Isolation Hampers Well-Being of Gay Seniors

A walk through Manhattan's gay Chelsea district is no longer as enjoyable for Charles Cole as it once was. Many of his longtime neighborhood haunts, from gay bars and hangouts to gay-catering businesses, have closed as the area's LGBT population moves to other sections of New York City.

And at the age of 64, the gay single New Yorker can sense the younger men who remain don't acknowledge him when he does venture out.

"One of the things I do notice when I am out in the real world ... since I am an older gay man I can be invisible to a lot of people. I can walk down the street and other gay men that are younger than I am don't even see me," Cole said. "Definitely, I felt isolated."

Four years ago, while attending a job fair at New York City's LGBT community center, Cole overheard talk about computer classes offered by SAGE, short for Services and Advocacy for GLBT Elders, and enrolled. Although he knew about the agency, Cole didn't see himself as a senior citizen and had never sought out its services.

"I don't know why, I definitely was. I laugh now when I think about it," he recalled. "When I came through the doors here the very first time, I thought for the first time I was somewhere where being an older gay man wasn't going to automatically be two strikes against me."

Today, Cole volunteers at the SAGE Center, a community center for LGBT seniors that opened in 2012, where he works as a receptionist and programs a popular movie night. Instead of eating a TV dinner alone at home, Cole now often eats at the center, breaking bread nightly with other LGBT seniors and SAGE staffers.

"I like to say that I came here to get some computer classes and I found a community and I found a home," said Cole.

Yet many LGBT older adults are lacking the social bonds and connections that Cole has formed through the center. Various research studies have found that LGBT seniors are vulnerable to being socially isolated, which can hamper their well-being and elevate their risk for depression, anxiety and other maladies.

"LGBT elders don't feel like they fit in to the LGBT community, which is more youth focused," said Robert Espinoza, SAGE's senior director for public policy and communications. "In general, the aging field believes isolation is one of the biggest issues facing all older people. That it is more pronounced among LGBT elders only speaks to that."

A 2011 study by the UCLA Center for Health Policy Research based on the results of the 2003, 2005, and 2007 California Health Interview Survey found that half of gay and bisexual men in California live alone compared with 13.4 percent of heterosexual men. Lesbians were more likely to live with a partner than gay men, according to the study, but more than 25 percent of lesbians lived alone compared with about 20 percent of straight women.

"Social isolation and lack of family and community support has a significant impact on the mental and physical health of LGBT older adults," noted a 2013 report issued by the National Gay and Lesbian Task Force titled "No Golden Years at the End of the Rainbow: How a Lifetime of Discrimination Compounds Economic and Health Disparities for LGBT Older Adults."

A study of 616 LGBT San Francisco residents aged 60 to 92 years conducted in 2013 found that almost 60 percent lived alone. (A 2010 study found that 28 percent of all older adults in San Francisco lived alone.)

"LGBT participants who live alone are at risk for poorer outcomes on all assessed health indicators, compared to those who live with others," concluded the report based on the survey, titled "Addressing the Needs of LGBT Older Adults in San Francisco: Recommendations for the Future."

The report did find that most of the participants "have moderate levels of social support." But it also concluded "there remain some (9 percent) who say they have no one to turn to for social support."

And among the 15 percent of the seniors in the survey who had children, 60 percent reported that their children were not available to help them if needed.

Commissioned by the city's LGBT Aging Policy Task Force, which finished its work last month, the survey report found that "gay men are at higher risk for lacking social support than lesbians."

Almost three-quarters, or 72 percent, of the survey participants indicated they had a "close friend" who was their "most common source of social support." The next most common was a partner or spouse (36 percent), therapist (23 percent), and neighbor (22 percent). The survey's transgender participants were the most likely to turn to faith communities for social and emotional support.

It noted that having social support is "critical to our health and well-being, especially among older adults."

Alarming Statistic

One statistic that alarmed the researchers behind the study was the finding that 15 percent of the survey respondents had "seriously considered" committing suicide within the last year. Those LGBT seniors in legally recognized relationships were less likely to have contemplated suicide than those in relationships not legally recognized or those not in a relationship.

