Older LGBTQ adults face unique challenges in giving and receiving care

每天早上, Luther 莫克斯利 helps his partner of 35 years, 韦恩·柯蒂斯, out of bed and into his wheelchair. 柯蒂斯, who has Parkinson's disease and is partially blind, washes himself seated in the shower, but he needs 莫克斯利 to dry him and help him back into his chair.

莫克斯利 makes their meals and cuts 柯蒂斯' food into bite-sized pieces. He manages the household and does the grocery shopping. He takes 柯蒂斯 to and from the doctor and anywhere else he needs to go. But in truth, they rarely go anywhere anymore.

“我们非常孤立，”74岁的莫斯利说，她全职照顾83岁的柯蒂斯. Though 柯蒂斯 has some family, there are none who will help. 这对夫妇没有孩子. 莫克斯利, 谁没有幸存的家人, wonders what will happen to him should he someday need care of his own.

"I guess I would have to go into some kind of assisted living," he said.

的ir situation is all too common among people who identify as LGBTQ, whose caretaking needs are rising as the population ages. 的 National Resource Center on LGBTQ+ Aging estimates that by 2030, there will be 7 million U.S. adults 65 and older who identify as LGBTQ.

当年轻一代步入老年时，这一数字可能会更高. 2021年的一项盖洛普民意调查显示，认为自己是LGBTQ的人的比例每一代都在增长. Roughly 21% of Generation Z adults openly identify this way, 相比之下，千禧一代的这一比例为11%, 4% of Generation X and 3% of baby boomers.

And unlike their cisgender and heterosexual peers, LGBTQ people are more likely to end up as caregivers for friends, 伴侣或家庭成员. An estimated 1 in 5 LGBT people are caregivers, compared to 1 in 6 people in the general population, 根据… 2015年护理报告 from National Alliance for Caregiving and the AARP Public Policy Institute.

LGBTQ人群不太可能有孩子来照顾他们，更有可能独自生活, 大卫·文森特说, SAGE的首席项目官, 这是一个总部位于纽约市的全国性LGBTQ老年人倡导和服务组织. 的y also are more likely to face discrimination and feel isolated. "的ir support networks are incredibly thin."

莫克斯利和柯蒂斯住在棕榈泉的时候拥有强大的社会支持网络, 加州, 以其蓬勃发展的同性恋而闻名, 女同性恋, bisexual and transgender community. 但五年前，他们退休了，搬到了往西266英里的圣玛丽亚，那里没有那么公开的同性恋.

“我们来到这里，就在我们开始社交的时候，开始了解这个地区的同性恋者, COVID打击,莫斯利说. By the time pandemic restrictions were lifted, 柯蒂斯的病情已经严重恶化，无法享受晚上外出的乐趣，也无法让莫斯利把他一个人留在家里.

"At this point, I've accepted what my situation is,莫斯利说. “我已经学会了适应."

莫斯利说，由于种种原因，引入外部帮助的尝试都没有成功.

对于LGBTQ人群来说，不愿意向陌生人寻求帮助并不罕见, 杰森·弗拉特说, 内华达大学社会和行为健康系的助理教授, 拉斯维加斯, 公共卫生学院. 除了让陌生人完成亲密任务的一般不适之外, 比如如厕, 他说，许多LGBTQ人群担心，由于他们的性取向或性别认同，他们可能会受到歧视，因此得不到良好的照顾.

詹德Keig, a 56-year-old transsexual man in Orlando, 佛罗里达, 他说，同性伴侣经常对被虐待感到非常担心，所以当家庭健康来临时，他们会“去同性恋公寓”, because they don't want to face any prejudice or mistreatment. 这一直是一个问题. 他们会注意到什么?"

Keig and his wife provided care for his father when he developed dementia. 那时Keig才意识到对LGBTQ照顾者的支持是多么的少，尤其是男性. He eventually connected with someone online who shared his experience, but that person lived in another state. His struggles led him to co-found the LGBTQ看护者中心, 一个在线资源目录和社会支持中心，以解决LGBTQ照顾者的独特需求.

"I wanted to create a place where people could find resources," Keig说.

He now finds himself thinking about his own future. Like 莫克斯利 and 柯蒂斯, he and his wife have no children to care for them. 他们正在寻找一个生活计划社区，在那里他们可以随着年龄的增长而得到持续的护理服务.

"I'm not worried about fitting in," Keig说. "No one would know I'm trans if I didn't tell them.但是Keig的余生都需要注射睾丸激素，他想知道如果他的智力不够强，或者他遇到了护理人员的阻力，他是否会接受注射.

根据… 2021年美国退休人员协会调查, 在45岁及以上的LGBTQ成年人中，有41%的人至少有点担心，他们不得不隐藏自己的LGBTQ身份，才能获得老年人住房. 担忧在跨性别和非二元性别的成年人中最为常见，58%的人表示担忧.

的 LGBTQ看护者中心 为与LGBTQ老年人和养老院工作人员一起工作的人提供培训, 这样变性人或有同性伴侣的人就不会受到歧视, Keig说. Efforts also are underway at the Human Rights Campaign, 与SAGE合作, 制定一个长期护理平等指数，根据LGBTQ居民和患者的公平和包容来评估设施.

Vincent said SAGE has provided more than 100,在老年护理领域，000人接受教育，提供有文化能力的护理. 他们已经认证了全国大约1000个机构，这些机构的工作人员接受了这种培训.

“我认为，作为一个社会，我们需要继续培训和支持医疗服务提供者和社会服务提供者，为LGBTQ老年人提供具有文化能力和敏感性的护理，让那些需要服务的人感到安全，得到他们需要的护理和支持,文森特说.

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