Cultural Considerations for Older LGBTQ Adults During the COVID-19 Pandemic: Case and Review

Introduction Throughout the COVID-19 Pandemic, older adults have been disproportionately impacted by both illness and fatalities. Of the nearly 39 million adults over age 65 in the United States, approximately 2.4 million older adults identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). LGBTQ older adults face unique challenges due to their intersecting identities and histories, including the effects of heterosexism, ageism, and being more likely to live alone, be single, and not have children. As we implement social distancing as a primary COVID-19 prevention method, older adults have faced increased isolation. Methods We present one case of a lesbian older adult patient who has experienced increased depression during the COVID-19 pandemic. A table will be added featuring culturally competent recommendations for LGBTQ older adults from a literature review. Results A 77-year-old female with history of major depression, attention deficit disorder, hypertension, xerostomia, and polymyalgia rheumatica. The patient has been on multiple trials of medications for depression as well as ECT treatments. She described being a shy child and felt criticized and often rejected by her mother. She was initially engaged to a man and after some years fell in love with a woman. The patient is currently single and has no children. She typically has a strong support system with her lifelong friend and attends church. She transitioned from independent living to an adult living facility, with the hope of increased social activity and connectedness. However, due to COVID-19, she experienced her move as extremely difficult, and was disappointed that all social activities were canceled. For a period of several months, she was unable to visit her chosen family, was limited to attending church via Zoom, and was restricted from multiple areas of the complex. As a result, she reported increased depression, anxiety, and difficulty sleeping with passive suicidal ideation due to isolation and no direct family support. Conclusions The latest research highlights current vulnerabilities and health disparities of the older adult population, as well as ways to increase support and resiliency through the ongoing COVID-19 pandemic. Older LGBTQ populations are at disproportionately higher risk for mental health conditions and with the current social distancing measures in place, social isolation and loneliness has been exacerbated. Connection with accepting family and community are well documented in the literature as key protective factors and sources of resiliency in LGBTQ populations. Culturally competent care is integral to psychiatric treatment of older LGBTQ adults. Funding Not Applicable