Coping strategies used by LGB older adults in facing and anticipating health challenges: A narrative analysis

ABSTRACT

Given that lesbian, gay, and bisexual (LGB) older adults face notable health disparities compared to their heterosexual counterparts, there is a need for understanding how LGB adults cope with health challenges in late life. The current study analyzes narratives from nine LGB adults age 65 and older living in an urban area in the Southeast United States. Participants spoke of coping strategies related to health promotion behaviors, shifting perspectives of health and body, trusting in spirituality for comfort, and accepting the end of life. We discuss implications for social services professionals who work with older LGB adults and for future research.     

Caregiving and Care Receiving Among Older Lesbian,Gay, and Bisexual Adults

Abstract

A survey research design was used to examine caregiving, care receiving, and the willingness to provide caregiving among lesbian, gay, and bisexual (LGB) older adults recruited from community groups. More than one-third reported receiving care from people other than healthcare providers in the last five years; more than two thirds provided care to other LGB adults. Those who had given care were more likely than non-caregivers to give care in the future. The gender and sexual orientation of recipients of future help affected participants' willingness to provide care, as did their education level and style of coping. Participants willing to provide care to older LGB adults perceived such experiences to be less burdensome and more personally rewarding than those who were un-willing to provide care.     

Planning for the Residential Needs of Lesbian,Gay, Bisexual,and Transgender Older Adults

Lesbian, gay, bisexual, and transgender (LGBT) older adults experience housing-related barriers. Previous research has described residential challenges experienced by this population, but few studies have examined implementation of housing solutions. This exploratory study conducted 7 semistructured phone interviews with program directors and/or development managers from initiatives offering residential services to LGBT older adults. Qualitative analysis identified themes that characterize the implementation of housing solutions. Study results suggest that future residential solutions for LGBT older adults should consider housing in relation to other aging-related barriers and frame solutions that promote collaboration among community actors (e.g., residential and service providers).     

Gay, lesbian, and bisexual foster parents: strengths and challenges for the child welfare system

Historically, a shortage of skilled and dedicated foster parents has existed in America. Lesbian, gay, or bisexual (LBG) foster parents have received little attention in the published literature. This article documents the challenges and successes of a group of 60 LGB foster parents. All participants provided foster parenting for public (state or county) agencies. The primary successes of this group included meaningful and gratifying parenting and successful testing of whether adoption might be a natural next step after foster parenting. The primary challenges included insensitive, inappropriate, and difficult social workers; state or local laws that worked against successful foster parenting by LGB adults; failure to recognize parents' partners; and lack of support by the system to acknowledge the important role of LGB parents. Numerous recommendations are identified for improving how LGB foster parents are supported within child welfare systems including foster parent and social worker training in LGB issues.     

Psychotherapy with Lesbian,Gay, Bisexual,and Transgender Older Adults

A small literature has addressed psychotherapy with lesbian, gay, bisexual, and transgender (LGBT) samples over the past two decades. Older adults have also been investigated in a growing number of psychotherapy research studies. However, psychotherapy specifically with LGBT older adults has not received adequate investigation. This review relies on converging lines of research to provide an integrated discussion of evidence-based psychological treatments (EBTs) with current research and clinical observations in the field of gerontology and suggests ways in which these topics can inform psychotherapy practice with LGBT older adults. We summarize current research on aging in several areas of practical interest to psychotherapists seeking to apply EBTs in their work with LGBT older adults. These areas include: adult development, coping, stigmatization, social context, and the effects of cohort membership. The results of these studies belie stereotypes regarding both the aging process, in general, and more specifically LGBT older adulthood, with significant implications for the practice of psychotherapy. EBTs are adaptable to a variety of issues encountered in later life by LGBT older adults, and these modifications to therapeutic technique are addressed throughout.     

Effect of resistance-exercise training on cognitive function in healthy older adults: a review

Several studies have demonstrated that exercise helps reduce or prevent cognitive deterioration among older adults, and recent studies have further examined the effects of resistance-exercise training on cognition. The purpose of this review was to examine the role of resistance-exercise training on cognition in healthy older adults. Specifically, it describes the definition, health benefits, and the design of resistance-exercise training. The authors also review the research related to resistance exercises and cognition and found that this exercise modality may enhance specific cognitive performances. Next, they examine the potential mechanisms underlying resistance exercise and cognitive enhancement. Finally, they consider potential therapeutics and recommendations for further research on resistance-exercise training and cognition in older adults.     

Living a Calling,Life Satisfaction,and Workplace Climate Among a Lesbian,Gay, and Bisexual Population

Previous research on calling has resulted in a model that relates living a calling to life satisfaction through job satisfaction and life meaning. However, no research has examined this model in a lesbian, gay, bisexual (LGB) population. With a sample of 171 sexual minority adults, the current study aimed to (a) test the fit of an established model of living a calling and life satisfaction and (b) examine how having a supportive LGB workplace climate functioned within this model. Results revealed an excellent fit of the model and that a supportive LGB workplace climate predicted both living a calling and job satisfaction. In addition, the relation of living a calling to life satisfaction was fully mediated by life meaning and job satisfaction, and the relation of climate to life satisfaction was mediated by job satisfaction. These results suggest an expansion of the potential utility of the calling construct to an LGB population.     

