Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care. [ Journal of Psychosocial Nursing and Mental Health Services, 56 (1), 32–35.]