"We need to bring older people together to counter that isolation. It is why senior centers all around the country and day centers exist," said Espinoza. "It is a way for older people to find community, to meet friends, and to get out of their house."

Openhouse, a nonprofit that provides services to LGBT seniors in San Francisco, has increased the types of social activities it offers over the last five years in order to provide more outlets for older adults to connect.

"Isolation is a huge theme for much of the work Openhouse does," said Seth Kilbourn, the agency's executive director. "LGBT seniors have a higher risk for isolation than non-LGBT seniors because they tend not to have children, tend to live alone, and don't have family members to step in for them like non-LGBT seniors."

Being socially isolated, added Kilbourn, is the number one predictor of the health and well-being for all seniors.

"The more isolated the senior is, the less likely they are to maintain their health and well-being," he said. "The more connection to family and community members, they live longer, stay out of the hospital, or delay any type of institutional housing placements."

Monthly film showings, potlucks for men, women-specific gatherings, and groups focused on poetry, opera, or books are among the offerings Openhouse provides. It recently started offering Spanish classes to those wishing to learn the language, and based on its success, is looking to add other language courses.

"It is an entr�e, so to speak, into Openhouse," said Kilbourn, "so as circumstances change we as an agency are able to work with those folks who may initially come for Spanish class and, a year down the road, need help finding affordable housing."

The agency also launched a friendly visitor program to match volunteers with seniors who may be homebound, looking to make a new friend, or need someone to help them get out of the house. And it is hoping to attract a broader spectrum of the LGBT older adult community, from those in the middle class to LGBT seniors of color.

"What our goal is over the next five years is to expand the activity programs we offer so that we will have something for a wide variety of interests that will attract the full diversity of our community," said Kilbourn. "It is all wrapped up around reducing isolation toward having a healthy aging experience."

In its report finalized last month called "LGBT Aging at the Golden Gate: San Francisco Policy Issues and Recommendations," the city's LGBT Aging Policy Task Force determined that "currently there are very limited individual supportive services that address the emotional and behavioral health challenges of isolated LGBT older adults in San Francisco."

It found just four agencies in the city - Openhouse, the UCSF Alliance Health Project, Queer LifeSpace, and the Access Institute - that offer some form of supportive services to LGBT seniors. Thus the task force is recommending that city officials expand the peer support-based counseling, emotional and practical support services offered to LGBT seniors in order to reduce their social isolation and to address their emotional and behavioral health needs.

"As a social worker I am really concerned about the issue of emotional well-being as the older adults community continues to age," said Scott Haitsuka, 52, a member of the task force who served on its health and social services work group.

An associate clinical social worker and a program coordinator at Openhouse, Haitsuka stressed that he was speaking as a task force member and not as an Openhouse employee. He believes the lack of social support services for LGBT seniors in San Francisco can be traced to the 2010 closure of New Leaf: Services For Our Community, which focused on offering mental health services to LGBT clients.

"I feel like the closure of New Leaf and their Outreach to Elders program in 2010 was really unfortunate, first and foremost, and I think left a huge gap in mental health services for LGBT older adults currently," said Haitsuka, who had worked at the agency in an administrative capacity. "Now there isn't one place that focuses on - and is welcoming and understands the life experiences of - LGBT older adults. That is key, to have a safe and welcoming space where LGBT older adults can get mental health services."

He is hopeful the city's Department of Aging and Adult Services will implement the task force's recommendations to fund an LGBT senior peer counseling program as well as an LGBT peer support volunteer program.

"I feel a framework of peer services can be a bridge to maybe more formal or traditional therapy services," said Haitsuka. "It is so empowering for people who lived with, or were in recovery from, mental health issues to take an active role in helping others who may be living with those."

At SAGE's senior center in New York City, Cole has seen firsthand the positive impacts that come with providing a safe space for LGBT seniors to connect with one another and access the services they need.

"It is great to feel I do have a network here and that I am not alone out there," Cole said of the friends he has made at the center. "We do take care of each other ... like I said, it is a family."