Victimization experiences of lesbian, gay, and bisexual individuals: a meta-analysis

This meta-analysis quantitatively compiled the results of studies from 1992 to 2009 to determine the prevalence and types of victimization experienced by lesbian, gay, and bisexual (LGB) individuals. Based on the results of three searches, 386 studies were retrieved and coded. Comparisons were made across all LGB individuals (138 studies), between LGB and heterosexual individuals (65 studies), and between LGB females and males (53 studies), with over 500,000 participants. Multiple types of victimization were coded, including discrimination, physical assault, and school victimization. Findings revealed that for LGB individuals, reports of victimization experiences were substantial (e.g., 55% experienced verbal harassment, and 41% experienced discrimination) and some types have increased since a 1992 review, while others have decreased. LGB individuals experienced greater rates of victimization than heterosexual individuals (range: d = .04–.58). LGB males experienced some types of victimization more than LGB females (e.g., weapon assault and being robbed) but, overall, the gender differences were small. It can be concluded that LGB individuals still experience a substantial amount of victimization. Implications for research methods are discussed, including recommendations for sampling and measurement of victimization.

[Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Sex Research for the following free supplemental resource(s): Supplementary Tables. These tables are referred to in the text of this article as “Table S1,” “Table S2,” etc.]     

The LGBQ Social Climate Matters: Policies,Protests, and Placards and Psychological Well-Being Among LGBQ Emerging Adults

Sexual minority youth, including emerging adults, are at risk for negative health outcomes. Minority stress theory posits that heterosexism can contribute to these outcomes among sexual minorities. Researchers have tested this theory with respect to interpersonal heterosexism; however, little attention has been given to macro-level and environmental forms of heterosexism, especially among lesbian, gay, bisexual, and queer (LGBQ) youth. In this study, we examine the role of objective social climate (LGB state-level policies) and experiential distal and proximal environmental microaggressions on the psychological well-being of LGBQ emerging adults. Furthermore, we examine the role of LGBQ identity salience as a moderating factor on the macro/environmental-heterosexism and well-being relationship. Multivariable linear regression results suggest that living in a state without same-sex marriage laws is associated with greater self-esteem, whereas both distal and proximal environmental microaggressions are risk factors for anxiety and perceived stress. Furthermore, identity salience can ameliorate the effects of distal microaggressions and intensify the effects of proximal microaggressions and same-sex marriage legislation. Implications for practice with sexual minority youth are discussed.     

Social Support as a Predictor of Psychological and Physical Well-Being and Lifestyle in Lesbian,Gay, and Bisexual Adults Aged 50 and Over

Aging lesbian, gay, and bisexual (LGB) adults often differ from their heterosexual counterparts in their social network. This study examined a sample of 220 LGB adults over 50-years-old; most were White, well-educated, and employed. Social networks were used to predict physical and psychological well-being and lifestyle/risk. Respondents had on average 2.5 members in their social network; 56 percent had at least one close friend. Support from friends rather than family predicted higher mental quality of life and lower depression, anxiety, and internalized homophobia. Study participants functioned within normal ranges of most psychological measures. However, they had serious health risks due to alcohol consumption and obesity (inwomen). Findings add further evidence of the importance of friends in providing social support among LGB adults.     

Ideology,Context, and Obligations to Assist Older Persons

Are older adults responsible for meeting their own needs, is it their children's obligation to care for them, or is there a collective responsibility to see that older adults have their needs met? The purpose of this study was to examine the normative obligations of individuals, family members, and the government to provide for the needs of older adults. The authors examined how ideological beliefs and contextual circumstances are related to beliefs about obligations to older persons. Data were collected from phone interviews of a sample of 270 adults who were over 40 years old. The results indicate that ideological beliefs were better predictors of normative obligations than were contextual variables. Future research should reflect the complex relationships among ideological beliefs, contextual circumstances, and normative obligation beliefs.     

Conducting Research with Lesbian,Gay, and Bisexual Populations: Navigating Research Ethics Board Reviews

The acceleration of research with lesbian, gay, and bisexual (LGB) populations amid existing sexual prejudice and advancing human rights leads to sometime conflicting stances between researchers and ethics boards over acceptable methodological practices. Ethics boards, charged with ensuring the safety of research participants, may engage in ostensibly protective stances regarding potential risks and informed consent that are unwittingly founded upon negative stereotypes of LGB populations. We examine four case studies that demonstrate divergent stances between researchers and ethics boards, researchers’ responses to ethics reviews and their resolution. Based on these cases, we describe themes and strategies for researchers working with LGB populations in responsibly navigating ethics board concerns.     

