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To explore the experiences of residents who had signed an advance directive on admission to a long-term care facility and apply the Advance Directive Decision-Making Model to this process.Interactive interviews with 13 elders. Questions related to how each felt about their life and death, how each perceived the advance directive discussion, and what factors influenced their decisions were discussed.The thematic analysis suggested that the decision regarding advance directives was multifaceted and complex. It required preparation, understanding, and time. Decision-making ability was sometimes compromised by the other stressors associated with the move to a long-term care facility.Nurse practitioners will have an easier time discussing medical conditions and choices regarding end-of-life care with residents and their families if advance directives are discussed thoroughly on admission to a long-term care facility and are updated routinely.