As the Coronavirus impacts more people we’re hearing devastating stories of what’s happening to seniors -- particularly those who live in congregate settings. Seniors living in complete isolation, losing contact with loved ones, or dying with no loved ones nearby. It’s heartbreaking.
 
But what you aren’t hearing about is how much harder this social isolation has been for our lesbian, gay, bisexual, transgender or queer (LGBTQ) seniors. This is a community that was largely ignored -- invisible -- before the spread of COVID-19. But the effect of social distancing on these 3 million seniors has been devastating. 

LGBTQ elders have always feared who will speak for them. But, imagine if health care forms worried less about what is your spouse’s name, and more about what matters to you, who do you love, who do you want in the room? Check out these links to learn more about the work Sojourns scholar, Carey Candrian, is doing to ensure LGBTQ elders have a voice and receive the support and connection they deserve.
 

• Listen to Carey speak more about her research on a HealthChangers podcast: The Power of Communication: Carey Candrian on Improving Health Equity in How LGBT Seniors Experience Care and on National Public Radio's Here and Now: Keeping LGBTQ Seniors Out Of The Closet
• Watch Improving Serious Illness Care for LGBTQ Seniors - part of the PBS Newshour Brief but Spectacular series where Carey dives deeper into how health care transformation begins with open discussions and the creation of space for all to receive the support, connection and advocacy that they deserve. 
• New resource guide from NHPCO (co-authored by Carey) on providing equitable and inclusive hospice and palliative care for LGBTQ+ patients and those who care for them. Timely, necessary, and comprehensive. Free to download here: http://nhpco-netforum.informz.net/z/cjUucD9taT04NDA4NzI1JnA9MSZ1PTc5NjE3MTg3MCZsaT03MjAzNDg5Ng/index.html

In addition, read the excerpts below from more than thirty in-depth interviews Carey conducted with lesbian women between the ages of 56 and 84. The meetings took place just before and as Colorado was heading into lockdown to prevent the spread of COVID-19. The concerns raised by the interviewees are not unlike the headlines: fear of loneliness, fears about having their wishes be honored, and fear of dying alone. 
   
For many LGBTQ seniors, friends become their “family of choice.” Because the family they were born into may have rejected them. Imagine losing your only support system -- the people who knew your true identity and who you really love.
   
Imagine if hospital visitation policies for LGBTQ elders were talked about with as much devastation as those being talked about right now with restrictions to family members entering the ICU. 
   
Imagine if dying alone was not your only fear but dying with the tragedy of “having a bag” over your head to avoid discrimination at the bedside was taken more seriously. 
   
Imagine if all senior living communities had an LGBTQ social group, like they have a yoga class, and bible study, and flyers could be posted on elevators without residents ripping them off to remind people that LGBTQ elders need community like everybody else.  
   
Imagine if living with chronic depression, PTSD, and anxiety was already your new “new normal” before stay-at-home and social distancing orders?
   
Imagine if inclusive end of life grief support -- like for widows of wives -- was more readily accessible, provided, and validated to all -- regardless of sexual orientation and gender identity?
   
Imagine if solutions and interventions to improve health equity among disenfranchised populations were community-initiated so they were designed by and for the people most affected?
   
The women interviewed -- and millions of other LGBTQ seniors around the country -- are absent from our national discourse surrounding this pandemic. Just as they’re nearly invisible most of their lives. Long before the pandemic they'd lost jobs, friends, family, and homes because of who they are. In hospital settings some have checked the box for “emergency contact” instead of “married” despite being married over 30 years -- in fear of poor care. They are used to “disenfranchised grief” -- which means grieving in isolation and without society understanding that they’ve lost a spouse -- because their spouse was the same gender.  Seniors who are LGBTQ are also used to being alone. But this doesn’t mean they’re OK being alone. 

What this all means is when visitors are allowed in elder congregate settings again, and hugs are permitted, isolation and loneliness will still persist for LGBTQ seniors. 
 
Among the many things we are learning with this pandemic are the effects of loneliness for physical and mental health. We must do a better job at keeping all our older citizens connected. And we need to understand that LGBTQ elders -- with non-traditional spouses and often no children or extended family to rely on -- face additional obstacles.  As we begin to move forward from this health crisis, we must create spaces and communities -- whatever this looks like -- for all seniors to finally have the voice, the support, the connection, and advocacy that they deserve.  

Author ID: Carey Candrian is an assistant professor of health communication at the University of Colorado Anschutz Medical Campus and a Cambia Health Foundation Sojourns Scholar.