Michael Brady is grateful for small kindnesses offered at the nursing home where his longtime partner faces late-stage Alzheimer's disease. Staff members, for example, point to photos of the couple and ask where they were taken.

"They show an interest in us as a couple," said Brady, 65, of Golden Valley. "I appreciate the fact that they treat me like a spouse."

Brady, who is gay, knows how lucky he is. At the first nursing home in which he placed 73-year-old Ed Mikkola, the staff told them they could not kiss goodbye publicly. "We had to do that in his room," Brady said.

They were out of there in three weeks.

Brady's story seems almost sweet in comparison to other startling tales coming to light among aging men and women in the LGBT community, including a transgender woman forced to live in the men's wing of a care facility and wear men's clothing, physical abuse of LGBT elderly by staff and other residents, and a nursing home worker arriving with a Bible to help the elder pray and ask for forgiveness, or to be "cured."

"I can fight for Ed, but not all people have that," said Brady, a retired teacher.

Just how true his words are will be crystal clear this Thursday, with the public screening of "Gen Silent." The 2011 documentary features six people in the LGBT community, including an interracial gay couple, navigating the health care system. It's a reminder that not everybody is receiving safe, quality and equal care as they age.

Elder abuse has long been a concern for families, nursing home providers and lawmakers. The rape of an 89-year-old nursing home resident by her male caregiver in northern Minnesota that's recently made headlines highlights the potential dangers to this vulnerable population.

But the LGBT community faces unique challenges, said Greg Voss, executive director of the Twin Cities Chapter of Little Brothers — Friends of the Elderly, a nonprofit agency providing home visits, meals and activities to older adults.

He points to a 2012 Twin Cities LGBT Aging Needs Assessment Survey, which found that members of this population are more likely to live alone and are less likely to have a caregiver or children to look after them as they age.

This is because most grew up in an era when it was too risky to come out, so they moved away from families of origin, in the hope of living an authentic life elsewhere. Many who were brave enough to come out lost families and friends in the process.

The film points out struggles that most of us take for granted, like coming up with an emergency contact on medical forms. "My landlord?" they wonder. "I don't know who to put here."

In addition, LGBT elderly are more likely to suffer physical and emotional abuse by caregivers, either as punishment for, or denial of, their sexual orientation.

Not surprisingly, many choose to avoid care altogether, left to die alone.

Little Brothers is sponsoring the forum with Prime Timers MSP, a social group for gay and bisexual men over age 50.

Paul Blom, owner and CEO of Bloomington-based Right at Home, also has had a stake in this issue since seeing the first troubling survey results regarding aging gay and lesbian people about seven years ago. His in-home care agency serves 540 seniors throughout the Twin Cities.

Some fears may be more perception than reality, Blom said, but that doesn't mean they should be ignored, particularly when considering the person's history.

A 90-year-old lesbian, for example, was a teenager during the 1930s when electric shock therapy was touted as a "cure" for homosexuality, he pointed out. In the 1950s, gays and lesbians were banned from federal employment.

No wonder many remain skeptical about how they will be treated in the health care system.

Good training, and honest conversations, such as that set to occur Thursday, are important first steps toward creating trust and competent care, Blom said. Even something as simple as an affirming question can make a huge difference, such as moving past "marital status," and asking instead, "Tell me about the significant relationships in your life."

"Gen Silent" reminds us that too many among us cannot do even that. One particularly sad segment of the film focuses on a 59-year-old transgender woman dying of cancer. When she is hospitalized, no family member steps forward to care for her. A generous team of volunteers rallies to support her, but it's still a heartbreaker.

Brady's heart is breaking too, but for a different reason. He and Mikkola, who were married in a Lutheran church in 2006, will never again travel, or go the Guthrie or Orchestra Hall, or enjoy long conversations. "He seems to know who I am," Brady said. "He'll pick up my hand and kiss it."

Brady came out at 52, after a 25-year marriage. He has two grown children and knows that if and when his time comes to need help, loving family will step up. Most important now is that he has found a welcoming place for Mikkola.

"They refer to me as Ed's spouse," Brady said. "You can tell they're loving people."

The "Gen Silent" screening is at 6 p.m. at the Center for Changing Lives, 2400 Park Av. S., in Minneapolis, followed by a panel discussion about elder isolation with geriatric professionals and legal experts.

The evening is free and open to the public, although registration is recommended. To register, contact info@littlebrothersmn.org or call 612-746-0726.)

gail.rosenblum@startribune.com

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