I live in a coastal community in Southern California. I have shells and seahorses and mermaids all over my house. My house is near a lagoon and I like to take my standup paddle board or my kayak there and be alone with nature and my thoughts, though I don’t go as often as I’d like. My boyfriend is a singer, so I frequently go out and enjoy his music and his band community. My house is full of kids, animals, laughter, and noise. These things I have described to you are lifestyle choices. Tomorrow I can decide to design my life around a country theme, take up archery for a hobby, and refuse to attend my boyfriend’s shows. I can enforce quiet in my home and get rid of the pets. Then I would have a different lifestyle and it all would be my choice. My lifestyle choice.

An area of my life where I don’t have much of a choice is my sexual orientation. I’m heterosexual. I was born that way. I’m a woman who’s always been attracted to people of the opposite gender. I remember feeling that way when I was a small girl. Before the age of seven, I had a crush on a boy in my kindergarten class, on Superman from the television series, and sorry, on a priest in my Catholic school. I still love men. This isn’t a lifestyle choice. It’s just the way I was made for this lifetime.

A possible result of my orientation is that I have four children. They are good kids, devoted to their dear mom. I trust that when I’m older, they will all pitch in with my care coordination. Whether in a private home or a long-term care community, they will be loving and outspoken advocates for me. I realize that I am very fortunate. Many people are not that lucky, because they will not have children to advocate for them; they are a different orientation than I am and having children is simply more complicated for them. They are homosexual or bi-sexual or one of the many other orientations that are non-heterosexual.  And some people have the same orientation as I have but, unlike me, they are transgender.

They have traits that are not lifestyle choices. Traits. Unchangeable. These people are being true to themselves and being honest with the world about it. Living the way you are designed is not a lifestyle choice; it is simply living.

Lifestyle choice versus living. Aren’t we just talking semantics here?  No, we aren’t. Because when we are talking about services and rights for our fellow citizens, we want to be sure we all get the care and respect we deserve every day, especially as we age. We don’t want caregivers stating that they don’t want to provide assistance to a homosexual man because they don’t agree with his lifestyle choice anymore than we would like a caregiver to say they are unwilling to care for a black woman because they don’t agree with the color of her skin.

Our policies for care need to be inclusive of all people. When we exclude people based upon who they are, while calling it a lifestyle choice we are guilty of discrimination.

Our policy and political leaders need to distinguish between lifestyle choice and living for humanitarian purposes. It does not matter if we find others’ orientation to be immoral. It is unacceptable to act on beliefs that are, in fact, ignorant of unchangeable realities.

If caregivers choose to be ignorant, a clear example of a lifestyle choice, they must keep their thoughts to themselves while providing the highest level of loving care for their clients, or they need to walk away from the job. Caring for people of every shape, size, and orientation is required in the medical arena. Doctors, nurses, health aides, and caregivers need to put any judgment and ignorance to bed and focus on the job of caring. A transgender body with breasts and a penis is a still a body that needs care when it is aging. An aging person that has loved members of its own gender is still a person that deserves assistance with Activities of Daily Living (ADL’s) including bathing, toileting, and feeding. Caregivers need to be prepared for these growing subsets of the aging population; education and training have to be part of their preparation.

Many of the people I have mentioned will not have children to stand up for them in their old age. Who will advocate for them? What kind of care will they receive? I am committed to advocate for those groups now with the confidence that one day my children and many more will continue that advocacy, and all elders will receive the best care possible regardless of orientation. Caregiving is a lifestyle choice. A higher calling that we answer. I am committed to helping to make sure now that the caregiving community is open to their responsibility to treat all of the declining and aging people with respect and compassion.

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