A major issue in the LGBT community is the recognition of partners or, in their absence, of caring communities that provide important support and services. The need for this recognition, though not confined to seniors, takes on additional import as we grow older. There's the likelihood of hospitalization and additional health issues like medical decision making and disposition of remains. In "straight" families this is handled by the "next-of-kin," usually spouses and children, but an LGBT senior in need of care and physical and emotional support faces a serious problem. There are laws that prohibit hospital visitation by anyone other than blood relatives and in many states this means that a gay partner can be shut out of his or her partner's life at the most critical time.
Our current laws were created in a context which assumed the stereotypical family. As a result, LGBT seniors face many challenges when dealing with medical crises and end of life issues.
Changes in New York State Law
At the end of the 2005 session, the New York State Legislature passed a bill that provides domestic partners, both same sex and opposite sex, the ability to make decisions in the disposition of partner remains. Before this bill, it was unclear in New York who had the authority to bury or cremate bodily remains. The legislation creates a simple proxy form and recognizes that a written document expressing the wishes of the deceased always takes highest precedence.
It's important for us to be aware of these changes in the law, as some health care providers may not be aware of them. If you are in a situation where your rights as a partner are challenged you should not hesitate to make the provider aware of the new laws and if they do not respond, consider taking legal action.
Issues that Need to be Addressed
An important step for LGBT seniors to take is the completion of a health care proxy. This is a form that gives someone the authority to make all health care decisions. In the absence of a proxy (and in some cases, even when a proxy is provided), biological family members are often identified as the primary decision makers. (You can download a copy of the New York State Health Care Proxy form from the Department of Health web site.)
In our culture, law, medical and social work schools and theological seminaries don't teach their students about the needs of any old people, except, perhaps the frail elderly. And they have little, if any, training in the needs of the LGBT elderly. Without prepared professionals it becomes the task of LGBT seniors to educate the providers in areas such as well spouse support, grief recovery, and end of life decision making including funeral and burial practices. RAI and others are working to bring this needed education to the professionals, but seniors don't have the time to wait for everyone to becomes educated. Most professionals are not adverse to learning about the issues; they are simply ignorant of them. Therefore, you should feel free to bring your provider copies of this information and direct them to sources which will help them learn.
The mental health care system shares many of the heterosexist assumptions. "Well spouse support" groups and grief recovery groups are usually geared toward "spouses" in the traditional sense - husbands or wives. Well spouse groups that welcome LGBT people are found in the few social service agencies that are LGBT specific. But surviving partners who have not been "out" despite being in a monogamous relationship for 20, 30, 40 or more years may have difficulty finding an understanding group or agency. And very often, if the partner attends the group, the surviving family will use the occasion to express their dislike of the relationship. When a partner dies without a will or specific instructions about disposition of the remains (and sometimes, the property) the situation is exacerbated. We need to make sure the agency or group understands the danger of such a situation and that steps are taken to head off any such confrontation.
Grieving rites usually involve gathering to support the surviving family, but this does not happen when the "survivors" are unknown or unrecognized by the family, the religious institution, or other parts of the community. During the height of the AIDS crisis there was "constructed" family and community in place that may not have been included in grieving rites. This phenomena still holds true for many LGBT seniors.
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The information provided by Rainbow Access Initiative, Inc. is for educational purposes only and is not intended to render medical advice or professional services. The information should not be used for diagnosing or treating a health problem or a disease and is not a substitute for professional care. If you have or suspect you may have a health problem, consult your healthcare provider.
Rainbow Access Initiative is a 501(c)3 tax-exempt organization.
These materials were produced through a grant from the New York State Department of Health.
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Permission may be obtained by contacting the Director.