46 | Summer฀2016฀•฀Vol. 40 . No. 2 GENERATIONS – Journal of the American Society on Aging Copyright © 2016 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or distributed in any form without written permission from the publisher: American Society on Aging, 575 Market St., Suite 2100, San Francisco, CA 94105-2869; e-mail: info@asaging.org. For information about ASA’s publications visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join. N orth American attitudes toward the end of life cluster around denial and avoidant behaviors (Kearl, 1995); thus, preparations for end of life often are wanting. If, as research shows (The Conversation Project, 2016), the uncomfortable issues surrounding life’s ending are rarely discussed by families, it should be no surprise that such topics fall outside the fuz- zier boundaries of friendship discourse, with its more sociable focus (Barker, 2002; Johnson, 1983). Such dynamics pose particular challenges for those who stand outside of traditional family structures, including LGBT older adults. Anxieties Exist Over Late-Life and End-of-Life Planning As reported elsewhere and also in this journal, LGBT older persons, especially gay men, dispro- portionately reach the very later years without partners, without children, without traditional families—i.e., without those people typically called upon to provide care or to participate in end-of-life preparations (de Vries, 2013). Con- comitantly, LGBT older adults report poorer overall health (MetLife Mature Market Institute, 2010), higher rates of disability (Fredriksen- Goldsen et al., 2011), and greater psychological dis- tress (Wallace et al., 2011) than do heterosexual persons of similar ages. As a result, LGBT older adults may have higher needs for care and fewer traditional resources for care provision in the very later years than do heterosexual and gender- conforming older persons. The importance of preparing for later life and end of life arguably is greater among LGBT persons—as is their anxiety about these preparations. Research supports this assertion. In a large, national survey study, LGBT baby boomers, rel- ative to those of comparable age in the general population, were found more likely to fear dying alone and dying in pain, particularly in settings wherein LGBT rights are poorly defended (de Vries et al., 2009)—which is how long-term- care settings are viewed within this community (SAGE, 2011). De Vries and colleagues (2009) linked these fears—a type of unfortunate spur abstract LGBT persons disproportionately reach later life without partners or children—the people most likely to provide support to older adults, and to engage them in conversations about advance care planning and end-of-life issues. Friends often rise to the challenges of caregiving, but with limits imposed by family-centered social customs and family-first policies and practices. Friends often feel unqualified to discuss advance care planning, or are not invited into such conversations. This dynamic, these limits, and their consequences are the focus of this article, which summarizes the literature, with examples drawn from the authors’ qualitative study. | key words: LGBT caregiving, families of choice, advance-care planning, end-of-life discussions End-of-Life Preparations Among LGBT Older Adults By Brian de Vries and Gloria Gutman LGBT elders tend to reach late life without partners or children, making it doubly difficult to engage in effective end-of-life planning.