Advance care planning (ACP) is an indispensible part of end-of-life care. It is a communicative process that involves repeated and prolonged discussions between healthcare professionals, relatives, and patients. These discussions focus on the sorts of treatments that patients want (or not) when they are receiving medical care at the end of their lives. Crucially, these discussions are undertaken while the patients are still capable of making such decisions. ACP usually concludes with parties signing an advance directive (AD), a document outlining the patient’s wishes for their end-of-life care. Owing to the centrality of communication in ACP, our research focuses on understanding the interactional practices occurring in such consultations in Hong Kong. Our work has examined how people talk about death, construct family dynamics, and position ADs as a clinically-relevant next step. We also focus on the social actions accomplished by these discursive practices. Our findings have the potential to be used as part of a clinician’s ‘interactional toolbox’ for when they interact with patients and relatives during ACP.