Advance care planning, which enables patients to make informed decisions about their care as they approach the end of their life, has been part of UK policy and strategy for almost two decades. Yet despite evidence of the benefits, advance care planning completion rates are low. This is due, in part, to healthcare professionals’ lack of confidence in initiating such conversations and insufficient knowledge of the available advance care planning options. Moreover, although recognising when a patient is approaching end of life can provide nurses with an opportunity to initiate advance care planning discussions, predicting this life stage is inherently difficult. This article provides an overview of advance care planning and the challenges of predicting when someone is nearing end of life. The article also considers how nurses might approach advance care planning discussions with patients in a timely and sensitive manner and discusses some of the options available, such as an advance decision to refuse treatment or advance statements.