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If you were looking for a sexy lesbian topic, you came to the wrong article. But if you are middle-aged and in a lesbian life partnership and want to stay that way till death do you part, read on.

Long term care. What exactly does that mean? In the medical world, long term care (LTC) is the phraseology used to describe the plans we put in place for our old age–especially if we become disabled. If you are aged 45 or older it is not too early to start thinking about. Better yet, sign up as soon as possible. The younger and healthier you are when you purchase a LTC plan, the cheaper it is. In fact, if you develop a serious medical condition at some point in the future, you may be ineligible to purchase LTC insurance at all.

As lesbians, we have special considerations when planning our distant futures. In most states, our rights as a couple are not protected. That means that unless we set up power-of-attorney (POA) for each other and make other significant arrangements, we can be separated when we become unable to care for ourselves.

So, let’s say as a couple you have already contacted a lawyer and have POA papers filed. Now, one of you becomes disabled. Everything is still under control because the able bodied/minded partner is able to handle the arrangements. The able partner can provide care herself, hire help in the home or arrange for appropriate nursing home care. Great.

Now, fast frame 3 years forward and the able partner becomes disabled also. In effect, your partnership ends at this point. The original POA’s you filed for each other would no longer be in effect, because both partners are now unable to make decisions for each other. In this case, each of your secondary named POA’s take over. In states without marriage or civil union protection, it is as if your relationship never existed.

This means you can be placed in separate rooms within a nursing facility. Or worse, in separate facilities altogether, at the discretion of your secondary POA. In fact, even with good intentions, a POA may have no choice in the matter if there are financial constraints, not enough open beds in the nursing facility or for a variety of other reasons. And the system feels no obligation to try to make special arrangements for you as it does for hetero married couples. In addition, according to Affirmations Lesbian and Gay Community Center:

• Nearly 20% of gay seniors have no one to care for them should they become ill, vs. 2% for heterosexual seniors.
• 2/3 of gay seniors live alone vs. 1/3 of heterosexual seniors.

So, what to do? There are four options I have identified, but more may exist and please comment if you know of one! First option, you can buy into a private continuous life care community. Typically, this is an apartment you purchase in an age restricted community when you are both well, but over a certain specified age…usually over 55. There are usually 3 sections to a continuous life care community: independent living (the apartment you purchase), assisted living and a nursing home division. Typically, all of these sections are on the same campus and that is important, as I will explain.

Roughly, the assisted living section is where you will be moved when you are no longer able to cook, clean or do laundry for yourself. The nursing section is where you are moved when you are no longer able to perform self-care functions, such as bathing, eating, dressing or toileting. Since all sections are on the same campus, if your partner is moved to a nursing section, you will still have access to visiting and even taking them back to the apartment during the day. The vital part of this arrangement is to purchase the plan as a couple and make sure you have contracted with the facility that you will be treated as a couple. Before signing up, ask for a codicil to the contract assuring you of this.

Option two: Contract with RainbowVision. These are communities that are devoted solely to the gay and lesbian population and may include assisted living and/or home care divisions. Right now they are only located in New Mexico, California (where there is gay marriage protection anyway) and in Canada (ditto). Hopefully they will be building more facilities throughout the country.

Option three: Purchase an aging-in-place plan. Aging-in-place means you and your partner will not be moved from your home. Instead, caregivers come to you, up to 24/7/365 if that is what you need. An example of such a plan is the one provided by the Society of Friends (Quakers) in Pennsylvania, called Friends Life Care At Home. For the lesbian and gay population, the advantage is that you will not be separated, especially if you have joint ownership (with rights of survivorship) of your home or condo. The Friends’ service is unique in that you contract directly with them rather than with an insurance company. Also, the Friends have a strong history of being gay-supportive. This is the option my partner and I have chosen. Check your locale for similar plans.

Option four: Purchase as much LTC insurance as you both can afford. This will enable you to afford a higher rated private nursing home placement, where they are more likely to accede to your wishes (because you are a paying customer rather than a medicaid customer). Then see a lawyer to set up a living will that states your wishes to be placed together. And hope that it gets recognized.

While it may not be a particularly pleasant topic to think about, it is an important one. Your distant future is best planned while you are both able bodied/minded. It is even more important to us in the lesbian population, since we are at increased risk for being separated at our most vulnerable time in life.

DISCLAIMER: Pat Cheney is a life coach–not an attorney. Please see a qualified attorney for counsel specific to your situation.