Health and Long-term Care of Lesbian and Gay Older Adults

University Of Maryland Baltimore County, Baltimore MD

Investigators

Abstract

? DESCRIPTION (provided by applicant): The need for health care and public health knowledge about older lesbians and gay men is critical and pressing. For example, they may be ignored, dismissed, and the recipients of open discrimination in health care settings thus causing many to feel isolated, stigmatized, socially rejected, and at risk for unmet health care needs. With the number of lesbian and gay individuals age 65 and over in the US estimated to be between 1.4 and 3.8 million, and with the figure expected to double by the year 2030, research on this socially less visible cohort is crucial. As this population ages and becomes frail, they will need increasing care in community and institutional settings, including assisted living and nursing homes. In addition, despite the increasing longevity of those with HIV infections, this issue has rarely been considered in the context of senior housing and institutional support. This is a particular gap with respect to the African-American population which not only experiences disproportionately greater rates of HIV/AIDS and lesser access to health care, but also manifests culturally significant differences in meaning attached to aging, family, use of long-term health care resources, and social support. The major focus of the proposed research is on residential care settings for older adults, specifically assisted living. Long-term care has been cited as an important concern for lesbian and gay older adults because of potential need due to poor health and frailty, lack of access for caregiver support systems, and fear of having to return to the closet in their later lives out of fear of abuse, isolation, discrimination, neglect, safey, hostility, strain, and forced lack of contact with friends and families of choice. Research has emphasized the fact that these adults feel invisible and ignored, encountering increased bias with age at the time they are at most risk for institutionalization. Senior housing has been cited as a critical need, yet the framework and ideology of current senior housing has been labeled institutionalized heterosexism, with sexual and gender minorities made to fit within a heteronormative framework. In this proposal, through ethnographic interviewing, we attempt to understand the perceptions of long-term care held by gay and lesbian older adults, determine their current and projected health and care needs related to assisted living, and explore how assisted living settings can best meet their needs and wants. In this 24-month research project, we propose to conduct ethnographic interviews with 60 lesbian and gay informants age 65 and over (15 European-American lesbians, 15 African- American lesbians, 15 European- American gay men, and 15 African-American gay men) about these topics for a total of 60 interviews. Because of the sexual minority status of this population, participants will be drawn in part from community organizations and other institutions identified as lesbian and gay friendly or pro-diversity as well as from purposive sampling. Standard methods of qualitative data analysis will be used.