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1
 
APa
With a oreword by 
Services & Advocacy
for Gay, Lesbian, Bisexual& Transgender Elders
ImProvIng the LIves o LgBt oLder AduLts
March 2010
© B i   g C h e e s e  P h ot  os  on F ot  oS  e a r c h .c om. D i   s c l   a i   me r :   t  h e  woma n i   n t  h i   s  ph ot  o i   s  a  mod e l    a nd  t  h e  i   ma ge  i   s  b e i   ng us e d  f   or  i   l   l   us t  r a t  i   v e  pur pos e s  onl   y .
 
2
 
ti p wa a by:
LgBt m Aac Pjc (mAP)
The LGBT Movement Advancement Project is an independentintellectual resource or the LGBT movement. MAP’s mission isto speed achievement o ull social and political equality orLGBT people by providing strategic inormation, insights, andanalyses that help increase and align resources or highestimpact. For more inormation, go towww.lgbtmap.org.
sic a Acacy  gay, Lbia, Bixal ata el (sAge)
SAGE is the world’s oldest and largest nonprot agencydedicated to serving LGBT older people. Since its inception,SAGE has pioneered programs and services or the agingLGBT community, provided technical assistance and trainingto expand opportunities or LGBT older people across thecountry, and provided a national voice on LGBT aging issues. In2005, SAGE became the rst ocial LGBT delegate at a WhiteHouse Conerence on Aging. In 2010, SAGE was awarded a3-year, $900,000 grant rom the U.S. Department o Health andHuman Services and the Administration on Aging to createthe nation’s only national resource center on LGBT aging. Formore inormation go towww.sageusa.org.
ti p wa lp i paip wi:
Aica sciy  Ai (AsA)
The American Society on Aging is an association o diverseindividuals bound by a common goal: to support thecommitment and enhance the knowledge and skills o thosewho seek to improve the quality o lie o older adults andtheir amilies. The membership o ASA is a multidisciplinaryarray o proessionals who are concerned with the physical,emotional, social, economic and spiritual aspects o aging.ASA’s 6000 members are researchers, practitioners, educators,business people and policymakers concerned with thephysical, emotional, social, economic and spiritual aspects o aging. For more inormation go towww.asaging.org.
C  Aica P (CAP)
The Center or American Progress is a think tank dedicatedto improving the lives o Americans through ideas andaction. CAP combines bold policy ideas with a moderncommunications platorm to help shape the national debate.CAP is designed to provide long-term leadership and supportto the progressive movement. CAP’s policy experts cover awide range o issue areas, and oten work across disciplines totackle complex, interrelated issues such as national security,energy, and climate change. For more inormation seewww.americanprogress.org.
naial si Ciiz’ Law C (nsCLC)
The National Senior Citizens Law Center works to promotethe independence and well-being o low-income elderly anddisabled Americans, especially women, people o color, and otherdisadvantaged minorities. NSCLC believes in publicly-undedsaety net programs, and works to preserve and strengthenMedicaid, Medicare, Social Security and Supplemental SecurityIncome. To guarantee air treatment, NSCLS works or greateraccess to ederal courts or citizens and or better enorcemento consumers’ legal rights in saety net programs. NSCLC workstoward an America in which elderly people and people withdisabilities can: live in dignity and saety, ree o the worries andpain o poverty; aord health care to the end o their days; andcontribute to their amilies and societies to the best o theirabilities. For more inormation, seewww.nsclc.org.
Cac Iai
LgBt m Aac Pjc (mAP)
2215 Market StreetDenver, CO 80205720-274-3263
www.lbap.sic a Acacy  gay, Lbia, Bixal ata el (sAge)
305 7th Avenue, 6th FloorNew York, NY 10001212-741-2247
www.aa.mAP ak  llwi , wi wi p wl  a b pibl.
Arcus FoundationDavid Bohnett FoundationDavid DechmanGill FoundationJim HormelJohnson Family FoundationAmy Mandel and Katina RodisWeston MillikenKevin J. Mossier FoundationMona PittengerH. van Ameringen Foundation
 
3
tABLe o Contents
oreWord ...................................................................................................................................................................ieXeCutIve summArY ................................................................................................................................................iiIntroduCtIon ............................................................................................................................................................1LgBt ol Al i Pl ...............................................................................................................................2overvIeW: KeY ChALLenges ACIng LgBt eLders.............................................................................................4Call 1 —ec  scial sia a Pjic ...................................................................................4Call 2 —rliac  Ial aili  Cic ................................................................................6Call 3 —uqal ta u Law, Pa a sic ....................................................7hw  t Call Ip LgBt el’ sccl Ai ..............................................................10At Issue: InAnCIAL seCurItY or LgBt eLders ................................................................................................10Ai LgBt el’ iacial WllBi ...................................................................................................11uqal Ipac: g Pa a LgBt el’ iac...........................................................12
Social Security ...................................................................................................................................................................12Medicaid and Long-Term Care .....................................................................................................................................15Tax-Qualied Retirement Plans....................................................................................................................................19Employee Pensions/Dened-Benet Plans ..............................................................................................................19Retiree Health Insurance Benets ...............................................................................................................................20Estate Taxes ........................................................................................................................................................................22Veterans’ Benets .............................................................................................................................................................22Inheritance Laws...............................................................................................................................................................23
rcai: hlpi LgBt el Aci iacial sciy .........................................................24At Issue: heALth And heALth CAre ......................................................................................................................30hw  hal Ca sy ail LgBt el ...............................................................................................30
Inattention to LGBT Elders’ Health Disparities ........................................................................................................30Limited Support or Family-o-Choice Caregivers .................................................................................................33An Oten Inhospitable Health Care Environment ..................................................................................................34Failure o Nursing Homes to Protect LGBT Elders ..................................................................................................35Exclusion o Families o Choice in Visitation and Medical Decision Making .................................................38
rcai: hlpi LgBt el Aci g hal a hal Ca .....................................40At Issue: soCIAL suPPort And CommunItY engAgement ............................................................................48Ky obacl  scial spp a Ciy ea  LgBt el ......................................48
Unwelcoming Mainstream Aging Programs............................................................................................................48Isolation From the Broader LGBT Community ........................................................................................................49Insucient Opportunities to Contribute ..................................................................................................................49Housing Discrimination..................................................................................................................................................50
rcai: hlpi LgBt el sc scial spp a Ciy ea ...........51
 a la pi i  i p, pla ii www.lbap.  www.aa.
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