Institutional abuse of older adults: what we know, what we need to know

Although Canadian policies support "aging in place," there still will be a number of older adults who will require institutional care in the future. Most research on elder abuse, however, has focused on domestic abuse and has paid less attention to institutional abuse. The purpose of this article is to comprehensively review current research to identify gaps in knowledge and methodological issues in the study of institutional abuse. Overall, 49 studies in English and 20 studies in French were reviewed, and 11 key-informant interviews were conducted with methodological experts. Methodological challenges are addressed in light of the review and interviews.     

Traumatic Experiences and Drug Use by LGB Adolescents: A Critical Review of Minority Stress

High rates of illicit drug use found among lesbian, gay, and bisexual (LGB) adolescents are often attributed to unique and chronic traumatic events tied to sexual minority identity. Although initiation of drug use is relatively common within adolescence, little research contributes to our understanding of the disparities found among LGB adolescents. This review synthesized existing literature to determine if the minority stress model is applicable to LGB drug use disparities and fits within a trauma framework. Findings indicate that minority stress experiences have been inconsistently related to drug use among LGB adolescents. Implications for future research and practice are described.     

Ambivalence and Living Apart Together in Later Life: A Critical Research Proposal

Most unattached older persons who would like an intimate partnership do not want to remarry or be in a marriage‐like relationship. A growing trend is to live apart together (LAT) in an ongoing intimate relationship that does not include a common home. We address the debate about whether LAT constitutes a new form of intimate relationship in a critical assessment of research on LAT relationships that applies ambivalence and concepts from the life course perspective. We conclude that among older but not younger adults, LAT relationships are generally a stable alternative to living with a partner, negotiated in the context of current social institutions and arrangements. We propose research questions that address later life living apart together as an innovative alternative intimate relationship. We encourage comparative work on the unique challenges of later life living apart together, their implications for other family ties, and their connection to social and cultural arrangements.     

Families in Later Life: A Decade in Review

Later-life families encompass the legal, biological, romantic, and kin-like relationships of persons ages 65 and older. Research on older families has flourished over the past decade, as population aging has intensified concerns regarding the capacities of families to care for older adults and the adequacy of public pension systems to provide an acceptable standard of living. Shifting patterns of family formation over the past half-century have created a context in which contemporary older adults' family lives differ markedly from earlier generations. Decreasing numbers of adults are growing old with their first and only spouse, with rising numbers divorcing, remarrying, forming non-marital romantic partnerships, or living single by choice. Remarriage and the formation of stepfamilies pose challenges and opportunities as older adults negotiate complex decisions such as inheritance and caregiving. Family relationships are consequential for older adults' well-being, operating through both biological and psychosocial mechanisms. We synthesize research from the past decade, revealing how innovations in data and methods have refined our understanding of late-life families against a backdrop of demographic change. We show how contemporary research refines classic theoretical frameworks and tests emerging conceptual models. We organize the article around two main types of family relationships: (1) marriage and romantic partnerships and (2) intergenerational relationships. We discuss how family caregiving occurs within these relationships, and offer three promising avenues for future research: ethnic minority and immigrant families; older adults without close kin (“elder orphans”); and the potentials of rapidly evolving technologies for intergenerational relationships and caregiving.     

Diversity and inclusion in local governance: An Australian study of seniors' participation

The importance of hearing older people's voices within local governance processes is well recognised; however, the increasing diversity among older people makes this complex. Questions around inclusion and exclusion, representation and representativeness create challenges for the ways in which diverse older people are engaged. This paper uses the results from a qualitative study conducted in Australia to address the key research question: how does diversity impact on older people's perceptions and experiences of barriers to participation in local governance? Results indicate that diversity impacts not simply on what barriers are reported by seniors, but on how those barriers are experienced. Patterns among the barriers reported and their relationship with diversity reflect questions around representation and inclusion. Thus despite broad acceptance of the notion that understanding diversity is integral to inclusion, challenges remain for older people's engagement with local governance processes. A deeper understanding of diversity and how it relates to inclusion are required.     

Aging and undocumented: The sociology of aging meets immigration status

Being undocumented is strongly correlated with low wages, employment in high risk occupations, and poor healthcare access. We know surprisingly little about the social lives of older undocumented adults despite the vast literature about youth and young undocumented migrants. Literature about the immigrant health paradox casts doubts on the argument that unequal social conditions translate to poorer self-reported health and mortality, but few of these studies consider immigration status as the dynamic variable that it is. Reviewing research about older migrants and minorities, I point to the emergence of undocumented older persons as a demographic group that merits attention from researchers and policymakers. This nexus offers important lessons for understanding stratification and inequality. This review offers new research directions that take into account multilevel consequences of growing old undocumented. Rather than arguing that older-aged undocumented migrants are aging into exclusion, I argue that we need careful empirical research to examine how the continuity of exclusion via policies can magnify inequalities on the basis of immigration status and racialization in older age.