FORT LAUDERDALE, Fla. — Gay and lesbian elders have lived long enough to see amazing changes: marriage rights, the rise of AIDS activism, celebrities coming out. But there is something that may drive some of them back into the closet: long-term care.

FORT LAUDERDALE, Fla. — Gay and lesbian elders have lived long enough to see amazing changes: marriage rights, the rise of AIDS activism, celebrities coming out. But there is something that may drive some of them back into the closet: long-term care.

Afraid of abuse or discrimination, LGBT seniors who are open about their relationships with friends and families may hide that part of their lives if they enter nursing homes or assisted living facilities.

It's a real concern. "Gen Silent," a 2011 documentary, hopes to shed light on the issue. The one-hour film by independent California director Stu Maddux opens the doors of nursing home rooms and private homes, letting LGBT seniors and the people who care for them tell their stories.

"We forget that we have an entire generation of people for whom being out wasn't even an option," said Tony Plakas, CEO of Compass Gay & Lesbian Community Center of Lake Worth, Fla. "They can't be guaranteed an environment, as they age, where they will be treated equally."

One social worker in the film, who coordinates sensitivity training in care facilities, describes watching a nursing aide offer to pray with a frail resident to be forgiven for the sin of being gay.

"I watched this film and got sick," said Ellen Wedner, chairwoman of the Miami Jewish Film Festival who brought "Gen Silent" to South Florida through her nonprofit, Creative Arts Enterprises, in association with Treece Financial Group Inc. "None of us imagine aging or getting older, so this is serious and thought-provoking."

No one is sure exactly how many gay and lesbian seniors there are in South Florida, yet alone the numbers in retirement centers. There could be as many as 53,520 LGBT elders in Palm Beach and Broward counties alone, by the common estimate that 10 percent of the overall population is homosexual.

Lawrence Johnson, a 68-year-old retired teacher in Delray Beach, Fla., was recruited by Maddux to be in "Gen Silent" shortly after the state of Massachusetts named Johnson as Caregiver of the Year in 2007.

The camera follows him from his former home in suburban Boston into a nearby care facility where his partner of 38 years, Alexandre Rheaume, struggles with conversation during their daily visit.

"I love you," Rheaume finally murmurs clearly through the dementia that clouds his memory and blurs his speech.

Johnson and Rheaume, who was 22 years Johnson's senior, had met at Harvard University. They made a home together, supported each other in life's ups and downs. And like many other couples who grow older together, Johnson suddenly found himself a caregiver when Rheaume was diagnosed with Parkinson's disease.

Johnson suddenly discovered that in other ways they weren't like other couples. A social worker connected him with a caregiver support group, "but I felt uncomfortable, being the old gay person there. I never felt I could talk about my issues," he told the Sun Sentinel.

At the first nursing home where Rheaume lived, "they weren't prepared to deal with us as a couple. You could pick up the vibrations, especially from the aides," Johnson said.

A second nursing home stay went much better, after Johnson had a frank talk with management in advance. The administrator "made it very clear we were welcome and if I got the feeling we weren't wanted, I should come to him," said Johnson, who eventually moved to Delray with his new partner after Rheaume died in 2009. "It starts from the top and filters down."

A 2010 national survey, done by a coalition of gay and nursing home residents' civil groups, polled a mix of 769 gay seniors, family members and care providers. Among them, 43 percent reported 853 cases of mistreatment.

Yet while the debate about Chick-fil-A fast-food restaurants supporting anti-gay causes has made national news, advocates say the public is largely clueless about the extra pressures aging LGBT people face when they can no longer care for themselves. Gays also are more likely than their straight counterparts to face these pressures alone, as their lifestyle denied them life partnerships or estranged them from family.

"Stories from the Field," the report that included the 2010 survey, found that the most common complaint was abuse or harassment of gay or lesbian residents by other residents, accounting for about one-fourth of the instances. It was followed by being abruptly discharged, about 20 percent of the cases; and verbal or physical harassment from staff.

More than three-fourths of the LGBT survey respondents said gay seniors would hide their sexual orientation if they ended up in institutional care.

James Lopresti, clinical education director for SunServe in Wilton Manors, said sometimes facilities err not because they're hostile but because "they just don't know how to deal with it."

One local assisted living center, when residents complained about having to live and eat with a gay person, moved the man to the memory ward, where management assumed the residents would be too confused to notice. But spending his days being the only mentally sharp person surrounded by cognitively impaired people was so depressing that the man eventually committed suicide, Lopresti said.

He's developed a new program for SunServe, an LGBT social service agency, which will help long-term care facilities and home health agencies develop gay-sensitive policies, train staff and create welcoming environments. Gay and lesbian seniors searching for long-term care would be able to ask which providers participate in the program, Lopresti said

Some corporate care providers already are interested. "South Florida is a retirement destination for many LGBT seniors, and that means there will eventually be a lot of people needing long-term care," he said.

"Gen Silent" screenings will include panels of experts so viewers can get more information after seeing the film.

One will be David Treece, a gay man whose Miami financial planning service has about one-third LGBT clients.

Gay couples can ease the path into old age by stating their wishes in living wills and drafting powers of attorney, Treece said. But other benefits, like veterans' long-term care pensions and Medicaid allowances that let one spouse keep some assets when another needs government-funded nursing home care, are outright denied gays because they cannot legally marry in most states, Treece said.

One of his clients, in a committed relationship for years, ultimately had to declare bankruptcy after his partner died because, unlike a legally married spouse, he had no rights to his deceased mate's benefits. Another man initially could not claim the life insurance benefit his long-time partner left him, Treece said, because the hospital would only release the death certificate to the immediate family.

"The gay community rallied during the AIDS crisis," said Treece, an accredited investment fiduciary. "Now we need to rally to support our elders, many who are alone."