, many LGBTQ+ do not have informal caregivers to assist them. While they can use utilize paid caregivers or choose to enter a long term care facility such as a nursing home or another residential setting. Long Term Care is very expensive, and resources and access to benefits are likely to be less available to LBGTQ+ older adults. There is also the issue of discrimination that exists amongst providers, or even other residents. The fear of abuse and neglect in a long term care facility is even stronger for LGBTQ+ older adults.

Advanced Planning and research into LGBTQ+ ally Providers, Caregivers, senior care facilities, nursing homes and other services is critically important,  so when the time comes for the need for these services they know who to turn to.  Building relationships with a trusted medical team who can step in and advocate in situations where their rights are denied or threatened is a good strategy. It is a good idea to ask potential providers “if I am denied rights in an emergency situation or medical setting based on my sexual orientation or gender identity, are you willing to step in and advocate on my behalf?’ Knowing well ahead of time that your medical providers and support system will be there for you can be very reassuring.

Locally we have Aging Rainbows, a non profit organization whose mission is to provide community outreach, education, and supportive programs that support the LGBTQ+ aging community and to make the world a better place for all individuals! If you need more information or support as an LGBTQ+ older adult in Northern Virginia, Aging Rainbows is a good place to start!

Sources of Information:


The Movement Advancement Project (MAP) is an independent think tank that provides rigorous research, insight, and analysis that help speed equality for LGBT people. MAP works collaboratively with LGBT organizations, advocates and funders, providing information, analysis and resources that help coordinate and strengthen efforts for maximum impact. MAP’s policy research informs the public and policymakers about the legal and policy needs of LGBT people and their families.

SAGE is the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults. Founded in 1978 and headquartered in New York City, SAGE is a national organization that advocates for public policy changes that address the needs of LGBT older people. SAGE also offers supportive services and consumer resources to LGBT older adults and their caregivers, provides education and technical assistance for aging providers and LGBT organizations through its National Resource Center on LGBT Aging, and cultural competence training through SAGECare. With staff located across the country, SAGE coordinates a growing network of affiliates across the country. Learn more at

About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here



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