Most American adults will need some form of long-term care later in life, either in an assisted living center or from family members — but only 39 percent of heterosexual adults think they will need it.
In contrast, 50 percent of their lesbian, gay and bisexual counterparts expect to need it.
A University of Minnesota School of Public Health study published these findings earlier this month, and though researchers aren’t sure whether the respondents’ reports are accurate, lead author Carrie Henning-Smith said the relatively high rate of health issues in the LGB community could contribute to the results.
Few adults prepare themselves for long-term care in the final stages of their lives, Henning-Smith said.
“I would say that people don’t want to think about [long-term care],” she said. “We don’t want to talk about dying. We don’t want to talk about getting older, and we don’t want to talk about long-term care.”
Though researchers still don’t know whether LGB adults need long-term care more than heterosexual adults do, Henning-Smith said LGB adults have more realistic
expectations than do heterosexual adults.
About 80 percent of older adults reported receiving long-term care from family members according to a 2002 study, though LGB adults are less likely to seek help from loved ones than heterosexual adults are.
As the population of elderly Americans outgrows the population of family members who can act as caregivers, expecting family to provide assistance will become unrealistic, said Deb Taylor, CEO of Senior Community Services, an organization that helps individuals find senior living.
Although there were about 7.2 potential family caregivers for every elderly person about five years ago, that number will sink to about three potential family caregivers in the next 35 years, according to an AARP study.
By 2050, the number of 80-year-olds and older will triple compared to today’s count, Taylor said.
Relying on family members can put physical pressure on those caretakers, she said, like in the case of an elderly spouse who would have difficulty taking care of their partner.
Depending on family caregivers is often the only option for some adults due to the high cost of assisted living, according to the study. Because LGB adults are less likely to be married and have children and are more likely to live alone and have poor relationships with their family members, that option sometimes disappears.
LGB adults report worse physical and mental health than do their heterosexual counterparts, Henning-Smith said, which could mean that community’s large number of reports of planning for long-term care is realistic.
Physical and mental health issues stem from greater stress at home, said Stef Wilenchek, director of the University’s Gay, Lesbian, Bisexual, Transgender, Ally Programs Office. Stress related to fear of being attacked, feeling isolated and losing family support can also lead to health problems.
Discrimination in assisted living
Though assisted living is available for adults in need of long-term care, LGB adults are more susceptible to discrimination and neglect due to under-trained professionals in those facilities, according to the study.
“Having folks learn more about the experiences of LGBTQ elders is really important,” Wilenchek said. “Education is key — it allows for stability, better interactions and better care, but it needs to come from the leaders of these organizations.”
In a survey of LGB adults and their families, about 38 percent of people reported being mistreated in long-term care facilities.
“I think there are also not a lot of care facilities out there targeting LGTBQ, but I think that’s changing for sure,” Wilenchek said. “I think the awareness is bigger because it is currently not a need that has been met.”
Henning-Smith recommends families have open dialogue about their care plans later in life, despite tendencies to steer away from what can be an awkward conversation.
“It’s kind of the elephant in the room,” Henning-Smith said. “Most people are aware that there are nursing homes, but they don’t want to think about them, and they don’t want to go to them. I think we need to be a lot more open as a society and talk about it.”
