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

Abstract

IntroductionThroughout the COVID-19 pandemic, older adults have been disproportionately impacted by both illnessand fatalities. Of the nearly 39 million adults over age 65 in the United States, approximately 2.4 millionolder adults identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). LGBTQ older adults faceunique 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 socialdistancing as a primary COVID-19 prevention method, older adults have faced increased isolation.MethodsWe presented a case of a lesbian older adult patient who has experienced increased depression during theCOVID-19 pandemic. A table will be added featuring culturally competent recommendations for LGBTQolder adults from a literature review.ResultsA 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 asECT treatments. She was initially engaged to a man and after some years fell in love with a woman. Thepatient is currently single and has no children. She typically has a strong support system with her lifelongfriend and attends church. She transitioned from independent living to an adult living facility, with the hopeof increased social activity and connectedness. However, due to COVID-19, she experienced her move asextremely difficult, and was disappointed that all social activities were canceled. For a period of severalmonths, she was unable to visit her chosen family, was limited to attending church via Zoom, and wasrestricted from multiple areas of the complex. As a result, she reported increased depression, anxiety, anddifficulty sleeping with passive suicidal ideation due to isolation and no direct family support.ConclusionOlder LGBTQ populations are at disproportionately higher risk for mental health conditions and with thecurrent 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 psychiatrictreatment of older LGBTQ adults.