Essential Strategies for a Gay Retirement
Notes from the session
In presenting this, we are discussing if the present state of eldercare services are ‘person-centered’ enough. Eventually, we should think about self-advocating and seeing how it’ll work out. If we advocate there will be demand for change, otherwise, there would not be. Currently, many nursing homes and eldercare facilities are still developing a more person-centred care approach. This will likely take time based on the current state of eldercare, and what may contribute to the speed of development will likely come from our self-advocacy skills. Without any demands to be engaged as equal partners in the process of care, the supply in this area will fall short as well.
Yes, the legal aspect is just one part, there is always a social part to gay retirement and eldercare too. So the question is, what does retirement mean to you? Retirement can come in many forms. In the theatre industry so many art practitioners joked about retiring in a house in Thailand, where male nurses serve them when they’re older. Jokes aside, what does retirement look like for gay seniors?
In the Hong Kong movie ‘Shu Shu 叔叔’ there was a scene that is particularly affecting. It was of a retired cab driver whose safe space was a gay bathhouse. In that bathhouse, many gay people came together to eat Tze Char and play mahjong. It made me think: who will be around when we grow old in our 60s and 70s?
When we talk about retirement, we are really talking about 4 big things: (1) Money, (2) Healthcare, (3) Community, and (4) Legal Documents.
Of course, LGBT people have some special characteristics.
Studies have indicated that LGBT people may be less financially better off than ourt cis heterosexual counterparts and we have many barriers to entry to healthcare. Nursing homes for instance, are often gender segregated. Trans individuals seeking gender affirming healthcare often find these services difficult to access or are curtailed. As for rental housing, trans individuals who have not undergone sex reassignment surgery may be forced to room with another person of the same assigned gender at birth.
Even when we talk about cultural competency, really, it’s about whether our current healthcare staff have the language to talk to us and understand what our needs are.
When it comes to being an LGBT-friendly law practice to serve the community, some clients have complex arrangements like throuples. Other lawyers may not be so open minded to such uncommon arrangements.
We also have the issue of the minority stress model.
When we are talking about minority stress, the main thing is recognizing that we all belong to different age groups and have different experiences. The older generation for instance, may not have gone through a very open society and have as a result, faced bullying or discrimination. Minority stress talks about how LGBT individuals face an inherent increase in stress, unlike our cis counterparts, due to their experiences. This in turn negatively affects the individual health of LGBTs. In research, people of minority status, be it LGBT, or POC, these individuals have more health conditions that make it difficult to manage. People who are LGBT may have more mental health conditions and this may not be picked up or they may avoid healthcare systems/ institutions all together owing to their personal experiences of discrimination. Such avoidance and distrust of the healthcare system is an issue, and such trends have been observed in studies in the States indicating that the uptake rate by LGBT individual of healthcare or legal options is low.
Earlier, there was a talk at 1.30 p.m. about wills, mental capacity, et. cetera. That talk has covered the basics of estate planning.
I reiterate: for wills, anyone can make a will. For completeness, a Will does not cover your CPF. You should do a CPF nomination. With a will, you can dictate what assets and how they are distributed. It’s a little bit different for Muslims, who are bound by the Shariah Law. Without a will, a person’s assets will fall under the default distribution law.
As for the Lasting Power of Attorney, the law allows a person to have the choice of appointing who they want to make decisions for them. The Advanced Care Plan is a process where you nominate a healthcare spokesperson to be advocating for you.
Also, consider what kind of life do you want? When you’re in a coma, you have to consider if you want to be tube fed for instance and also consider what other sort of choices would be necessary for your palliative care. These need to be discussed and communicated. The Advanced Care Plan is a process for you to have that conversation. As for Advanced Medical Directive, you need to consider if you want your assigned doctor to continue with life-sustaining treatment or not.
Okay here are four things you need to consider: (1) CPF Nomination, (2) Will/ Intestacy, (3) Lasting Power Of Attorney and (4) Advanced Care Plan (ACP)/ Advanced Medical Directive (AMP). Do note that an AMD can only be done with a certified doctor and another witness. The first signer must be a doctor.
Ok, for LPAs, you can consider appointing Professional Deputies if you have no other options. There are professionals, organizations or companies that you can entrust to help you take over your decision-making roles should you be unable to due to certain health conditions. The problem for us is that some of these organizations are religious. Oh, and in my line of work, most of the time I encounter LGBT couples asking me about their pet and what to do. Generally, your pet cannot sue your executor. But there are professional trustees that may help look after one’s pet post-death.
Lastly, there are also rich LGBT individuals that will do a trust with companies like UBP, Credit Swiss Bank; a Trust document can be executed according to a person’s letter or wishes. The caveat is that you probably need around SGD $3 to $5 Million to set up a trust with some financial institutions.
Continuum of Care in Singapore: This area looks at an individual in terms of their frailty. Those who have increased frailness tend towards institutional care. Frailty may eventually require institutional care at some point. Overall, there isn’t a lot of space for those who want to access institutional healthcare services. As such, a variety of options are often discussed for those who are gradually requiring more support as their health condition deteriorates. Examples of these options include assisted living, nursing homes, home care, centre-based care, community health centres/posts, and senior group homes. Part of the consideration for these options also include the financing considerations for the individual and their families - as their household income can affect the amount of subsidies they can receive. Those of lower socioeconomic status (SES) may tend to choose senior group homes or nursing homes as they may not be afford additional help and services that can enable them to thrive in the community with their health conditions. As there are many different options and consideration factors, it can become quite troubling for any individual to initially identify what is the best living arrangement. LGBT individuals also have to consider whether healthcare practitioners are friendly/ open towards them and also if a gender-affirming environment is necessary. Currently in Singapore, we are still just building our options.
