End-of-Life Planning in Aging Same-Sex and Different-Sex Married Couples

Research on end-of-life (EOL) planning has largely focused on heterosexual couples, overlooking the experiences of sexual minority spouses. Using dyadic data from the Health and Relationships Project, this study applies a minority stress framework and dyadic perspective (i.e., considering both partner's views) to examine how gay, lesbian, and heterosexual couples engage in informal (e.g., discussions) and formal (e.g., legal arrangements) planning. Multilevel logistic regressions assess how both spouses' health, dementia concerns, social relationships, and experiences of discrimination shape planning behaviors. Results show that gay and lesbian couples are significantly more likely than different-sex couples to engage in both forms of planning. While marital quality, health, friendships, and discrimination are important predictors, they do not explain the observed group differences. This may suggest that same-sex couples are more motivated to plan ahead due to other unmeasured factors, including concerns about legal recognition, potential discrimination in healthcare, legal literacy, or community support.