Policy Related Topic in Ageing - Essay Example

Policy and Societal Issues Facing the GLBT Elderly Population The gay, lesbian, bisexual and transgender (GLBT)segment of our popular has been discriminated against for decades. The elderly GLBT population is particularly vulnerable to this discrimination and is victim of numerous policies that preclude them from many of the rights afforded to their heterosexual counterparts. This study presents some of these policy decisions and illustrates where we are headed as a society as we learn how to effectively deal with a segment of the population that is living longer, healthier, and more prosperous lives today than ever before. Policy and Societal Issues Facing the GLBT Elderly Population Introduction There are numerous issues facing the elderly in our world today. As medical advances continue, this population is living longer and healthier lives. As such, the demands on society have grown as well. Depending on the culture in any given society, the elderly face issues of loneliness, isolation, physical infirmities, loss of income, and the list goes on. The sad reality is that these same problems seem to be compounded for the gay, lesbian, bisexual, and transgender elderly population. Society is still coming to terms with how they want to view this particular segment of the population. For decades, marriage was not an option and couples were shunned when being seen out in public. While younger people can make the choice to confront these issues head-on, there are certain policy decisions and prejudices faced by the elderly that can become too difficult to bear. These issues range from not having hospital visitation rights and end-of-life decisions to simple inheritance and property issues. Retirement homes have been ill equipped to handle this particular population, and many family members have been less than accepting as well. Society seems able to handle the social issues that it faces with the elderly who are heterosexual, yet there are some major obstacles that the GLBT community must overcome. This report will deal with current published studies in this area in an effort to begin a dialogue about certain policy decisions that should be reversed moving forward in order to give the elderly GLBT a better quality of life in their remaining years. Literature Review In their younger and middle years, homosexual individuals and couples usually live independent lives. They have few family constraints, are far more mobile than the average heterosexual couple. In addition, they tend to rely less on social services. As this population ages, however, studies have shown that they do grow more dependent on public programs, social services, and assistance programs. They dependence on government and private programs in order to get the help they need because the trend of independent living has reversed itself. As they age, homosexual couples tend to become less independent and more reliant on assistance programs than their heterosexual peers (Cahill & South, 2002, p. 49). As they age, the GLBT elderly population quickly discovers that they face some uphill battles in terms of certain benefits they have worked all of their life to attain. These include, but are not limited to, unequal treatment by the Social Security Administration, pension plans, 401(k)s, and issues related to housing, healthcare, and long-term care. These are issues that married heterosexual couples do not typically grapple with. Recent reports also show us that this population is a sizeable and growing segment of the population. Estimates are that there will be as many a 6 million elderly GLBT couples in America by the year 2030 (Cahill & South, 2020, p. 51). With this growing segment of the elderly population comes a need for social services, but the reality is a bit sobering. As Donahue and McDonald (2005) note, “The social work profession and other health service professions have been accused of not only ignorance, but insensitivity and intolerance concerning the issue of homosexuality” (p. 361). This situation does appear to be improving with the removal of homosexuality being labeled as a psychological disorder. In the early days of caring for this population, treatment was actually clinical. Much was done to focus on the psychology of the ‘disorder’, yet little to nothing was done to actually create a community of acceptance amongst this population, nor were any major policy decisions handed down that would positively impact the elderly GLBT among us (Price, 2008, p. 1341). Breaking it down even further, evidence suggests that gay men in particular have a higher tendency towards eating disorders, suicide, cigarette smoking, sexually transmitted diseases, depression, panic attacks, and psychological distress. In addition, gay men tend to exhibit higher levels of anxiety, mood disorders, and substance abuse than their heterosexual counterparts (Adam, Braun, & McCreanor, 2008, p. 108). These issues compound themselves with age and are critical areas that need to be resolved in the health care sector. As this population ages, family ties are less existent, hospitals often discriminate in the level of care given to such disorders, and society is less equipped to compassionately take care