This article first appeared in the St. Louis Beacon, July 14, 2009 - When Sylvia Squires' husband was dying of cancer three years ago, no medical professional questioned her constant presence and her right to make decisions. Now, Squires, 67, can't count on the same acceptance as she and her partner Mary Ann Roos, 56, look to their future.
Already, their relationship has been challenged. During Roos' recent medical appointment, the doctor told Squires she wasn't allowed in the examination room. After Squires explained that Roos was her partner, the doctor reluctantly let her in.
"The way she looked at me was like, 'You don't belong here,'" Squires said.
SAGE ADVICE FOR OLDER GAY ST. LOUISANS
Squires and Roos of Maplewood are one of many couples and single lesbian, gay, bisexual and transgender people concerned about prejudice as they age.
sageAccording to a MetLife Mature Market Institute study, 32 percent of gay men and 26 percent of lesbians ages 41 to 60 nationwide fear discrimination from assisted-living facilities, home health-care providers and other caregivers.
Making the golden years less scary is the goal of an advocacy group called Service and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) Metro St. Louis. The year-old local chapter, part of the national SAGE organization, late last month announced that it been asked for the first time to conduct a policy review for inclusiveness for an organization that provides services to seniors.
St. Andrews Resources for Seniors (STARS) home health services is asking SAGE to review all policies and procedures, as well as intake and employment forms. SAGE will look for items such as relationship checkboxes that go beyond "marriage" to also include "civil union" and "domestic partnership." Same-sex partners should be the primary emergency contact, and orientation materials for new employees and volunteers should include training in gay issues.
It's important for caregivers to realize that gay clients are twice as apt to live alone and four times as likely to be childless than heterosexuals, said Heather O'Brien, STARS eldercare specialist. It's not unusual that they're estranged from their family of origin, who may be unable to accept their sexual orientation. Though many have friends they consider family, others are left completely alone -- a dire situation for all seniors.
"Isolation can lead to not only depression and loneliness but also physical health problems," O'Brien said.
As a non-profit, faith-based organization associated with the Diocese of the Missouri-Protestant Episcopal Church and the Presbytery of Giddings-Lovejoy Presbyterian Church, St. Andrews has a mission to be inclusive, O'Brien said. There's been no negative reaction, she added.
"People should anticipate we would make every effort to include this community," O'Brien said. "Not doing so would go against the very mission of St. Andrews."NETWORK OF CARE FOR THE GAY POPULATION
More than three dozen local organizations and businesses have signed on to another of SAGE's offerings, a referral network of care providers that includes housing, hospice and legal services. Network members have agreed to care for older gay adults, their families and caregivers in a healthy, safe and accepting environment.
One important service of the network is letting prospective clients know they're choosing a caregiver who's sensitive to the gay community.
Network providers are also asked whether they have nondiscrimination policies, including sexual orientation and gender identity. Most check "yes" to both. Eventually SAGE would like each of them to undergo a policy and procedures review like St. Andrews. Such a step sends a clear message of giving way more than lip service to inclusiveness.
"It's one thing to say, 'We don't discriminate'; it's another to truly embrace this as culture change within your organization," said Sherrill Wayland (right), founder and executive director of the local SAGE chapter.
Not everyone buys into the network concept. Delmar Garden Enterprises, which provides home health care and has nine housing complexes in the St. Louis area, is not planning to join. Ruth Sirko, vice president of marketing, said Delmar Gardens is already "totally inclusive" and doesn't discriminate on the basis of age, sex, sexual orientation or any other category.
"We've had a nondiscrimination policy in place for 45 years. Being part of something else -- I don't know how that's going to enhance that policy," Sirko said.
EVEN WHEN LAWS PROTECT, ATTITUDES LAG BEHIND
It may be especially important for health-care providers to have clear non-discrimination policies in Missouri. Same-sex relationships aren't recognized in the state, and no statewide nondiscrimination law protects gays.
As a Madison County, Ill., resident, Dick Wagner, a single 69-year-old gay man, knows he has some protections. Like 20 other states and Washington D.C., Illinois protects gays and lesbians in housing, public accommodations, employment and credit transactions. Its 2005 law also shields against discrimination based on gender identification, as do 11 other states and D.C.
Those laws make Wagner feel he has a fighting chance against discriminatory behavior should he ever live in a seniors' facility.
"I do worry that my friends who are gay might be prevented from visiting me," Wagner said. Would he be more worried if he lived in Missouri? "Definitely," Wagner said.
But it takes time for laws to change attitudes. Though Terry Williams, 62, lives in Illinois, the former Edwardsville nursing-home activities assistant is concerned about ending up in a care-giving facility. Two years ago, he witnessed a client dying of cancer, as the partner at his bedside pretended to be a brother. During daily visits over a period of several months, it was obvious the two men loved each other but with three beds to a room and frequent interruptions by staff, the couple never talked or interacted like two people who'd shared a life together.
"Their sadness was palpable," Williams said.
Wayland knows other gay singles and couples in St. Louis who were once out of the closet but felt they had to become "re-closeted" when they needed home health or assisted living care to dodge discrimination.
"I've heard stories of people going in together under the pretense that they're sisters," Wayland said. "Or one has a disability and the other one will say they're the paid caregiver."
Others talk about leaving the Midwest as they age, seeking a more accepting environment. But few of the handful of all-LGBT elder-care properties like RainbowVision in Santa Fe and Palm Springs with their spas, tennis centers and cabarets are affordable for most people.
St. Louis will probably not see an exclusively LGBT facility any time soon, Wayland said. Given its current resources, it makes more sense for SAGE to continue working with existing services rather than to initiate new ones.
GETTING LEGAL DUCKS IN A ROW
Many gay men, now in their 50s and older, thought they might not live long enough to worry about growing older. They were young men in the mid-1980s when AIDS was a death sentence that began killing off their partners and friends. Between Wagner's poor family health history, hemophilia and sexual activity in his youth, he never expected to be on the cusp of his 70th birthday.
"I am indeed surprised," Wagner said.
Richard Schiffer, partnered and monogamous during the 1980s, never worried about AIDS. Now 79 and in a relationship with 52-year-old Chris McLellan, he knows health-care decisions are much easier for everyone -- gay, straight, single or partnered -- if they have their legal paperwork in place. Designating a power of attorney for finances and health care, and creating a living will and other important documents ensure that health and end-of-life wishes will be carried out.
Having their affairs in order gives Schiffer and McLellan great peace of mind.
"If Richard was in the hospital, and I ran across a nurse who was unwilling to provide me any information about his condition, I could produce the documents and say, 'I have power of attorney, I'm his health proxy; you are violating my rights,'" Chris explained. "The legal documentation is going to supersede anybody's own personal opinion or bigotry."
Nancy Larson is a freelance writer in St. Louis.
