(Editor's note: This is the last article of a series. Click to see Part 1 for links to the other stories.)
SAN FRANCISCO -- Having been diagnosed with Parkinson's disease, Bernard Mayes was confronted with a stark choice. Should the fiercely independent gay man move into a senior assisted living facility?
Or was it feasible to hire caregivers so he could remain in his home in San Francisco's Bernal Heights neighborhood? Mayes, 84, like many elders of any sexual orientation, preferred to live out his life in his own home.
At the time of his diagnosis, Mayes was living with a younger gay male couple he helped introduce while living on the East Coast. An ordained Anglican priest, Mayes, who had immigrated to the United States from Britain, later presided over their wedding.
Eventually, though, said Mayes, "You deteriorate until you become incompetent. My friends and I decided I should be in permanent care. I couldn't go it alone."
Trouble despite his brilliant career
But despite Mayes’ distinguished background--as a priest, teacher, university dean, lecturer, author and broadcaster—he discovered that even the City by the Bay has a shortage of affordable retirement communities that are both LGBT-friendly and close to his extended family of friends.
One of his former housemates, Matthew Chayt, recalled, "It was a process of several years where we all sort of struggled with what was the right thing to do."
Chayt, 37, first met Mayes when he enrolled at the University of Virginia in 1995 and Mayes, then chair of the school’s communication department, became his faculty adviser.
Years later, while both were living in Washington, D.C., Chayt attended a party Mayes co-hosted with his friend, Will Scott. Chayt and Scott fell in love, and when Scott, an Episcopal priest, was hired to work at San Francisco’s Grace Cathedral, they convinced Mayes to move west with them.
Mayes had first lived in San Francisco in the late 1950s, when the Episcopal Diocese of California hired him to oversee a parish.
In those years, Mayes’ many capabilities would emerge as he established San Francisco Suicide Prevention, and later, having been a journalist for the BBC, founded the city’s KQED public radio. Her also served as the executive vice president of KQED TV and went on to cofound National Public Radio, serving as NPR’s first working chairman.
In an interview last fall, Mayes acknowledged that he had never planned out his golden years. "It is something we hold off for ourselves until we need to do something," he said. "The question is: Is it better off being by yourself or in a community? A community, though, has rules, which doesn't sit very well with me. I like to be independent."
Scott, now 34, and Chayt initially pondered whether they could serve as Mayes’ caregivers. But with each building his career, they determined doing so wasn't feasible.
Few assisted living options
So the trio began searching the Bay Area for an assisted living facility that would best suit not only Mayes' health needs, but also his personality and lifestyle. Chayt observed, "Bernard has lived most of his life so far, and will continue to do so, very open and, quite rightly, being unapologetic about being gay and being himself in other ways."
Scott recalled, "I was expecting there to be more options in the Bay Area for LGBT seniors," he said. "There were some, but we need more. If there is any place in the world gay folks in old age would want to be, this seems like the place to be."
Although facilities outside the city were less expensive, they were far from Mayes' support network and social life in San Francisco.
"We knew the further out of the city he was, we would see him less often and he would be socially isolated," said Chayt.
In the fall of 2012, Mayes moved into The Heritage, a retirement community in an historic Julia Morgan-designed building in San Francisco's Marina district. Operated by the nonprofit San Francisco Ladies' Protection and Relief Society, The Heritage also has a 32-bed on-site health center for residents who require more specialized health care.
"I still don't know if it was the right decision to make. There are all women here," said Mayes. "It is an excellent location right near parks with views of the Golden Gate Bridge. But it is a long way from the center of the city."
He still wishes he could have remained in his Bernal Heights home. The main barrier to staying, he said, was, "I couldn't walk up the hills."
Care needed closer to extended families
Location has also been an issue for Fountaingrove Lodge, an LGBT-focused retirement community in Santa Rosa, north of San Francisco. Since it opened its doors last November, the facility has found it can be a hard sell among those LGBT seniors already living in gay-friendly cities, such as San Francisco and Palm Springs.
"Yes, we have run up to some barriers in places, San Francisco being one of them, because it is such a great community there for LGBT people," said Chris Kasulka, president and CEO of Oakmont Management Group. The firm operates the 77-unit Fountaingrove Lodge, plus a 22-unit facility called The Terraces for seniors, both LGBT and straight, needing specialized care for memory impairments or Alzheimer's disease.
Although the company has no plans to open additional LGBT-friendly retirement communities, Kasulka said Oakmont would look at property closer to urban gay neighborhoods.
"People are really ingrained into their local community, like the [San Francisco’s] Castro or Palm Springs, where their family is--their extended family is--and the people they know are," she said.
As Mayes visited various facilities, he said he made a point not only to be out, but also to inquire if a facility had other LGBT residents. "It was a very important aspect of the whole search. I insisted they be gay friendly at least," he said. "They were all uniformly supportive but ignorant as to how many they had."
Friendly as other residents have been at The Heritage, Mayes has not encountered other LGBT residents there. Generally, he said, "There are people who are but they are terrified to reveal it. People in their 80s lived through a lot of homophobia," said Mayes. "It is very difficult, even now, to broach the subject."
One of the biggest adjustments for Mayes has been being assigned seating for meal times and sharing a table with the same people for three months at a time.
"As a person who has been very independent all my life, I find that very difficult to bear," said Mayes. "Still, the biggest concern for me is losing my freedom. Groupiness is what I fear most."
Task Force Calls for LGBT Senior Housing Innovation
There is a growing need for more LGBT-focused retirement communities throughout the United States, where today’s 3 million LGBT elders is expected to double by 2030.
San Francisco has and estimated 20,000 LGBT seniors 60-plus. A 2013 survey of he city’s LGBT city residents (a sample of 616 people ages 60 to 92 found) less than 7 percent living in senior housing, assisted living facilities, nursing homes, or an age-restricted community.
"LGBT seniors are more likely to require facility-based care than straight seniors because they are less likely to have informal caregivers available to help them remain in their homes," according to a recent report by the city’s LGBT Aging Policy Task Force [http://bit.ly/1hC5Hct], which commissioned the survey.
In addition, "LGBT seniors are reluctant to access long-term care facilities for fear of discrimination," said task force member Marcy Adelman, Ph.D., who co-founded the LGBT senior services agency Openhouse. [http://openhouse-sf.org/]
To ensure facilities in San Francisco are meeting the needs of their LGBT residents, the task force recommended that the city adopt an ordinance to ensure LGBT seniors in long-term facilities receive "appropriate care and treatment" and require licensed-care facilities to have a dedicated LGBT liaison among its staff members.
In its report, the task force noted, "The city has a significant opportunity to innovate and lead in demonstrating how LGBT seniors should be cared for in long-term care facilities."
-- Matthew S. Bajko
Matthew S. Bajko wrote this article for Bay Area Reporter through the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America. This post was originally published on New American Media.)