of GLBT individuals when compared to others. Given the issues already discussed here, many studies are being conducted to determine how to take care of this growing segment of the population as they continue to grow in number and in age. Various health policy organizations have openly admitted to healthcare disparities between the GLBT population and other segments of society. It has been discovered, for example, that current nursing education programs entirely lack much mention at all of the aging GLBT population. As these nurses enter the profession, therefore, they are ill equipped to deal with the emotional and social effects of these particular patients (Lim and Bernstien, 2012, p. 170). Studies conducted as recently as 2011 have discovered that GLBT patients overwhelmingly report negative experiences with the healthcare system. Efforts have been made to eliminate the perceived disparities in care between the homosexual and heterosexual population, yet little difference has been noted. This is of particular concern, as it is noted that homophobia is still evident in certain segments of society, even among healthcare professionals. As the conditions of certain GLBT elders are quite chronic, the fear is that they are not getting the proper care and treatment that others in society are receiving. Current policy decisions in many states preclude non-working partners of a GLBT person from receiving health benefits. This becomes particularly troubling as one partner passes away and leaves the other without any health insurance or access to other important social benefits afforded to heterosexual couples. This precludes them from seeking out medical treatment in many situations, and causes them to receive substandard care when they have no other alternative (Frederiksen, 1999, p. 144). Discrimination is another particularly troubling concerning facing this particular segment of the elderly population. Gabrielson (2011) mentions that, “Gay, lesbian, bisexual, and transgender older adults fear discrimination in long-term care and voice a preference for GLBT specific services” (p. 357). It has again been discovered that the nursing sector has been particularly negligent in the attention paid to the unique health care issues facing the elderly homosexual population. Reforms are needed in terms of nursing research, education, and social services it order to make sure that this population is better understood and service. Recent policy initiatives, such as Healthy People 2020, have placed renewed requirements that emphasize the health and well being of elderly GLBT individuals continue to be evaluated and assessed. This policy was implemented based upon numerous reports that there is a significant difference in support needed between homosexual and heterosexual elderly individuals (Gabrielson, 2011, p. 358). It is also well documented that the GLBT population is often victimized and are at risk of physical attacks and verbal harassment. This makes it more plausible that the elderly will refuse to seek out much needed assistance for fear of how they will be treated. This victimization inflicted upon GLBT individuals often leads to physical and mental health problems. This causes such individuals to be less open about their sexuality, creating feelings of inner-turmoil, loneliness, and despair as such people enter the later years of their life (D’Augelli & Grossman, 2001, p. 1009). A policy criminalizing such discrimination, in addition to more awareness among social service professionals, is needed to address these issues moving forward. Discussion We all have issues as we age. The body grows weak, the mind grows frail, and friends and family seem to come and go. This is nothing new. What is new, however, is having a growing segment of the elderly population that continues to suffer discrimination in terms of health and social services. As we have already discussed, research points out a statistical significantly prejudice that exists in society the GLBT segment of the population grows older. They lack access to many of the same benefits and services the rest of the community receives. While advances have been made in when recent years, and policies have been rewritten, there is much work to be done. The United States of America has a longstanding policy against recognized marriage between same sex couples. This means that federal benefits have largely been denied to this segment of society. While this is a workable situation throughout the working years of a homosexual couple’s life, it quickly becomes debilitating once one or both partners can no longer work, or retires. Since heterosexual couples do not face this type of discrimination, many in society are crying foul and asking for new legislation to be passed. As it stands now, marriage is left up to individual states, meaning that homosexuals can be wed in a handful of localities, yet the discrimination remains as their unions do not typically have to be recognized by health care providers, retirements systems, or the Social Security Administration, which includes Medicare (Meyer and Rosemelia, 2007, pp. 67-68). In recent years, the major players in terms of shaping policy for this age group and lifestyle centers on politics and religion. Shaped