The study examines how sexual and gender minority older adults communicate end-of-life and daily care preferences in long-term care settings and explores ideas for a video-based intervention to share preference information. During focus groups with sexual and gender minority adults age 55+, participants raised concerns about discrimination, autonomy, chosen family and community. They recommended creating community support networks to help peers discuss preferences and produce videos before the transition to long-term care, and to assure compliance afterward. Video-recorded preferences, supported by peers, could enhance culturally competent long-term care for sexual and gender minority older adults.