Imagine living through the gay rights revolution that has transformed the lives of LGBT+ people in many parts of the world - and then, in old age, forgetting it.
That is one of the many challenges facing gay people with dementia, who can find themselves plunged into a more hostile past, or be left struggling to remember who knows about their sexual orientation.
It is among the issues discussed over tea and cakes at London’s Rainbow Memory Cafe, where LGBT+ people impacted by dementia can socialize and receive support.
“It’s nice to come to somewhere where you aren’t judged and people respect you for who you are,” said Ben, whose husband who has Alzheimer’s disease.
“I want to find out ways to understand the condition more and also get to know like-minded people, enjoy the cafe environment, meet new friends and speak to people in the same situation,” said Ben, who asked not to be identified in full.
There are 850,000 people with dementia in Britain, with that number estimated to rise to 1 million by 2025, according to the Alzheimer’s Society, a charity.
Memory cafes - found across the world - are a vital resource for older people with dementia, especially those at risk of loneliness or isolation.
But few are equipped to provide support that directly addresses the needs of LGBT+ people, who often have markedly different life experiences.
The Rainbow Memory Cafe is run by Opening Doors London (ODL), the largest charity offering information and support services specifically for older LGBT+ people in Britain.
When it opened in October 2017, it was the only dementia support group for the estimated 56,000 lesbian and gay people living with dementia in the country, though others have since opened.
“I feel that there is a real community here. There are lots of different ages and sexualities, and we somehow support each other – it’s very diverse,” said member Basil Thompson.
Outside of welcoming spaces such as this, in care homes and housing for older people around the world, anti-gay sentiment is still visible.
Nearly half of all lesbian or gay couples have encountered adverse treatment when seeking housing, according to a study by non-profit civil rights organization Equal Rights Center published in 2014.
Elderly members of the LGBT+ community who require in-home care or support often have to consider cultural or religious sensitivities before making their sexuality known to care workers.
“A lot of people working in care homes happen to come from a conservative religious background, or from a country that outlaws homosexuality,” said Thompson.
“There are all those barriers – you come from this nice friendly world and then you find yourself in a ghetto where you’re almost back in the 1950s.”
A report published by British LGBT+ charity Stonewall in 2011 found 50 percent of older lesbian, gay and bisexual people were uncomfortable being out to care home staff.
In response, many countries are opening housing facilities catering specifically to older LGBT+ people.
New York City’s first such building is set to open in June following a similar project that opened in Stockholm in 2013.
More than 100 older LGBT+ people live in the Swedish capital’s Regnbagen facility, which is so popular there is now a waiting list to join.
“In that house setting is when you are at your most vulnerable – it’s personal,” said Alice Wallace, director of Opening Doors London.
“Twice in the past two years I’ve heard examples of care workers who have insisted on praying for the cleansing of the homosexual soul of a client, before doing the work they were supposed to be doing.”
Wallace said the development manager for a group of care homes had explained to her how the company has changed its approach to be more inclusive of the LGBT+ community.
“They used to ask, ‘So are you married? Is your wife still at home because she’s not here with you?’,” she said.
“Now they don’t do that anymore. Now it’s, ‘Have you been in a relationship? Who do you want to have involved in your decision-making process?’.”
The Rainbow Memory Cafe goes beyond just offering participants support around dementia, with a strong focus on general wellbeing.
“Some of the things talked about here are presumably spoken about in all Alzheimer’s society groups – there’s nothing particularly different about the content we talk about,” said coordinator Sally Knocker.
“But there is a relaxed feel where everyone understands each other’s history.”
The cafe offers reminiscence therapy through which life experiences and stories are shared. In a traditional memory cafe, that will often focus on marriages or having children, excluding people who may not have experienced these milestones.
At the Rainbow Memory Cafe, the therapy is based on different shared experiences such as coming out or attending a first pride march.
“Before the LGBT cafe, we attended a local Alzheimer’s society group a few times, but we just didn’t feel comfortable,” said David, who regularly attends the cafe with his husband, and did not want his full name to be used.
“They were nice people, but being two guys in a couple, it just didn’t feel right. We had nothing in common with the other people.”