by traditional arguments against homosexuality, the religious right has often shied away from allowing the government to accept the GLBT population as being equal under the law. They have worked politically to keep marriage as strictly between a man and a woman, which has lead to the current denial of benefits they are facing today. Contrary to this, there is a growing number of religious moderates that are embracing the gay community, and they feel it is time for society to change in this regard. As such, the tide politically is slowly changing and politicians and more moderate judges have issued several favorable rulings that directly impact the gay and lesbian community, particularly the elderly among them. For the aging gay and lesbian couple, being married is more than just a symbolic gesture. It is a way to protect their livelihood, health, and decision-making abilities. As partners grow old, for example, one person in the relationship is likely to get quite ill, while the other one remains healthy. For couples, this can be a traumatic experience at an age. This issue is further compounded for the GLBT elderly couple, however, because they often lack any health-care related decision-making ability. To be fair, all 50 states and the District of Columbia allow for health care proxies to be appointed. The only qualification is that this person be an adult, of sound mind. So, in theory, a gay or lesbian partner qualifies. Once again, however, the discrimination often prohibits this very theory from working in practice. If, for example, an adult child enters into the scene and does not approve of their relationship, most health care providers will take the side of the child, regardless of any health care proxy that has been signed. In addition, if such a proxy was not signed and there was a tragic accident, or sudden trauma or terminal illness, most states mandate that only a direct family member can be involved in any health related decisions. Again, since marriage is not currently an option, the elderly GLBT couple is often left without a viable alternative in periods of serious illness (Gallanis, 2002, pp. 612-614). This issue does not just present itself in terms of health related policies and procedures. As homosexual individuals become elderly, the time comes when they may not be able to live in their own homes. When this occurs, they are forced to either live with family members, in assisted living communities, or in full-care nursing centers. In each of these environments, the gay and lesbian gives up that sense of freedom we discussed earlier. They often no longer feel free to live ‘out of the closet’ for fear of discrimination. There have been many reported cases of such people simply refusing to make their sexual orientation known under these living conditions, thereby going back into the closet. They would rather live in their own little apartment, not really free to be themselves, rather than face the discrimination that they fear would come should be reveal that they are a member of the GLBT community (Donahue & McDonald, 2005, p. 362). This issue is compounded ever further for the GLBT elderly couple. If one partner is unable to care for the other any longer, and there is the absence of any safe family member for them to move in with, the couple is forced to seek out assisted living or retirement homes as well. The problem here is that many such homes do not allow same sex couples to share the same apartment or the same bed. This is an age-old problem of discrimination that seems to remain to this day. There may not be any legislation against the practice of same sex couples living together, yet some societies and retirement communities simply do not allow it. One could suppose that the elderly gay and lesbian could fight such policies, but at this age, few are willing to go through the emotional turmoil that this would cause. This simply further compounds the many problems that plague this age group and chosen lifestyle, and illustrates the strong need to eliminate the prejudice that still exists in society and to work on drafting policies that are more protecting of elderly GLBT rights (Gallanis, 2002, p. 633). Strengths and Weaknesses of Current Policy Any discussion about the strengths or weaknesses of current policies designed for the GLBT community must begin with the lack of uniformity between state government and federal guidelines. While nearly a dozen states and the District of Columbia recognize same sex marriages, for example, the federal government has refused to do so. So, in essence, this has strengthened policies related to gays and lesbians at the state level, while weakening them further and causing confusion at the federal level. Gay men are often stigmatized in society as being at high risk of HIV transmission. Statistically, and sadly, this population is more at risk at contracting the virus. Discrimination, however, still persists in society towards all GLBT individuals and current legislation does little to protect them. While privacy rights are guaranteed for any HIV patient, many social services discriminate against this population and deny services to them. If an elderly individual is without proper insurance, and social services are denied