In a special report for PinkNews.co.uk, V King Macdona explores the issue of ageing in the LGBT population.

Older gay, lesbian, bisexual and trans people not only face the challenges usually expected with the prospect of advancing years, but are also likely to encounter a whole raft of other issues related to their sexuality.

Research shows they are more likely to smoke and drink than their straight counterparts and are far more likely to live alone. In addition, only ten per cent are estimated to have children.

Despite the fact that a significant proportion of the older population is LGB or T, there is little awareness of their particular needs and concerns.

The fear of having to discuss the subject of sexuality and reveal personal circumstances to healthcare workers and organisations is one significant problem for a large proportion of elderly gay people. Antony Smith, the national development and policy officer for older gay men, lesbians and bisexuals at Age Concern, says the issue of coming out as one of the most significant challenges.

Calling it a “huge potential stress factor”, he says: “The decision to come out can be life-changing.” Those who decide not to come out to their doctor or other care providers may suffer from not receiving care specifically suited to their needs. Smith continued: “As people get older they come more into contact with services. They start to ask themselves: ‘Do I have to de-gay the house?’ It’s the coming-out conundrum.”

Age Concern encourages service providers to send out a clear message that they are LGBT-friendly. Smith adds: “There is a world of difference between not discriminating and actively showing you are gay-friendly.” The difference lies in whether services make themselves visibly inclusive or not. If people are unaware of LGBT-friendly services then they may never know how supportive a particular service would be.

Smith says: “There are simple things GPs’ surgeries can do, such as putting up posters featuring same-sex couples to make people aware they offer an inclusive service.”

On the subject of providing the right care for older LGBT people, PinkNews.co.uk spoke to Andrew Hinchcliff, chair of the Older LGBT Network in Wales: “What if you’re older and also gay? Would you get the right services? What if social services sent someone homophobic to clean your house? Things like this do happen.”

In addition, Hinchcliff says, health issues also need to be tackled correctly. “LGBT people tend to drink and smoke more than others. On top of that, homophobia victims are unlikely to seek help. Healthcare professionals should be aware of common issues should ask themselves if a patient might be showing signs of post-traumatic stress or depression”.

Along with issues of coming out, social isolation is another significant problem for older gay people. According to Age Concern, up to 75 per cent of older lesbians‚ gay men and bisexuals live alone compared with 33 per cent of the general older population. Ninety per cent have no children to call upon during difficult times.

Smith says: “Social isolation is a real issue. What people really need is opportunities to get together with people to be themselves.” While, regrettably, many still feel isolated, work is being done in some areas to create social groups and bring older gay people together.

Steve Masters, the chair of the Berkshire Older Lesbian and Gay Forum, a group for older gays and lesbians, provides a social network for older LGBT people which meets twice a month. He said: “The group was founded because around Berkshire there’s nowhere for older or middle aged gay people to go. All the venues are very youth-orientated. Most of pubs turn into clubs later in the evening, so if you don’t like dance music, you’re out.”

Older LBGT groups play an important role not only in the social aspect of their members’ lives, but also by offering invaluable practical assistance when people are met with specifically LGBT-related issues. For example, Age Concern cites “the double discrimination of ageism and homophobia” as a key problem.

Masters says: “People still suffer from homophobia at an older age. Two people recently contacted us through our website as they had been subject to verbal abuse, asking who they could turn to. Someone from our group went to meet them and we put them in contact with the police.”

Declining health and illness as another significant problem faced by the older gay people, whose status may bring added difficulties to the process of dealing with such issues. Roger Newman of the Alzheimer’s Society’s lesbian, gay, bisexual and trans support group says there are an estimated 35,000 gay people suffering from dementia in the UK, but this is a largely invisible population. There is too narrow a focus on LGBT people when it comes to helping them cope, stressing the importance of informing service providers in order to help them meet the distinctive needs of older gays.

“Being older and gay involves the issue of coming out,” Newman says. “I know of older people who actually go back into the closet. Many people build defensive walls around themselves, but when we need care from outside, these walls get breached.”

Gay people who begin to lose their decision-making powers due to Alzheimer’s disease are in a particularly vulnerable position. “There is an urgent need amongst older LGBT people to look at getting power of attorney.” he states. Since older people are less likely to be amongst those getting a civil partnership, many do not have the rights that a legal spouse would have when it comes to deciding about their partner’s finances and care. Newman adds: “People can have difficulties with their families over who holds control over the Alzheimer’s sufferer’s affairs; their same-sex partner or their blood relatives. Homophobia can raise its ugly head when you least expect it.”

The overall message is that older LGBT people must be recognised as a significant group, and deserve informed, inclusive care tailored to their specific needs and rights.

Roger Newman summed up the way in which older LGBT people should be treated: “A lot of services hide behind the fact that they ‘treat everyone the same’. But we don’t want to be the same. We’re saying: ‘Treat us in a holistic, inclusive and informed way’. Every time someone discusses this issue it’s like a stone being thrown into a pond. Hopefully the ripples will radiate and it will help other older gay people.”

For more information, visit ageconcern.org.uk/openingdoors/ and alzheimers.org.uk/gay_carers/