In addition to the challenges most of us face as we age, lesbian, gay, bisexual and transgender (LGBT) elders encounter additional obstacles due to inequality, bias laws and policy that affect their financial security and health care options. This inequality is most evident and tragic when these unfair laws prohibit life partners from being together for the last years, hours, and even minutes of a loved ones life.

The cost of health care for the elderly is very high, making private care unaffordable for many elder Americans, and, especially difficult for LGBT elder Americans. As a group, LGBT older adults are overall poorer and less financially secure than mainstream American elders. Contributing to the financial security discrepancy between LGBT elders and American elders in general is the financial result of facing a lifetime of discrimination, which is then compounded by federal laws and safety net programs that fail to protect and support LGBT elders equally with their heterosexual peers.

Of the numerous safety net programs that fail to support LGBT elders, including but not limited to Social Security, retiree health insurance benefits, and veterans’ benefits, the program that has one of the harshest effects on LGBT elders is Medicaid. When a person has spent all of their assets, lacks long term care insurance, and can no longer afford to be cared for in their home, the only option available to them is to apply for Medicaid and transition into a nursing home. To be eligible for Medicaid in Illinois there are asset and income level requirements; basically, to qualify a person must be impoverished. The Medicaid program does have a provision that allows the spouse of a person receiving Medicaid, “the community spouse,” to keep certain assets including their home to protect them from being impoverished as well. Because relationships between same sex partners are not recognized federally or on a state level in Illinois, couples are legally considered to be strangers and no community spouse protection is in place. LGBT elders left in the community are in danger of becoming impoverished, and may end up in a nursing home as well.

Once an LGBT elder enters a nursing home, they and their partner are likely to face additional obstacles. LGBT elders often feel isolated in nursing homes and face discrimination. To make matters worse, few nursing homes have guidelines for the protection of LGBT residents. The devastating effects of isolation and discrimination can be intensified when a same sex partner is treated as an absolute stranger and not allowed visitation during their loved one’s nursing home stay. Tragically, often times during incapacity, a life partner is denied the opportunity to have any part in making healthcare decisions for their loved one. Current law gives preference to spouses and biological family members. Therefore, without proper legal documents, such as a properly executed power of attorney for healthcare, some LGBT elders find themselves completely shut off from even seeing their partner. When their partner is unable to make decisions on their own behalf, same sex partners are unable to make medical decisions for them or obtain medical records without a Power of Attorney designation.

Heartbreaking cases have happened all over the United States as LGBT couples have been denied access to their loved ones during the last moments of their lives. President Obama recently signed a memo directing the Secretary of Health and Human Services to take steps to address hospital visitation and other health care issues affecting LGBT families. However, as we learned from the past, we cannot wait for a government program to help alleviate the discrimination and obstacles that LGBT elders face. On an individual level, proper planning with a comprehensive estate plan that includes a power of attorney for healthcare and a Medicaid asset protection trust can empower LGBT elders. These tools can help LGBT elders to protect themselves, their loved ones, and their finances so same sex partners can age together with dignity.

This post was edited by Alix Burns.

Photo courtesy of bbheart.