them out of prejudice or discrimination, life can become extremely difficult to say the least. The weakness of current policy involves a lack of enforcement and action against agencies that deny services either on the basis of sexual orientation, or because of a sexually transmitted disease. It is not enough to simply past such legislation criminalizing such behavior, but more must be done to police these actions and move society towards a more accepting attitude. The current presidential administration, in conjunction with state and federal courts, in addition to the Supreme Court, are beginning to weight on issues directly related to gays, lesbians, bisexual, and transgendered people. This directly impacts the right of elderly homosexuals and this segment of society is waiting with baited breath to see if the tide of prejudice and discrimination they have faced for some many years is finally beginning to dissipate. Some policies have already been strengthened in favor of the GLBT people group. Some states now extend government benefits to people in same sex marriages, which is a positive sign. The fact remains, however, that this group remains immobile because access to certain important services is not portable from one state to another. This is an area that certainly needs to be strengthened. In the coming months, courts will take up the issue of the Defense of Marriage Act. Passed in 1996, this legislation makes it federal policy to only recognize marriages that are between a man and a woman. The policy has come under fire in recent years, however, as more states have adopted same sex marriage as a course of law. The argument is that the federal government should be not be able to supersede in this area of personal rights and freedoms that have been granted to GLBT individuals at the state level. As the policy currently stands, elderly GLBT individuals are now free to get married and receive certain benefits and services only if they move to one of the handful of states or the District of Columbia where they are permitted to do so. If the Court overturns the Defense of Marriage Act, however, innumerable policies will immediately be impacted that will strengthen the rights of elderly GLBT people living together. Conclusion In summary, imagine being a person that is shunned by society all of your life, even though you have been a positive contributor to your community for decades. Then, imagine being in the twilight of your life and you are not allowed to live out your remaining years in peace together with the person that you love. We would like to think that this no longer happens in America, yet it is exactly the type of discrimination that has been promoted by current policies directed at individuals who openly choose to live a homosexual lifestyle. The elderly are particularly vulnerable as a people group because they do not have a loud voice. There are few organizations that speak up for the elderly in general, and even fewer willing to do so for the GLBT population as a whole. This is often a forgotten segment of the aging population and one with whom current legislative policies tend to shy away from. As such, many organizations simply refuse or deny services to these individuals on the basis of longstanding tradition. Traditions are wonderful until they impact an individual’s ability to live independently and in freedom. Even single individuals living as a homosexual are often discriminated against and denied basic services. This treatment must stop and be reversed as soon as possible. There appears to be a tide of change rolling through North America, and indeed much of the Western world, in terms of how the GLBT population is treated. For the elderly people in this group, may we hope that this trend continues so that they can live a productive and healthy retirement, free from prejudice and discrimination. Hopefully policies will be reversed soon and they will be able to live together in retirement homes, gain benefits long denied them, and make medical decisions for one another without fear of reprisal from society. The elderly GLBT individuals among us deserve at least that much. References Adam, J., Braun, V., & McCreanor, T. (2008). Framing gay men’s health: An analysis of policy documents. Gay and Lesbian Issues and Psychology Review, 4(2), 108-126. Cahill, S., & South, K. (2002). Policy issues affecting lesbian, gay, bisexual, and transgender people in retirement. Generations, 26(2), 49-54. Concannon, L. (2007). Developing inclusive health and social care policies for older LGBT citizens. The British Journal of Social Work, 39(3), 403-417. DOI: 10.1083/bjsw/bcm131 D’Augelli, A., & Grossman, A. (2011). Disclosure of sexual orientation, victimization, and mental health among lesbian, gay, and bisexual older adults. Journal of Interpersonal Violence, 16(10), 1008-1027. doi: 10.1177/088626001016010003. Donahue, P., & McDonald, L. (2005). Gay and lesbian aging: Current perspectives and future directions for social work practice and research. Families in Society, 86(3), 359-366. Frederiksen, K. 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Stress and mental health among midlife and older gay identified men. American Journal of Public Health, 102(3), 503-510. Read More