Gay men, lesbians struggle to find caregivers and old-age facilities that don’t discriminate

When a physical therapist paid a home visit to ABilly Jones-Hennin after a back operation, one element of the “treatment” harked back to an era he thought he had left behind decades ago.

“He took it upon himself to decide to pray for me,” said Jones-Hennin, 71, a qualitative researcher who identifies as bisexual and has been in a relationship with a man for 35 years. “He wanted to clear the demons out of me and my partner and started doing this ‘hell and damnation’ about homosexuality.”

The Shaw resident lived through the Stonewall era and resides in one of the nation’s most gay-friendly cities. Furious, he ordered the therapist out and complained to the agency that sent him. But older lesbian, gay, bisexual and transgender (LGBT) people, including those among the first to come out as a political and social force, are increasingly apprehensive about encountering discrimination as they grow older and more dependent on strangers for care.

An estimated 2 million Americans 50 or older identify as LGBT, with that number expected to double by 2030, according to the Institute for Multigenerational Health at the University of Washington. About 15,000 are estimated to live in the Washington metropolitan region.

Those over 65 grew up in what their younger counterparts now see as a dark age, when doctors viewed homosexuality as a disorder and gay men and lesbians were sometimes committed to psychiatric wards.

“They came of age and lived through an era when it was particularly dangerous to be out,” said Susan Sommer, senior counsel and director of constitutional litigation at Lambda Legal, an LGBT advocacy group. “They risked losing employment, losing family, losing friends, and even violence. They became habituated to a closeted existence.”

Those in their 50s came of age during a more tolerant time. Nevertheless, anti-LGBT attitudes are still common among people over 50, with just 50 percent of baby boomers and 47 percent of the Silent Generation saying they think homosexuality should be accepted by society, according to two Pew Research Center polls conducted this year. Among Generation X, the number was 63 percent, and among millennials it was 71 percent.

Since 2010, federal law has mandated such rights as hospital visitation for same-sex partners. But as they get older, many feel less comfortable standing up for themselves, particularly if they are not wealthy, and they are increasingly vulnerable to being pushed back into the closet, experts say.

“If you’re getting public assistance, you often have very little say on who’s assigned to you,” said Wendy Lustbader, a University of Washington professor of social work who specializes in aging. “Many people actually accept various kinds of abuse from health-care workers because they are dependent on their care.”

A 2011 survey by six LGBT and older adult advocacy groups found that just 22 percent of LGBT aging adults said they felt it was all right to be open about their sexual identity in a nursing home or assisted-living facility. Fear of discrimination from other residents was almost as high as fear of discrimination from staff, the survey found, and 43 percent said they had experienced mistreatment at facilities.

Older LGBT people are four times less likely to have children and grandchildren and twice as likely to live alone as their straight counterparts, according to the National Gay and Lesbian Task Force Policy Institute.

Many became estranged from their families when they came out, and many also saw their social support systems decimated by the AIDS epidemic in the 1980s and 1990s.

“I lost 100 friends, and after 100, I stopped counting,” said Wes Morrison, 66, a District resident. “So all the people that I would have relied on, people that would have been friends that I had known for years and years and years, are all gone.”

The more isolated LGBT people are, the more likely they are to return to the closet, advocates say, especially if they are middle- or low-income. Many of the LGBT retirement communities popping up across the country are high-end, some with move-in fees in the hundreds of thousands of dollars. But LGBT people earn less than their straight counterparts, and many must look for general-population facilities where they will feel comfortable.

It is not an easy prospect. “The existing senior housing that’s out there has not been welcoming to the LGBT community,” said Daniel Reingold, president and chief executive of the Hebrew Home in Riverdale, N.Y., adding that it can be risky for a facility to openly advertise itself as gay-friendly. “If they put that in their marketing and bring in 10 or 12 people, is the rest of the world going to turn away? They might. . . . I think the Greatest Generation will have difficulty accepting” openly gay-friendly facilities, he added.

One retired federal employee in Arlington County, who is 80 and has not come out, said he plans to move to a retirement community because he has no relatives. But he is apprehensive about how he would be received.

“Who would want me in there and not after a short time suspect that I was gay, and then bricks would start flying — you know what I’m saying?”

He said he plans to try living at a couple of facilities for a week at a time and discreetly talk to single men about what it is like to live there.

Although there is no systematic rating of the gay-friendliness of the facilities, there are informal ways to assess them. “There are places we’ve reached out to that say, ‘Well, this doesn’t pertain to us because we’ve never, ever had an LGBT person here,’ ” said David Mariner, director of the D.C. Center, an LGBT nonprofit community center. “Well, that’s just not true. . . . It means they’re not comfortable being out.”

A facility can employ more subtle messages of openness — a brochure that includes a photo of two men or two women, a questionnaire that uses the word “spouse” instead of “husband” or “wife,” or the placement of advertisements in gay publications.

And older LGBT people let each other know which facilities are open-minded.

“At one facility around five years ago, somehow the kitchen staff got access to medical records of some of the folks that were in the program” who were HIV positive, said Mariner, who declined to name the facility. “They were given separate plates and different utensils with their names on them. So they were kind of outed in front of the other seniors, both in terms of being gay and their HIV status.”

At the other end of the spectrum are facilities such as the Residences at Thomas Circle in the District, which holds events with LGBT organizations. A group gathered there recently for a screening of “Gen Silent,” a documentary about the difficulties of aging for LGBT people. Afterward, the audience sipped coffee and exchanged stories.

Mary Paradise, 61, who lives alone in Glover Park, talked about how she had cared for her mother, who had Alzheimer’s, and had a realization. “It just occurred to me, ‘Who’s going to be here for me?’ ” Her voice choked up. “I don’t have a daughter. I just felt lost.”

One possible solution stood propped up on a nearby easel — an architectural plan for Mary’s House for Older Adults, a residential facility that Imani Woody, head of the D.C. affiliate of Services and Advocacy for GLBT Elders (SAGE), hopes to build on land she inherited in the District’s Fort Dupont neighborhood. The house, which would provide affordable communal living for eight older LGBT people, would have a therapeutic hot tub and a shared kitchen and would be the first of its kind in the metro region.

“You can bring your whole self to the table,” said Woody, who has applied for 501(c)(3) status and hopes to raise $800,000 to build the facility.

For District resident Cecelia Smith, 69, it can’t come soon enough. “My heart just bleeds for people who all your life you have to fight tooth and nail for your rights and then when you get old you get treated shabbily by some people,” said Smith, who attended gay rights marches four decades ago.

Referring to Woody’s plan, she said, “Girl, you gotta build it, because I might need it! It’s important that we have our own. . . . We ought to be able to die with dignity.”

At the same time, experts say more education is needed for caregivers. “We have to ensure that people can provide competent care to LGBT older adults, so that they always feel safe to be who they are,” said Karen Fredriksen-Goldsen, director of the Institute for Multigenerational Health, which has been funded by the National Institute on Aging to lead the first longitudinal study of LGBT health and aging. “It’s important to create cultures that are inclusive.”

Jones-Hennin guesses that the physical therapist who tried to drive out his demons had noticed images of male nudes and an LGBT banner on the walls of his home and had heard him and his partner call each other “Baby.”

He said the incident underscored the different forms that discrimination can take.

“It can be a one-sentence comment, but that can trigger something, because you’re not used to it coming from the medical profession,” he said. “We have to be strong enough to say, ‘Stop. I don’t need you praying for me.’ ”