Background: Although most people have clear preferences with regard to end-of-life care, there is a disconnect between these preferences and what happens in practice. Advance care directives (ACDs) are a way of allowing people to plan ahead for any future loss in decision-making capacity, by allowing a systematic approach to decision making that respects the person’s previously ex-pressed wishes.

Objective: This article reviews ACDs, considering, in particular, aspects of their use for patients in residential aged care.

Discussion: All people should be offered the opportunity to make an ACD as part of their routine care prior to any need for residential care. Once there is a need for residential care, advance care directives become even more important. Systems to ensure routine review of advance care directives and appropriate transfer of information between healthcare providers should be implemented by clinicians and residential aged care facilities.