AARP AARP States Maryland Caregiving

Caregiving, Isolation Top LGBT Concerns


By Michelle R. Davis

Gay rights advocate Carlton Smith has lived for decades in Baltimore, where he created a close community of friends and fellow organizers.

A longtime HIV survivor who was once estranged from his parents, Smith designated a local friend as his caregiver if health issues arise.

Smith’s parents live in a state he considers “not LGBT-friendly,” and he wouldn’t want to move there. His potential caregiver knows his wishes regarding his health and life.

“I have a great support team here,” Smith said. “You live your life how you want to live it, and you don’t want family to come along and do the opposite of what you want.”

Smith, 54, can make that choice because Maryland is one of more than 30 states to pass a version of the Caregiver Advise, Record, Enable (CARE) Act. The law allows a patient to name a caregiver—including a nonfamily member—to be notified about hospital discharge and briefed on home-care needs.

This is important in the older lesbian, gay, bisexual and transgender community, where many people have created families of choice in place of families of origin, said Alex Kent, a coordinator for SAGECAP Baltimore, which serves older LGBT adults and their caregiving networks.

The program is a partnership between the LGBT Health Resource Center of Chase Brexton Health Care and SAGE (Services & Advocacy for LGBT Elders).

“The people they trust to make decisions for them are not the family members they talk to once a month,” Kent said.

But many people don’t know about the CARE Act, so AARP Maryland is working closely with SAGECAP Baltimore to provide information.

LGBT people are more likely to become adult caregivers than the rest of the population, according to a 2015 AARP/National Alliance for Caregiving report. That’s why AARP and SAGE developed a Prepare to Care guide especially for LGBT caregivers.

AARP Maryland and SAGECAP gave presentations and distributed information on the CARE Act in the Elder Pride tent at the Baltimore Pride Festival in June.

‘Relationships matter’
“For the LGBT community, the recognition that their relationships matter in a medical setting is quite new,” said Nancy Carr, AARP Maryland director for communications. “Our work appeals directly to an unmet need.”

Older LGBT adults face many of the same issues as the aging population generally—medical concerns, poverty, substance abuse and depression. Isolation is a particular problem.

Many older adults kept their sexual orientation a secret from friends, family and even doctors and have a distrust of medical and social institutions, said Nate Sweeney, executive director of the LGBT Health Resource Center of Chase Brexton.

As they age, their small circle shrinks further. About 1 in 3 older LGBT adults live alone, and 40 percent say their support networks have become smaller, according to a SAGE study.

AARP Maryland has hosted or cosponsored events to publicize resources and provide a social outlet, including a Baltimore storytelling event for National Honor Our LGBT Elders Day and a free Movies for Grownups screening of Moonlight, the Academy Award-winning story of a young gay man.

AARP periodically gives presentations at Chase Brexton’s monthly Lunch & Learn workshops for LGBT adults over 50 and their caregivers. Go to and search News and Events for more information.

Michelle R. Davis is a writer living in Silver Spring.

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