Older LGBT people and end of life care 

Those who grew up at a certain time might find it difficult to talk with healthcare professionals about their life circumstances and identity. The Marie Curie charity has recently looked into the ways many older LGBT people delay accessing care services, even when they have a terminal illness. Most uncomfortably, it’s been shown that they might think palliative and end of life care services are simply ‘not for them’. Here we look at the ways end of life care isn’t always as accessible to older LGBT people, and how planning ahead can help tackle the problem. 

Anticipating discrimination

The study by Marie Curie has found that older LGBT people anticipate discrimination when they have to face healthcare services near the end of life.

A major thought behind this concern is every new point of contact on the path to receiving care might require someone to ‘come out’, explain their living arrangements or defend their next of kin choice. The report shows that three in five older gay people are not confident that social care and support services will be able to understand and meet their needs.

Another way end of life care might tend to be less accessible for older LGBT people is the thinking surrounding assumptions about family structure, primary care givers and next of kin.

Why might these assumptions be harmful?

Older LGBT people at the end of life may choose to be surrounded by close friends and support groups, rather than birth family, for a variety of reasons. They can then feel concerned that their loved ones won’t be recognised or respected as next of kin because of this.  

The only policy around next of kin in most NHS hospitals and trusts is that the patient just formally state the next of kin. As long as it comes from the patient, and is written down, the phrase isn’t actually defined in law.

The study shows that confusion over who can be named as next of kin and a lack of legal clarity can result in partners or close friends of older LGBT patients being overlooked as the person most capable of acting on their loved ones’ behalf.

Here are some more reasons why older LGBT people are less likely to receive end of life support, from the study:

• Three times more likely to be single
• Less likely to have children
• Far more likely to not be in contact with birth families
• Significantly more likely to have mental health problems

Planning ahead if you’re an older LGBT person

Planning ahead can reduce the anxiety and roadblocks when it comes to the point where you actually need care, or are dying.

Thinking ahead and talking to the people involved in a patient’s care, such as their family, friends, doctors and nurses.

• Share your preferences, let the person closest to you know that you’d like them to be formally known as your next of kin
• Write down anything that’s important to you now that can be applied to the end of life in an Advance Statement. We have a guide on how to start writing one here.
• Apply to appoint someone as a Lasting Power of Attorney: this is someone you trust to advise on what you would have wanted if you reach the point where you can’t make a decision yourself.
• Make sure you get the support you need. If you don’t feel like opening up, Marie Curie offers support.

Find out more

You can read the Marie Curie report here 

See our Help and Support page for more details on where to go

Learn more about palliative and end of life care in our article

Take a look our series of articles on dying at home, in a hospice and in a hospital