Confronting aging: How LGBTQ+ seniors can tackle their special caregiving challenges

Margaret Roesch, 67, and her wife, Pat McAulay, 68, wanted to have a supportive community around them as they grew older. So they helped to create a cohousing development for LGBTQ+ seniors and allies, making it easier to offer support to one another. 

“We said we don’t want to have to go back in the closet when we get older,” Roesch said from the front porch of her home in Durham, North Carolina. 

Opened in 2020, the Village Hearth is a neighborhood of 28 one-story accessible homes for residents ages 55 and up — and one of the few housing developments in the country specifically designed with LGBTQ+ people and allies in mind.  

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“We decided that we were going to be better in community, after having spent eight lonely years in Florida,” McAulay said. “It’s so rewarding to know there’s 30-some people here who have our backs.” 

“I find it very refreshing,” Roesch added.

“We’re all … going to die. People will get sick,” she said. “These things are going to happen, but we also find that we are really good at taking care of each other.”

Older adults in the LGBTQ+ community are twice as likely to be single and four times less likely to have children as their non-LGBTQ+ peers, according to SAGE, a national advocacy organization for LGBTQ+ elders. They may also be estranged from members of their family who don’t accept their sexual orientation and/or gender identity.

“A lot of people in their 70s and 80s who have been closeted, they don’t feel safe and they remain closeted while going through care — that’s a stress,” said certified financial planner Stephanie Lee, founder of East Rock Financial in San Francisco. “You’re trying to get a caregiver, and you’re hiding who you are or hiding your relationship.”

Experts say that makes it especially important to have an aging plan early. 

“As with any stage of life, planning is unique and personal to the individual,” said CFP Kyle Young, a senior vice president at Morgan Stanley Wealth Management in New York. “The key is to start a conversation, educate yourself and finalize plans to assure your wishes are made clear.”

At Village Hearth, residents have taken steps to prepare their finances, arrange for care and consider end-of-life planning. They have held workshops on choosing financial and health-care powers of attorney, having an advance directive for medical decisions and finding an attorney to help draft those key legal documents. 

When you’re in the hospital or a care facility, “if you’re heterosexual, the spouse automatically gets visiting rights,” Lee said. That’s not always the case for same-sex couples, even if they’re legally married. 

“It’s really critical to get the legal papers to get those visiting rights,” she said, “so you can make those decisions.” 

The earlier you start planning, the easier it is to take steps to follow your plan and meet your goals.

“Having the benefit of time on your side will allow you and your loved ones to make sound, clearheaded decisions while considering cost, tax and broader estate implications of your plans,” said Young, who works with many LGBTQ+ clients.

Use the time between retirement and needing services to identify your support network, consider your financial situation, and educate yourself about care options that are available, recommends Allison O’Shea, founder of Openly Aging, an advisory firm in Durham.

“A lot of people don’t think about that in-between time,” said O’Shea, who works with clients as a so-called aging advisor after running senior living centers for many years. “There’s a really big piece missing when it comes to what you could be doing to prepare.” 

Build a support group — neighbors, family, friends, loved ones and professionals whom you know you can lean on. 

If you’re single or not sure if you have people around you who are willing and able to step in, O’Shea recommends hiring a geriatric care manager. These professionals, who may also be social workers, nurses, psychologists or gerontologists, deal with elder-care issues regularly. They can be your advocate, make sure you’re able to access resources, and organize the support you’ll need. 

It is critical to understand what options you can afford and where to find assistance. “Don’t let your finances scare you,” O’Shea said. “You can create a plan that fits around your finances.”

Getting a handle on your monthly income and assets in retirement can help you determine where and how you’ll receive care later on — whether aging in place in your home or downsizing, or moving into some type of senior living arrangement. 

Local senior centers can be a valuable resource for older adults to find community and information, and many are working to serve a more diverse population. FiftyForward, which has seven community centers in central Tennessee to support older Americans, is working to build more inclusive community, conducting research and hosting cultural competency training. 

“Our country is unprepared for the burgeoning older adult group,” said Gretchen Funk, FiftyForward’s chief program officer. Issues of service access and isolation affect seniors overall, but discrimination can exacerbate those challenges for the LGBTQ+ community. 

“As a society, we need to look at this for all of us, because we will all be facing that,” said Funk. “And there should be power in advocating together.”

Some care services may be free based on your income but have long waiting lists. Knowing where to apply and when could help you mitigate costs. 

“If you have a plan or if you’re educated in what the options are, you’re not stressed over these big life decisions when you’re in a … crisis,” O’Shea said. “You have a step-by-step plan already laid out which will only save you time and money.”