This is part of a Diversity Training I wrote in 2006 when I worked as a Program Director for a mental health facility in San Francisco. The training addressed the needs of older adults in our public mental health system and the bias against aging and elders.
- Fear of the elderly.
- Fear of aging.
In the United States, we define “old” in a number of ways.
2. Age 55 is the age at which low-income people might qualify for subsidized employment and learn new work skills. (Title V of the Older Americans Act)
3. Age 60 is the age of eligibility for Older Americans Act services. Due to limited funding, however, services tend to be targeted to those aged who are most needy. (Older Americans Act of 1965)
4. Age 62 is the age at which persons can take “early retirement.” (The Social Security Act)
5. Age 65 has been the “traditional” age for full retirement. However, because of longer life expectancy, the full retirement age is increasing for people born after 1938. Full retirement now goes from 65 to 67 depending upon the year of your birth. (The Social Security Act)
6. Age 70 is a mandatory retirement for the members of some professions.
Millions of our nation’s elderly do not receive of adequate mental health care.
Administrators often cut services for seniors on the basis that they are too old for services.
Primary care physicians have limited training in the care and management of geriatric patients.
Thus neither the patient nor the health care provider may recognize the symptoms of a mental health issue such as depression.
Elders often assume that complaints such as insomnia, changes in appetite, and mood fluctuations are the normal result of aging.
This assumption is often reinforced by their primary care physicians.
A 1990 study of elderly suicides in the Chicago area found that 20 percent of the suicide victims had seen their primary care physicians within 24 hours of their suicide, 41 percent within seven days, 84 percent within 30 days.
The lack of coordinated and comprehensive health care has a damaging impact on all age groups in the United States.
But for older adults who often have multiple needs, these fragmented health care systems are confusing
Long waits and complex bureaucracies discourage elders from seeking treatment.
”old bags,” “old hags,” “old biddies,” “old birds,” “old fogies,” “old fangled,” “old-fashioned,” “old geezers,” “old and decrepit,” “over the hill,” “blue hairs,” “golden oldies,” “vulnerable,” “frail,” “declining,” “dowdy,” “doddering,” “fuddy duddies,” “out of touch,” “little old lady,” “old witch,” “old coot,” “codger,” and particular to men the term, “dirty old man,” which implies that an older man who expresses his sexuality is unnatural perverse, and unclean.
Although sex roles have changed and we have more freedom of sexual expression since the 1960s, the stereotype that older people are physically unattractive, uninterested in sex, and incapable of achieving sexual arousal remains. (Hall, Selby & Vanclay, 1982).
Winn and Newton 1982, compared the sexual behavior of older adults in 106 cultures.
They concluded that continuance of sexuality for elderly persons in many societies indicates that cultural factors may be key determinants in their sexual behavior.
American culture restricts the sexuality of older adults.
Older residents in supported living facilities who display any form of sexual expression are often regarded by staff as having a behavioral problem and may even be tranquilized (Brown, 1989).
Staff attitudes toward masturbation or sexual activity between unmarried residents is disapproving and repressive, and adult children may complain of “permissive” institutional attitudes toward their parents’ sexual expression (Datan & Rodeheaver, 1983; Robinson, 1983).
Gerontophobia in the LGBTQ Community
Wrinkle room: A gay bar or nightclub primarily frequented by older men.
Troll: As a noun–an older or physically unattractive man.
Chicken Hawk: An older gay man who pursues boys or very young men.
Those in their fifties and sixties in the LGBT community find themselves in the peculiar position of being shut out of the very community they fought to create and helped to preserve during the worst days of AIDS epidemic.
Gay and Lesbian seniors face many problems that most heterosexuals never have to face, such as nursing homes where gays aren’t welcome, and a refusal to accommodate same-sex partners.
The National Gay and Lesbian Task Force estimates — very roughly — that there are more than 3 million gay, lesbian, bisexual and transgender Americans over 65, a figure they say will grow by a million in the next 25 years. San Francisco’s Department of Aging and Adult Services loosely puts the figure of gay and lesbian seniors in the city at around 17,000.
Federal programs designed to help elderly Americans nationally are ineffective or even irrelevant for LGBT elders. Several studies of nursing home administrators, of Area Administration on Aging directors, and of health care providers’ document widespread homophobia among those who have chosen to work with America’s seniors.
Most LGBT elders do not benefit from services on which other seniors thrive.
Because of this, many older GLBTQ people go back into the closet.
Several federal programs and laws treat unmarried same-sex couples differently from married heterosexual couples. This is why marriage for GLBT people is not so much about the sacred as it is about the fundamental right of GLBT citizens to live their lives without economic and social sanctions.
- Social Security pays survivor benefits to widows and widowers, but not to the surviving same-sex life partner of someone who dies. This used to cost LGBT elders $124 million a year in un-accessed benefits.
- Married spouses are eligible for Social Security spousal benefits, which can allow them to earn half their spouse’s Social Security benefit if it is larger than their own Social Security benefit. Unmarried partners in life-long relationships are not eligible for spousal benefits.
- Medicaid regulations protect the assets and homes of married spouses when the other spouse enters a nursing home or long-term care facility; no such protections go to unmarried partners.
- Tax laws and other regulations of 401(k)s and pensions discriminate against unmarried partners, costing the surviving partner in a same-sex relationship tens of thousands of dollars a year, and possibly over $1 million during the course of a lifetime.
Even the most basic rights such as hospital visitation or the right to die in the same nursing home are regularly denied unmarried partners.
Discussion: (Please feel free to answer these questions in your comments)
What is your perception of sexuality among older adults?
What should we do to protect ourselves from the stigma against aging?
How do you want to be treated in an assisted care facility?
What can you do to make life better for yourself and other citizen as you age?
(c) Rob Goldstein 2006-20215