I have heard jokes about older trans folk who go into community homes or rental units reverting back to being gay. They went back to being more masculine-presenting. This is quite scary because this is the reality and future we face. Nursing home activities may not be what we want as well.
To have some control over how we want to retire, here are some tips on several key aspects:
Find someone that you trust and can talk to about your preferences, also what kind of care options you are hoping for. Usually, it may be difficult to share about your identity. There isn’t clear Diversity, Equity, and Inclusion (DEI) training yet in Singapore’s healthcare services but seeing what’s happening overseas, this will likely start coming through to our local healthcare scene. As we are waiting on this, we should still try to find someone. For example, social workers, psychologists, and therapists are quite open. So, this person can help you look for and pool together resources. It’s important that you find people to link you up with possible LGBT-friendly services and options.
Generally, Singaporeans don’t retire well. If you see the old uncles and aunties at the coffee shop, you can tell roughly what their routines are. A lot of them have very limited (and often sedentary) activities, which may not be meaningful more than it is familiar/available. It is quite important that while we are still young, we develop a repertoire of meaningful activities to engage in which continue to improve and maintain our health as we get older.
Be open. It can be challenging to explore new activities. But, try to have an open mindset and don’t restrict yourself.
At the end of the day, we will find that as we age, we may end up more with our peer group, and trying to support each other as informal caregivers. Caregiving burden is a real issue, and it is therefore important that we also explore how to take care of ourselves while caring for others. Knowing and activating the range of available caregiver support services would be helpful in this direction.
This is something we can try to have some control over. For example, through LPAs and chosen families. It’s important to ask at the start when you are entering healthcare services whether your point of contact can be your partner. This is an example of how you can self-advocate to ensure that your main spokesperson follows previously set-up plans.
As for LGBT Clubs and Activity Centers, we should start asking for such spaces so we can continue these activities when we retire.
There’s a Hong Kong elderly queer group called greyinpride. Some of them have very interesting household models. Talking about assisted living, it is currently such a big problem. Recent housing news show that we are not fully integrated into the community as well.
Intergenerational housing as well. Like we said, if we are going to be ageing with each other, there is beauty in intergenerational housing, those are all possible living arrangements to explore. Dominant culture looks towards hiring domestic help in Singapore. You must also consider how you want to navigate your relationship with your caregiver and helper.
Oh and, there’s a senior mobility fund and assistive technology fund (ATF). For ATF, there’s currently a maximum limit of SGD $40,000. If that is something you can make use of to help you with your daily life, please look into it. So, be aware of different funding resources and make use of them.
We talked about this briefly but in terms of occupational strategies (as a potential caregiver given our families of choice), overseas infrastructure such as caregiver resources and support communities are more advanced. However, the problems they face can often be very different culturally and contextually. It is therefore important to find a caregiving community - and Singapore is just starting out. It is important that the communities you seek or join meet your needs, if not, start one yourself.
When we wanted to present this topic, it was about planting the seeds and thinking about what is to come. There are documentaries in the States about this topic. For example, the documentary ‘Ten More Good Years’ talks about how the United States was late in its legalization of same sex marriage compared to Canada started recognizing same-sex rights in the 1990s to 2000s, and the impact it had on gay retirement. These are the same issues facing Singapore now in 2023. We believe a lot in self-advocacy, which is why we are talking about this now.
In the Ibasho House of Ofunato, Japan, there are many seniors living together, organizing and providing back to the community with a strong emphasis on recognizing the unique roles and contributions of each senior.
There is a moving culture in terms of communal and institutional settings, and we need to step up.
Q1. Earlier you mentioned that Professional Deputies tend to be religious groups, can you elaborate on this more?
Some professional deputies may come from religious groups, e.g. social workers from a religious-affiliated organization. There are also trust companies and banks as well but they mostly cater to financial matters.
Q2. You mentioned during the talk that you’ve counselled many queer couples who find themselves in multigenerational household arrangements with each other and their chosen family. I was wondering if you’ve ever encountered cases where LGBT individuals have had to live with their blood/ biological family for a prolonged period.
Yes. There was a gay couple where one of them was in their early 60s and the other in their early 40s, but the 60-year-old was diagnosed with lung cancer. When the elderly gay man passed away, the other partner came distraught saying he did not know how to continue living with his life because of his loss. In his deceased partner’s will, the deceased had left his estate to his partner, and this caused the deceased partner’s family to come after him resulting in an estate dispute. Eventually, he had to move back in with his blood family, and they ended up helping him grieve over the loss of his loved one. I have also met clients who are in intergenerational relationships. They have younger partners. I wouldusually encourage them to think about what kind of future they want. This is because younger gay partners tend to take on that caretaker/ caregiving role. A lot of LGBT individuals usually also end up being the caregivers of their blood family and the issue is that, not a lot of us are equipped to take on that caregiving role. This is not just an LGBT exclusive issue.
What it comes down to is how do we make sure that we are intentionally building communities that will support us. Our niece and nephews may be more open when they’re younger and you never know, that could be a potential resource you can tap on. Of course, this comes with a lot of baggage (as you may still need to navigate your own family relationships), and it is therefore quite important for us to think about how we care about and navigate the relationships around us. It is important to try and see and work beyond your own peers and explore any possibilities.