'Chosen Family' and LGBTQ+ Older Adults: What Inclusive Senior Living Looks Like

When people think about family, they often picture spouses, children, siblings, and other biological relatives. But for many LGBTQ+ older adults, the people who provide the deepest support, companionship, and care may not fit that traditional definition. Instead, their most important relationships may include what is sometimes referred to as a “chosen family.”

As more LGBTQ+ older adults explore senior living options, understanding the role of chosen family is becoming increasingly important. Communities that recognize and affirm diverse support networks are better positioned to create welcoming environments where all residents feel respected, valued, and at home.

What is ‘chosen family’?

The concept of “chosen family” has deep roots within LGBTQ+ communities. The term generally refers to family-like relationships that people intentionally create with individuals who provide emotional, social, and practical support. These networks may include friends, partners, former partners, neighbors, mentors, caregivers, and other trusted individuals who function as family, regardless of legal or biological ties.

Researchers note that LGBTQ+ individuals often rely more heavily on chosen family networks than their heterosexual and cisgender peers. According to the National Academies report Understanding the Well-Being of LGBTQI+ Populations, sexual and gender diverse (SGD) adults frequently experience greater strain in family-of-origin relationships and thus turn to their chosen family for support and connection. Recent research examining LGBTQ+ older adults’ social networks also finds that chosen families often develop as a resilience strategy in response to discrimination, social exclusion, or family estrangement.

Importantly, chosen family is not always created because of rejection. Many LGBTQ+ people maintain positive relationships with their biological relatives while also building strong networks of friends and community members who become an integral part of their lives. These relationships provide emotional support, companionship, advocacy, and caregiving throughout adulthood and into later life.

Why chosen family matters as people age

As we age, social support becomes increasingly important. Research from the National Academies highlights the significant impact that social connection has on health, wellbeing, and quality of life among older adults. For many LGBTQ+ older adults, chosen family members are at the heart of that connection, as well as the people who join them at medical appointments, provide transportation, assist during illness, celebrate milestones, and offer emotional support.

In some cases, chosen family may be primary caregivers as well. A landmark analysis by legal scholar Nancy Knauer found that caregiving patterns among LGBTQ+ older adults can differ significantly from those of the heterosexual/cisgender population. While elder care in the United States is often provided by adult children or other relatives, LGBTQ+ older adults are more likely to receive care from partners, friends, neighbors, and other non-relatives within their chosen family networks. These findings underscore an important reality: The people most involved in an LGBTQ+ older adult’s daily life may not share a last name, legal relationship, or genetic connection.

For senior living communities, recognizing this reality is essential. Policies and practices that assume everyone has a traditional family structure can unintentionally exclude the very people who matter most to an LGBTQ+ resident.

How senior living communities can support chosen family

The most welcoming senior living communities understand that “family” comes in many forms. Rather than relying solely on traditional definitions, inclusive communities create systems that allow residents to identify who is important in their lives.

One of the easiest yet most meaningful changes senior living communities can make involves language. Admission forms, resident handbooks, emergency contact documents, and healthcare paperwork can be designed to use inclusive terms such as “partner,” “support person,” “loved one,” or “important person” instead of assuming relationships such as “husband,” “wife,” “son,” or “daughter.” These simple adjustments signal that all family structures are respected.

Visitation policies are another important consideration. While many senior living communities have become more flexible in recent years, it remains important to ensure that residents can welcome the people they consider family. Whether a visitor is a spouse, lifelong partner, close friend, or chosen family member, residents should feel empowered to maintain those connections. Such inclusive visitation policies help residents preserve important social bonds that contribute to their emotional wellbeing and quality of life.

Communities can also encourage residents to identify who should be involved in care discussions, celebrations, emergencies, and important decisions. Rather than making assumptions about next of kin, staff can ask residents directly whom they would like included. This resident-centered approach recognizes autonomy while acknowledging the diversity of modern family structures.

Creating an environment of respect and belonging

Policies are important, but culture matters just as much. Research on LGBTQ+ aging consistently shows that many older adults carry memories of discrimination experienced throughout their lives. Some came of age during periods when same-sex relationships were criminalized, LGBTQ+ identities were stigmatized, and legal protections were limited. As a result, some older adults still feel uncertain about whether they will be accepted in a new living environment.

Creating a welcoming culture within a senior living community requires more than simply stating that “everyone is welcome.” It involves visible and ongoing efforts to demonstrate inclusion for all residents.

For instance, staff training can help employees understand LGBTQ+ terminology, respectful communication practices, and the importance of chosen family relationships. Marketing materials can include diverse images and stories that reflect a variety of family structures. Community events can acknowledge and celebrate LGBTQ+ residents and their loved ones. Resident surveys can provide opportunities for feedback about inclusivity and belonging.

Such efforts communicate an important message: Residents do not need to hide who they are or who they love in order to feel accepted.

Questions older adults and loved ones can ask

For LGBTQ+ older adults exploring senior living options, it can be helpful to ask questions and take note of how a community recognizes and supports diverse relationships. For example:

How do resident forms define family and emergency contacts?
Are partners and chosen family members welcomed as visitors and participants in community life?
Has staff received LGBTQ+ cultural competency training?
How does the community support residents with nontraditional support networks?
Are there opportunities for LGBTQ+ residents and allies to connect with one another?

The answers to these questions can provide valuable insight into whether a community is truly committed to creating an inclusive environment for all.

Ensuring inclusive recognition of chosen family

As society’s definition of “family” continues to evolve, senior living communities have an opportunity to lead with compassion and inclusivity. For many LGBTQ+ older adults, chosen family relationships have provided decades of love, support, caregiving, and connection. These bonds deserve the same respect afforded to any other family relationship.

By adopting inclusive language, honoring resident-designated support systems, and fostering a culture of belonging, senior living providers can help ensure that every resident feels seen, respected, and valued.

At its core, affirming chosen family is about recognizing a simple truth: “Family” is not defined solely by biology or legal status. Rather, it is often defined by who shows up, who cares, and who walks alongside us throughout life’s journey. For many LGBTQ+ older adults, those people are their chosen family, and they should be an integral part of conversations about aging, caregiving, and senior living.

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